Endometrial ablation by balloon coagulation.

Different techniques of global endometrial ablation have been developed during the last 5 years, starting with the introduction of the thermal and the electrocoagulation balloon up to the latest development of bipolar coagulation techniques. Balloon application has many advantages to traditional hysteroscopic laser or electrotechniques. No pre-operative hormonal treatment is required. The operation itself is easier to perform and there is no need for experience in operative hysteroscopy. The main advantage is the lack of a distention medium. Even anesthesiological high risk patients can be treated by balloon techniques without problems. Hysterectomy can be avoided more and more. Essential for global endometrial ablation, in my mind, is a diagnostic hysteroscopy best performed immediately prior to endometrial ablation. In this way, the uterine cavity is evaluated and complications can be avoided or detected early. This combination results in excellent outcome with the lowest complication rate.