One patient, two uteri, two endometrial ablations: case report of thermal balloon ablation in uterine didelphys.

Objective: To describe the clinical application and outcomes after endometrial ablation with ThermachoiceIII (Ethicon, Somerville, NJ) in a patient with uterine didelphys with heavy menstrual bleeding.

Design: Case report.

Setting: Inner-city community obstetrics and gynecology clinic.

Patient(s): A 44-year-old Hispanic woman, gravida 3, para 0, with three spontaneous abortions.

Intervention(s): The patient underwent diagnostic hysteroscopy, gynecologic dilation and curettage, and endometrial ablation with ThermachoiceIII.

Main Outcome Measure(s): Menstrual pattern at 3 months postoperatively, as either amenorrhea (complete lack of menstrual flow), hypomenorrhea (scant or minimal flow lasting <5 days, requiring only light pads), or failure (flow similar to pretreatment state or requiring any other therapy), as well as dysmenorrhea reduction from baseline. Hemoglobin value at 3 months was compared with baseline.

Result(s): At 3 months, hypomenorrhea was maintained. Bleeding days were 10 per month at baseline and 2 per month after therapy. Visual analogue scale score for dysmenorrhea was 8 at baseline and 2 (mean) at study end. Hemoglobin was 8.9 g/dL at baseline (preoperatively) and 11.1 g/dL at 3 months postoperatively.

Conclusion(s): Successful conservative therapy of menorrhagia seems possible with thermal balloon ablation in a uterine didelphic patient.