Original scientific paper
Impact of Prostaglandin F2-Alpha and Tumor Necrosis Factor-Alpha (TNF-a) on Pain in Patients Undergoing Thermal Balloon Endometrial Ablation
Bojan Grulović
; General Hospital Bre`ice, Department of Obstetrics and Gynaecology, Bre`ice, Slovenia
Martina Ribič Pucelj
; University of Ljubljana, University Medical Centre Ljubljana, Clinical Department of Obstetrics and Gynaecology, Ljubljana, Slovenia
Mladen Krnić
; University of Split, University Hospital Centre Split, University Department for Endocrinology, Diabetes and Metabolic Disease, Split, Croatia
Višnja Kokić
; University of Split, University Hospital Centre Split, University Department for Endocrinology, Diabetes and Metabolic Disease, Split, Croatia
Abstract
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.
Keywords
thermal balloon endometrial ablation (THERMACHOICE); pain; prostaglandins; tumor necrosis factor
Hrčak ID:
118366
URI
Publication date:
30.12.2013.
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