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UBC Theses and Dissertations

Development and analysis of a computer model of endometrial thermal ablation for the treatment of menorrhagia Reinders, Daniel Martin

Abstract

Menorrhagia, the condition of excessive menstrual flow, affects up to 20% of women at some point in their lives. In the past decade a new treatment, endometrial thermal ablation, has been developed. Rather than removing the whole uterus, as in a hysterectomy, only the inner lining responsible for menstrual flow is eliminated. A computer model of the heat transfer and tissue burning process was created to analyse two different approaches that utilize heated liquid contained in a flexible balloon to cauterise the endometrium. One approach maintains a constant fluid temperature throughout the treatment protocol. The other approach, referred to in this thesis as the Thermal Reservoir System (TRS), oscillates preheated fluid between the balloon and a reservoir via an insulated tube. Validation of the model predictions was performed using data from the literature, meat analogues of the uterus with thermometry data, and the results of clinical trials of the TRS. The model accurately predicts burn depth within the limits of the inter-individual variation. The results indicate that both devices provide an adequate degree of endometrial destruction with minimal risk of thermal damage to organs in the peritoneal cavity. In general, the TRS is predicted to be less affected by variation in individual treatment parameters (such as the uterus cavity volume and the blood perfusion rate). The model also indicates that the use of higher temperatures improves the specificity of the burn injury, reducing damage to the non-targeted tissue while adequately cauterising the targeted tissue. The use of computer modelling in the study of endometrial thermal ablation has been very fruitful. As a result of this study, many useful insights have been obtained regarding both the physics of the TRS device and the general process of endometrial thermal ablation.

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