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Biomedical subjects

F D Loffer

Publications and source records attributed to F D Loffer.

At least 19 recordsLinked to original sources
PubMed2001

Three-year comparison of thermal balloon and rollerball ablation in treatment of menorrhagia.

STUDY OBJECTIVE: To compare uterine balloon therapy and hysteroscopic rollerball endometrial ablation with respect to efficacy and safety in treatment of menorrhagia. DESIGN: Multicenter, prospective, randomized study (Canadian Task Force classification I). SETTING: Fourteen North American university and private practice sites. PATIENTS: Women undergoing endometrial ablation for menorrhagia. INTERVENTION: Rollerball endometrial ablation or uterine balloon therapy. MEASUREMENTS AND MAIN RESULTS: Of 275 women randomized to one of these procedures, 255 were treated under the protocol and 214 were followed for 3 years. Results of uterine balloon therapy and rollerball endometrial ablation remained similar, with little difference at 3 years compared with results at 1 year. We noted a suggestion of an increase in hysterectomies in the rollerball group (14) compared with the uterine balloon therapy group (8) at 3 years. CONCLUSION: Endometrial ablation with the ThermaChoice uterine balloon or rollerball continues at 3 years to be a successful method for treating menorrhagia, avoiding hysterectomy, decreasing dysmenorrhea and premenstrual symptoms, and improving quality of life. (J Am Assoc Gynecol Laparosc 8(1):48-54, 2001)

Adult↗
PubMed2000

Preliminary experience with the VersaPoint bipolar resectoscope using a vaporizing electrode in a saline distending medium.

OBJECTIVE: To evaluate a new bipolar resectoscope that uses physiologic saline as a distending medium. DESIGN: Clinic-based, prospective, non-randomized study (Canadian Task Force classification II-2). SETTING: A free-standing ambulatory surgical facility. Patients. Eleven women with menorrhagia or menometrorrhagia and four with menorrhagia and infertility. INTERVENTION: Hysteroscopic removal of submucosal myomas with concomitant endometrial ablation in seven patients. MEASUREMENTS AND MAIN RESULTS: Complete removal of the submucosal myoma was achieved in all 15 patients. Eight patients had a European Society of Gynecologic Endoscopy type II myoma, five had a type I, and two had a type zero. Five patients had multiple myomas. There were no complications. CONCLUSIONS: The bipolar resectoscope is effective in the removal of submucosal myomas and in this series allowed completion of several cases that probably could not have been done with a traditional monopolar resectoscope.

Adult↗
PubMed1998

Thermal balloon and rollerball ablation to treat menorrhagia: a multicenter comparison.

OBJECTIVE: To compare the clinical efficacy and safety of a thermal uterine balloon system with hysteroscopic rollerball ablation in the treatment of dysfunctional uterine bleeding. METHODS: Two hundred fifty-five premenopausal women were treated in a randomized multicenter study comparing thermal uterine balloon therapy with hysteroscopic rollerball ablation for the treatment of menorrhagia. Preprocedural and postprocedural menstrual diary scores and quality-of-life questionnaires were obtained. Twelve-month follow-up data are presented on 239 women. RESULTS: Twelve-month results indicated that both techniques significantly reduced menstrual blood flow with no clinically significant difference between the two groups as reflected by return to normal bleeding or less (balloon 80.2% and rollerball ablation 84.3%). Multiple quality-of-life questionnaire results were also similar, including percent of patients highly satisfied with their results (balloon 85.6% compared with rollerball 86.7%). A 90% decrease in diary scores was seen in more than 60% of patients in both groups. Procedural time was reduced significantly in the uterine balloon therapy group. Intraoperative complications occurred in 3.2% of the hysteroscopic rollerball patients, whereas no intraoperative complications occurred in the thermal balloon group. CONCLUSION: In the treatment of dysfunctional uterine bleeding, uterine balloon therapy is as efficacious as hysteroscopic rollerball ablation and may be safer.

Adult↗
PubMed1998

Complications of fluid overload from resectoscopic surgery.

Excess absorption of liquid distending media is one of the most frequent complications of operative hysteroscopy. Although most women recover uneventfully, we are seeing cases of permanent morbidity or death resulting from this complication.

Female↗
PubMed1995

Complications of hysteroscopy-their cause, prevention, and correction.

Complications of hysteroscopy occur more frequently in operative than in diagnostic cases. Problems related to uterine distention are common, usually preventable, and potentially extremely serious. Perforation of the uterus may occur during hysteroscopy but do not always cause significant problems. In procedures of high risk for perforation the use of mechanical energy is safer than either laser or electrical energy. Laparoscopy and ultrasonography have some limited use in facilitating operative hysteroscopic procedures. Most complications occur during the hysteroscopic surgical procedure. However, some problems may not be apparent until the post operative period.

Blood Loss, Surgical↗
PubMed1995

Endometrial ablation and resection.

Many hysterectomies for abnormal uterine bleeding can be avoided by the use of endometrial ablation or resection. Their role in older and postmenopausal patients has recently been emphasized. Complications, although infrequent, relate primarily to fluid intravasation or the inexperience of the surgeon. This cost-effective technique should be offered to all appropriate patients.

Accreditation↗
PubMed1995

Contraindications and complications of hysteroscopy.

If the contraindications to hysteroscopy are observed, complications should be small. The risks of fluid overload, especially in operative cases, is the most common critical problem, so that accurate recording of fluid use and collection are essential. The inexperienced, unsupervised surgeon is most likely to encounter significant complications.

Contraindications↗
PubMed1990

Removal of large symptomatic intrauterine growths by the hysteroscopic resectoscope.

Fifty-three patients underwent 55 procedures with a resectoscope for the removal of large symptomatic intrauterine growths. The presenting complaint was menorrhagia, menometrorrhagia, or heavy postmenopausal bleeding in 38 patients; excessive menses plus infertility in 13 patients; and infertility alone in two patients. Forty-three patients had pedunculated or sessile submucous myomas and ten patients had large endometrial polyps. The long-term results are based on 45 patients followed for longer than 1 year. Excessive bleeding was controlled in 40 of the 43 women (93%). Failure to control abnormal bleeding was apparent within the first year. Seven of the 12 infertility patients (58%) delivered live-born infants. Five patients have undergone subsequent hysterectomies (9%). Two patients had repeat resectoscopic removal of myomas and two had subsequent non-resectoscope myomectomies. No major complications were encountered.

Ambulatory Surgical Procedures↗
PubMed1989

Resectoscopic removal of symptomatic intrauterine lesions.

In order to avoid major surgical intervention in women who refused or were poor risks for hysterectomy or myomectomy, a hysteroscopic resectoscope was used for 90 women with uncontrollable uterine bleeding due to submucous fibroids or large polyps or with menorrhagia with normal endometria. Of those patients followed for more than three months, 90% of endometrial ablation patients had an improvement in menstrual flow, with 79% having scant or no periods. For patients with submucous fibroids or polyps, 91% had resumption of normal menses. For the 15 patients who were infertile and underwent submucous fibroid or polyp resection the term pregnancy rate is 33% to date. With only two complications in the series (perforation and endometritis), the conclusion is that resection of submucous lesions and endometrial ablation using the resectoscope is a safe and highly effective alternative to hysterectomy for those conditions.

Adult↗