Is thermal balloon ablation in women with previous cesarean delivery successful?

Background/aim: Endometrial ablation is used to treat heavy menstrual bleeding in women who do not respond to standard therapy. This study aimed to compare treatment success in women with previous cesarean delivery and vaginal delivery who were subjected to thermal balloon ablation. Materials and methods: This cohort study enrolled women with symptoms of heavy menstrual bleeding who had major health problems and were considered as high-risk patients for hysterectomy. Patients were divided into two groups, vaginal delivery and cesarean section (C-section). Thermal balloon ablation was performed under general or regional anesthesia on days 3–5 of the menstrual cycle. Treatment success was compared between the two groups at 12 months. Results: This study involved 63 women with a mean age of 44.14 ± 6.56 years. Of these, 33 patients (54.1%) had a history of cesarean section and revealed positive results (69.7%) after 1 year of treatment. Age ≤ 45 years and uterine length < 9 cm were significantly associated with treatment success in women with a previous C-section. Conclusion: Thermal balloon ablation is a possible therapeutic option to treat menorrhagia occurring as a result of benign causes in women with previous C-section deliveries. The results are particularly successful in younger women with shorter uterine depth.