Thermal ablation performed in a primary care setting: the South Warwickshire Experience.

Objective: To assess the feasibility of performing outpatient thermal ablation in a primary care setting.

Design: Prospective study.

Setting: A small peripheral hospital in the UK used by local general practitioners and visiting hospital practitioners for its outpatient facilities.

Population: The area of South Warwickshire serves a population of 270,000.

Methods: Two general practitioners were trained to perform outpatient thermal ablation using the Thermachoice thermal ablation system (Thermachoice II). The unit functioned autonomously with support from a local gynaecologist and radiologist, accepting referrals from hospital consultants and general practitioners.

Main Outcome Measures: Severity of menstrual loss, premenstrual symptoms, dysmenorrhoea and quality of life assessed by visual analogue scales before treatment and at one month, two months, one year and two years.

Results: Eighty-seven women were treated. No major complications were encountered from the procedure. Reduction of menstrual loss or cure was reported by over 94% of women. Premenstrual syndrome (PMS) and symptoms of dysmenorrhoea were also improved by treatment. The majority of women were satisfied with the operation at one month (96%), two months (93%), one year (92%) and two years (94%).

Conclusions: Thermal ablation is a simple procedure well suited to an outpatient setting. There are few complications as a result of the use of the thermal ablation catheters, and this study has shown that the procedure can be undertaken in a primary care setting with excellent results.