Skip to main content Accessibility help
×
Hostname: page-component-5d59c44645-hb754 Total loading time: 0 Render date: 2024-02-21T09:53:47.569Z Has data issue: false hasContentIssue false

Case 44 - A 42-Year-Old Woman with Abnormal Uterine Bleeding Who Desires In-Office Ablation

Published online by Cambridge University Press:  19 November 2021

Todd R. Jenkins
Affiliation:
University of Alabama, Birmingham
Lisa Keder
Affiliation:
Ohio State University School of Medicine, Columbus
Abimola Famuyide
Affiliation:
Mayo Clinic, Rochester
Kimberly S. Gecsi
Affiliation:
Medical College of Wisconsin
David Chelmow
Affiliation:
Virginia Commonwealth University School of Medicine
Get access

Summary

A 42-year-old multiparous woman with heavy menstrual bleeding desires in-office endometrial ablation. She has regular but heavy menses that lasts 10 days and occurs every 28 days. Menses are so heavy that she passes large clots and has missed work on occasions. She denies any dysmenorrhea or intermenstrual bleeding. She has had a complete evaluation and no cause of abnormal uterine bleeding was identified. She denies fatigue, shortness of breath, or lightheadedness. She has intolerable side effects with systemic contraceptives and has previously trialed tranexamic acid and a levonorgestrel intrauterine device without success. She would like to avoid hysterectomy and requests in-office endometrial ablation. She has no history of chronic pain, anxiety, or intolerance of office procedures or anesthesia. Her partner has had a vasectomy. She has no medical comorbidities and does not take any daily medications.

Type
Chapter
Information
Surgical Gynecology
A Case-Based Approach
, pp. 134 - 136
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Fothergill, RE. Endometrial ablation in the office setting. Obstet Gynecol Clin North Am 2008; 35(2): 317–30, x.CrossRefGoogle ScholarPubMed
Galaal, K, Bryant, A, Deane, KH, Al-Khaduri, M, Lopes, AD. Interventions for reducing anxiety in women undergoing colposcopy. Cochrane Database Syst Rev 2011; (12): CD006013.Google ScholarPubMed
Glasser, MH. Practical tips for office hysteroscopy and second-generation “global” endometrial ablation. J Minim Invasive Gynecol 2009; 16(4): 384–99.CrossRefGoogle ScholarPubMed
Toledano, RD, Kodali, BS, Camann, WR. Anesthesia drugs in the obstetric and gynecologic practice. Rev Obstet Gynecol 2009; 2(2): 93100.Google ScholarPubMed
Hinkelbein, J, Lamperti, M, Akeson, J, et al. European Society of Anaesthesiology and European Board of Anaesthesiology guidelines for procedural sedation and analgesia in adults. Eur J Anaesthesiol 2018; 35(1): 624.CrossRefGoogle ScholarPubMed
Practice Guidelines for Moderate Procedural Sedation and Analgesia 2018: A Report by the American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia, the American Association of Oral and Maxillofacial Surgeons, American College of Radiology, American Dental Association, American Society of Dentist Anesthesiologists, and Society of Interventional Radiology. Anesthesiology 2018; 128(3): 437–79.Google Scholar
Deitch, K, Chudnofsky, CR, Dominici, P, Latta, D, Salamnca, Y. The utility of high-flow oxygen during emergency department procedural sedation and analgesia with propofol: a randomized, controlled trial. Ann Emerg Med 2011; 58(4): 360–4.e3.CrossRefGoogle ScholarPubMed
Mercier, RJ, Zerden, ML. Intrauterine anesthesia for gynecologic procedures: a systematic review. Obstet Gynecol 2012; 120(3): 669–77.CrossRefGoogle ScholarPubMed
Nagele, F, O’Connor, H, Davies, A, et al. 2500 Outpatient diagnostic hysteroscopies. Obstet Gynecol 1996; 88(1): 8792.CrossRefGoogle ScholarPubMed
Ahmad, G, O’Flynn, H, Attarbashi, S, Duffy, JM, Watson, A. Pain relief for outpatient hysteroscopy. Cochrane Database Syst Rev 2017; (10): CD007710.Google ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×