Study Objective. To determine the effectiveness of endometrial cryoablation in comparison with rollerball electroablation.Design. Prospective, randomized study (Canadian Task Force classification I).Setting. Ten university and private medical centers in the United States.Patients. Two hundred seventy-nine women with menorrhagia due to benign causes.Intervention. Endometrial ablation using a Her Option cryoablation device in 193 women and rollerball electroablation in 86.Measurements and Main Results. Women treated by cryoablation received significantly less general anesthesia (46%) than those treated by electroablation (92%). Subjects maintained menstrual diaries for at least one cycle before and for 12 months after the procedure. Success was defined as reduction of menstrual bleeding to a score of 75 or less in the absence of retreatment. Success rates in the cryoablation and electroablation groups were 77.3% and 83.8%, respectively. Bleeding declined by 92% and 94%, respectively. Both procedures led to significant improvements in a broad range of symptoms including menses-related pain, mood, and overall improvement in quality of life.Conclusion. Endometrial cryoablation is a safe and effective procedure in treatment of dysfunctional uterine bleeding. Its advantages include technical ease of performance, direct ultrasonographic view of depth of ablation, little anesthetic, and avoidance of potential complications related to distention media.

In a randomized trial, 93% of cryoablation patients who were evaluated at both 12 and 24 months and not retreated were free of abnormal uterine bleeding at 12 months and 94% at 24 months versus 92% of electroablation patients at both times. The retreatment rate was similar after cryoablation (12.9%) and electroablation (14.0%). (Am J Obstet Gynecol 2003;188:699-701.)

Papers on Current Clinical and Basic Investigation: Poster Sessions Monday, April 30, 2001: Gynecology: PDF Only

STUDY OBJECTIVES:To evaluate tissue effects of cryosurgical endometrial ablation in women just before hysterectomy, characterize ultrasound monitoring of freezing, determine the feasibility of a new probe-angling procedure, and assess the safety profile by monitoring serosal surface temperatures. DESIGN:Single arm safety study enrolling ten women at two centers (Canadian Task Force classification II-2). SETTING:Two clinical sites. Patients. Ten women scheduled for hysterectomy. INTERVENTION:Hysterectomy with a new cryosurgical device (First Option, CryoGen, Inc., San Diego, CA) that achieves surface temperatures below -90 inverted exclamation mark C to freeze endometrium. MEASUREMENTS AND MAIN RESULTS:The freeze protocol involved angling the probe toward each cornu. Maximum ice front diameter at the end of the first angled freeze ranged from 24 to 34 mm, and maximum ice ball diameter at the end of the second freeze ranged from 28 to 37 mm. The margin between the advancing ice front and serosal surface was monitored by ultrasound. In all cases the margin was safe and no reduction in serosal surface temperatures occurred. Depth of necrosis ranged from 9 to 12 mm as determined by tetrazolium staining and electron microscopy, and there was no full-thickness myometrial destruction. Total endometrial destruction was achieved. CONCLUSION:Cryosurgical ablation of the endometrium with the First Option system with angled freezes and ultrasound monitoring appears to be feasible and safe given our preliminary data.

Objective: To evaluate the safety and effectiveness of the First Option Uterine Cryoblation Therapy in women with abnormal uterine bleeding (AUB).

STUDY OBJECTIVE:To evaluate laparoscopic removal of adnexal masses using a plastic bag to avoid peritoneal spillage. DESIGN:An observational study. SETTING:A university-affiliated private hospital. PATIENTS:Thirty-one women (mean age 48.7 yrs) with adnexal masses. INTERVENTIONS:Laparoscopic removal of adnexal masses ranging from 3 to 12 cm (18 complex, 5 septated cystic masses, 8 persistent simple cysts). The masses were placed in plastic sandwich bag and removed through the umbilical incision. Hospital costs, length of stay and operating times were compared with those of 24 patients undergoing the removal of similar masses by laparotomy. MEASUREMENTS AND MAIN RESULTS:Three masses were functional cysts, 4 were tubal cysts, 4 were endometriomas, and 20 were benign ovarian neoplasms. There were no malignancies. Peritoneal spillage occurred during one ovarian cystectomy. The only complication was bleeding from the cannula site. Comparing laparoscopy and laparotomy, average operating time was 73.45 minutes (range 34-148 min) and 81 minutes, average length of hospital stay was 17.4 hours (range 6-73 hrs) and 2.92 days, and average hospital cost was $2401 and $3539, respectively. CONCLUSION:Laparoscopic access provides a cost-effective method of removing adnexal masses with a very small risk of peritoneal spillage. When managed in this manner, rather than laparotomy, the cost reduction was significant.

AORN JournalVolume 37, Issue 4 p. 695-696 DepartmentFree Access Physician says motive wrong for Pap smear guidelines Duane E Townsend MD, Duane E Townsend MD Clinical director of gynecology Cedars-Sinai Medical Center Los AngelesSearch for more papers by this author Duane E Townsend MD, Duane E Townsend MD Clinical director of gynecology Cedars-Sinai Medical Center Los AngelesSearch for more papers by this author First published: March 1983 https://doi.org/10.1016/S0001-2092(07)63890-3AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume37, Issue4March 1983Pages 695-696 RelatedInformation

Over the past decade, the management of intraepithelial lesions of the visible portion of the female genital tract has substantially changed with the introduction of cryosurgery and the carbon dioxide laser. Although cryosurgery and the carbon dioxide laser are very effective in eradicating preinvasive disease, the selection of patients by colposcopy and appropriate biopsies is more important than the treatment techniques. Failure to properly evaluate women with genital tract neoplasia can result in disastrous consequences for the patient. The CO2 laser shows considerable promise in managing dysplasia and carcinoma in situ of the vagina and vulva. The laser combines the accuracy of the operating microscope and the precision and control of the photon beam. Posttreatment sequelae are minimal, and scarring is absent.