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Comment and Controversy

Cryoablation is an important option for endometrial ablation

December 2007 · Vol. 19, No. 12

“ Endometrial ablation devices: How to make them truly safe,” by Michael S. Baggish, MD (September)

I was delighted to see an article discussing the little-known but serious complications that can be associated with global endometrial ablation technologies. However, I was disturbed to find that only four of the five currently available methods were discussed. Because cryoablation typically produces minimal pain symptoms, it is an important option in an ambulatory gynecologic office setting. Does this mean that there are no complications associated with the cryoablation method? I sincerely doubt it.

Readers of OBG Management should have the benefit of a comparison among all available methods.

Barbara S. Levy, MD
Medical Director, Women’s Health Center
Franciscan Health System
Federal Way, Wash

Dr. Baggish responds:
Article was based on a study that was limited to four devices

Our survey of Food and Drug Administration data did not find sufficient information on cryoablation; therefore, the technique was not included in the study upon which the OBG Management article was based.1

That should not be interpreted to mean that cryoablation is free of complications. Early studies in the United Kingdom reported at least one case of septicemia with a cryoablation device.

I would also like to point out that our original study1 did not mention several other devices, such as Cavaterm, and that the OBG Management article was never intended to be an “all-inclusive” review or meta-analysis or to endorse any particular technique or device.


1. Baggish MS, Savells A. Complications associated with minimally invasive nonhysteroscopic endometrial ablation techniques. J Gynecol Surg. 2007;23:7-12.

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Vaginal hysterectomy 
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