Thermal ablation performed in a primary care setting: the South Warwickshire Experience

Objective To assess the feasibility of performing outpatient thermal ablation in a primary care setting. Design Prospective study. Setting A small peripheral hospital in the UK used by local general practitioners and visiting hospital practitioners for its outpatient facilities. Population The area of South Warwickshire serves a population of 270,000. Methods Two general practitioners were trained to perform outpatient thermal ablation using the Thermachoice thermal ablation system (Thermachoice II). The unit functioned autonomously with support from a local gynaecologist and radiologist, accepting referrals from hospital consultants and general practitioners. Main outcome measures Severity of menstrual loss, premenstrual symptoms, dysmenorrhoea and quality of life assessed by visual analogue scales before treatment and at one month, two months, one year and two years. Results Eighty‐seven women were treated. No major complications were encountered from the procedure. Reduction of menstrual loss or cure was reported by over 94% of women. Premenstrual syndrome (PMS) and symptoms of dysmenorrhoea were also improved by treatment. The majority of women were satisfied with the operation at one month (96%), two months (93%), one year (92%) and two years (94%). Conclusions Thermal ablation is a simple procedure well suited to an outpatient setting. There are few complications as a result of the use of the thermal ablation catheters, and this study has shown that the procedure can be undertaken in a primary care setting with excellent results.