Impact of Prostaglandin F2-Alpha and Tumor Necrosis Factor-Alpha TNF-a on Pain in Patients Undergoing Thermal Balloon Endometrial AblationReportar como inadecuado

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Collegium antropologicum, Vol.37 No.4 December 2013. -

The primary objective of the study was to evaluate the correlation between prostaglandin F2-alpha and tumour necro- sis factor-alpha concentration and that of pain experienced by patients undergoing thermal balloon ablation. Further- more we evaluated the correlation between the endometrial and myometrial thicknesses and the degree of pain experi- enced by patients undergoing the procedure, and in addition the correlation between PGF2-alpha, TNF-alpha and endo- metrial and myometrial thicknesses. Single-arm cohort study Canadian Task force classification II-2. In University Medical Centre Ljubljana, outpatient setting, 40 perimenopausal women with dysfunctional uterine bleeding DUB, un- derwent endometrial thermal balloon ablation. The thickness of the endometrium and myometrium was measured prior to surgery using a transvaginal ultrasound that provided cross-sectional images. The degree of pain was rated using the visual analogue scale VAS and numeric rating scale NRS immediately and 60 minutes after the procedure. The con- centration of PGF2-alpha and TNF-alpha in venous blood was measured prior to, at the end of and 60 minutes after the procedure. The results showed a positive correlation between the concentration of PGF2-alpha released during endo- metrial ablation and the endometrial and myometrial thickness p>0.01, including the reported degree of pain p> 0.01. The concentration of TNF-alpha indicates a positive correlation with the level of pain p>0.05, but is not depend- ent on the thicknesses of the endometrium and myometrium. Endometrial thickness correlates to the degree of pain and the prostaglandin F2-alpha concentration. In clinical practice, performing the Gynecare ThermaChoice procedure im- mediately after menstruation or preoperative preparation of the endometrium using oral contraceptives enables this pro- cedure to be performed in outpatient settings and can be considered a valuable treatment option for DUB.

thermal balloon endometrial ablation THERMACHOICE; pain; prostaglandins; tumor necrosis factor

Autor: Bojan Grulović - ; General Hospital Bre`ice, Department of Obstetrics and Gynaecology, Bre`ice, Slovenia Martina Ribič Pucelj -



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