Radiofrequency induced thermal endometrial ablation - invention and primary assessment

The invention and development of Radiofrequency Endometrial Ablation (RaFEA) has been, by turns, exciting, frustrating and anxiety - provoking. Although one of the major motives for developing an alternative means of effective endometrial ablation to the hysteroscopically directed modalities was to improve safety, it seems that in using RaFEA, one set of potential dangers may have been exchanged for another set. Whilst the potentially fatal risks of uterine penetration and fluid toxicity are not encountered with RaFEA, the charging of the patient with an electric field for the duration of therapy brings its own risks, requiring very special precautions of their own (see section 2 - safety). At the time of writing, the future role of the technique is still being decided. It may be that the technique requires such specialist monitoring that it is unsuitable for general use, and may be restricted to one or two specialist centres for the treatment of certain patients who cannot be treated easily any other way. What is certain is that safety is of paramount importance, and the adequate training of those concerned and a basic knowledge of RF physics are both essential to safe practice. Practiced safely, the technique is highly successful, and has proved of considerable benefit to hundreds of patients. However, there have been a number of serious complications in other centres, each of which has been analysed in very great detail. These are considered in section 2 - safety.