Patients Satisfaction Undergoing Endometrial Thermal Balloon Ablation for the Treatment of Intractable Menorrhagia

Background: Heavy amounts of menstrual blood loss regularly in three or more consecutive cycles are characterized as menorrhagia which has been shown to be present among in many peri-menopausal and premenopausal women. Aim: To determine the frequency of patients’ satisfaction with TBA for the treatment of intractable menorrhagia. Methods: This descriptive study was undertaken in Department of Obstetrics and Gynecology, Lady Wallington Hospital Lahore from January to July 2017. A sample size of 200 patients was calculated and informed consent was taken to fill predesigned Performa. Prophylactic dose of 1g Ceftriaxon antibiotic was administered and Foly’s catheters were placed simultaneously in uterine cavity of patients after curettage and dilations. The uterine balloon catheter was then entered into the uterus and balloon was filled with sterile fluid. Results: A high number of 157(78.5%) women were found to be satisfied with thermal balloon ablation while different age groups presented an insignificant difference on level of satisfaction. Level of education and BMI had insignificant difference (p >0.05) while a significant difference (p<0.05) was observed among patients suffering from long duration of >6 months as compared to short duration of 3-6 months. Conclusion: Thermal balloon ablation is the method of choice for treatment of women suffering from menorrhagia and high number of patients revealed their trust on this method. Keywords: Menorrhagia, Dysmenorrhea, Blooding, Satisfaction, Endometrium.

Uptake of medical devices approved by NICE

BackgroundThe UK is sometimes considered to be slow in adopting new technologies. The recent Accelerated Access Review examined adoption challenges and identified opportunities for improvements. This study aims to determine the rate of uptake of selected new medical devices approved by the National Institute for Health and Care Excellence over a 10-year period, and to consider what factors may have influenced their uptake.MethodsThe selected devices were approved at least 10 years ago to ensure there was sufficient data to review uptake trends. The devices that met the selection criteria were drug-eluting coronary artery stents, the brush used in liquid-based cytology, and fluid-filled thermal balloon and microwave endometrial ablation. Data on uptake were collected from the National Audit of Percutaneous Coronary Interventions (drug-eluting stents), the national cervical screening programme (liquid-based cytology) and Hospital Episode Statistics (endometrial ablation).ResultsThe technologies illustrated different uptake scenarios. Liquid-based cytology showed rapid and complete uptake, probably because it was a nationally driven programme. Neither drug-eluting stents nor endometrial ablation technologies were part of a national programme, and their uptake was slower. The uptake of stents has gradually increased to 88.5% of percutaneous coronary intervention procedures in the most recent data. For both fluid-filled thermal balloon and microwave ablation, there was an increase and then decline in uptake as other technologies were developed.ConclusionsThe data show excellent uptake when promoted through a nationally managed programme. Uptake was slower when left to local systems. Obtaining good, reliable data about the use of medical devices in the National Health Service (NHS) is challenging—collecting real-world data linked to electronic patient records would allow us to better track the impact of new technologies in the future. More robust implementation plans may also increase the uptake rate of cost-effective and potentially life-saving technologies into the NHS.