Improving Patient Satisfaction During and After Endometrial Ablation

When choosing surgical treatment for patients suffering from heavy menstrual bleeding (HMB), the decision-making process should include more than the potential risks and outcomes of each procedure. The patient experience, both during and after treatment, should remain top of mind throughout these discussions to ensure both patient and clinical needs are met. 

For many women, endometrial ablation is the treatment of choice to effectively manage menorrhagia symptoms without resorting to hysterectomy. Overall, second-generation ablation devices generate an estimated 77% to 86% satisfaction rate for patients with HMB.¹ Even so, gynecologists should strive to continually enhance the treatment experience with equal improvements in both safety and tolerability, while also tailoring treatment plans to prioritize patient goals and expectations.

Five Key Steps to Improve the Ablation Experience

The ablation treatment itself is highly effective in relieving the painful, disruptive, and often debilitating symptoms of HMB. However, OBGYNs can make the procedure a more positive and patient-friendly experience by:

1. Providing a safe and well-tolerated experience. Far and away, the top priority during and after the ablation procedure is patient safety. Once a patient is established as a good candidate for ablation, the next step is selecting a treatment modality that can lower the risk of complications. The Cerene^® Cryotherapy Device leverages cutting-edge safety technology, including a cavity-conforming liner and thermally-insulating sheath, to uniformly deliver nitrous oxide across the entire cavity while preventing leakage and protecting adjacent structures from cryoablative effects. Together, the innovative device design and natural analgesic effect of cryoablation work to maximize safety throughout the procedure and improve tolerability. Patients treated with Cerene report a median pain score of two on a ten-point scale during their treatment, with 92% reporting their pain level was at or below the acceptable median pain score during treatment.

2. Offering treatment in the office setting. From lower financial responsibility to less time away from work and home, in-office procedures are a favorable choice for 70% of women, according to market research.² Moreover, receiving treatment in the comfort and familiarity of the doctor’s office can help reduce procedural anxiety, which directly improves the overall experience and may even contribute to positive treatment outcomes.³ While office-based pain control may still be a concern for certain gynecologists, cryotherapy offers an effective solution to lower the need for general anesthesia and IV sedation. A major advantage of Cerene’s nitrous oxide cryotherapy is the ability to provide natural pain relief by numbing local sensory nerves, creating a well-tolerated and safe treatment experience. To ensure a positive experience, gynecologists can use Cerene in either the office or operating room, depending on which site of service is best for each patient.

3. Allowing patients to return to activities quickly. A major step in improving satisfaction with endometrial ablation is to allow a prompt return to normal activities, ensuring patients don’t miss out on important work, school, family, and social engagements. This is a core differentiator between ablation and hysterectomy, which generally requires up to eight weeks for full recovery.⁴ While vaginal discharge is to be expected for two to four weeks after the ablation treatment, most patients treated with Cerene return to normal activities within just 24 hours, with a median pain score one day after treatment of zero on a ten-point scale. Likewise, one year after treatment, 90% of patients report little to no limitations in their activities.^† 

4. Effectively reducing dysmenorrhea. In addition to reducing excessive blood loss, a primary treatment goal for patients is also a measurable decrease in severe cramping and pain associated with HMB. Cerene not only helps 90% of patients achieve normal, light, or no periods^† but also relieves dysmenorrhea in 86% of patients^‡ — a critical component of improving quality of life for women suffering from HMB. Even with reduced blood flow, patients can still have trouble performing daily and leisure activities if they experience debilitating menstrual cramps during their period. Market research indicates that 86% of patients characterize treatment success as a normal period or better.²

5. Limiting ongoing menstrual complaints. Cerene’s ability to minimize post-ablation scarring can help prevent future complications such as cyclic pelvic pain (CPP) or post-ablation tubal sterilization syndrome (PATSS) and maintain cavity visibility to evaluate and diagnose recurrent bleeding.⁵ Patients with significant pain or limited cavity visualization may ultimately need a hysterectomy to address their concerns — according to one study with ten-year follow-up, 22% of patients underwent a hysterectomy after their ablation to effectively control their symptoms.⁶ By limiting the formation of intrauterine scarring and synechiae, Cerene maintains full cavity access in 96% of patients and has no reported symptoms of PATSS one year after treatment.^7,8

Achieve 90% Patient Satisfaction With Cerene^†

By addressing and improving each aspect of the treatment experience, Cerene helps gynecologists deliver a safe, well-tolerated, and satisfactory endometrial ablation treatment that provides positive outcomes during, shortly after, and for years after the procedure. To learn more about why 95% of patients would recommend Cerene to family and friends, visit https://cerene.com/healthcare-professionals/.^†††

† Patient-reported data are 1 year after treatment with durable results at 3 years

‡  Improvement reported one year after treatment for patients reporting severe/very severe period pain

††† Patient-reported data include definitely and consider recommending Cerene and are 1 year after treatment with durable results at 3 years.

Key Takeaways:

• Endometrial ablation is a highly effective surgical procedure to treat HMB, but there are key steps gynecologists can take to continue improving the treatment experience and delivering on patient expectations.
• These steps include providing a safe and well-tolerated treatment, offering an office-based procedure if possible, prioritizing a quick return to normal activities, effectively reducing cramping associated with HMB, and minimizing long-term complications.
• Cerene improves each of these treatment aspects and outcomes with a device design that performs safe, well-tolerated cryoablation and effectively relieves HMB symptoms while prioritizing the patient experience.

Sources

1. Kumar, V., Chodankar, R., & Gupta, J. K. (2016). Endometrial ablation for heavy menstrual bleeding. Women’s health (London, England), 12(1), 45–52.
2. Data on file. Channel Medsystems Market Research Iris Survey 2014.
3. Kassahun, W. T., Mehdorn, M., Wagner, T.C., Babel, J., Danker, H., & Gockel, I. (2022). The effect of preoperative patient-reported anxiety on morbidity and mortality outcomes in patients undergoing major general surgery. Scientific Reports, 12(1), 6312.
4. Recovery: Hysterectomy. (2022, October 11). NHS. https://www.nhs.uk/conditions/hysterectomy/recovery/
5. Wortman M. (2017). Late-onset endometrial ablation failure. Case Reports in Women’s Health, 15, 11–28.
6. Fürst, S. N., Philipsen, T., & Joergensen, J. C. (2007). Ten-year follow-up of endometrial ablation. Acta obstetricia et gynecologica Scandinavica, 86(3), 334–338.
7. Curlin, H., Cholkeri-Singh, A., Leal, J. G. G., & Anderson, T. (2022). Hysteroscopic Access and Uterine Cavity Evaluation 12 Months after Endometrial Ablation with the Cerene Cryotherapy Device. Journal of Minimally Invasive Gynecology 29(3), 440-447.
8. Curlin, H.L., Cintron, L.C., Anderson, T.L. (2020). A Prospective, Multicenter, Clinical Trial Evaluating the Safety and Effectiveness of the Cerene Device to Treat Heavy Menstrual Bleeding. Journal of Minimally Invasive Gynecology 28(4), 899-908.