Novasure VS HTA

Yah, I'd much rather use scolding hot water so I can burn the vagina with all that leaking hot saline into it. When you jokers can place in your IFU that you ablate deeper than 3-4mm in a Lupron pretreated uterus come talk to the docs. Even ACOG's May 2007 update on 2nd gen GEAs states optimal depth of ablation is 4-6mm....you jokers state right in your IFU that your max depth of necrosis is 3-4mm. Considering no docs pretreat with Lupron I guess that means HTA does, uh nothing....but at least you can hysteroscopically view it doing nothing. Guess that's why that radical study came out showing HTA can safely be done a 2nd time. If first you do not succeed, unecessarily bring the patient back for another suboptimal HTA to try again. Even then, your success rates sucked! Losers! Go sell your slings that have no data. AMS and Gynecare will continue to smoke you in that space as well!

 

Pretty harsh words for a jackass who clearly has not read or simply cannot understand data. What else could it be because everything I have ever seen shows HTA provides better results than Novasure. So who are you kidding with your aggressive response?

 

Are you kidding me!? It is amazing that you Cryo reps can say with a straight face that you are FDA approved to do Cryo ablations in the office. Have you read the DFUs for the other devices?! The FDA does not approve site of service, it approves a procedure/device. As long as you follow the rules you can do the procedure in your basement. I will admit that your marketing dept was slick in changing the name of your device to "office cryoblation" or something to that extent. They knew the procedure was worthless on the level playing field of the OR so they committed to the office. Wise choice, but now that NS and HTA (and even the balloon on occasion) are in the office you Cryo reps are having a tough go at it. Its not your fault, its just a lousy product. Fun to go up against though that's for sure.

 

Ok....I'm a patient, not a doc or a sales rep. I am considering ablation. I have a friend that had the Nova Sure procedure and had outstanding results. HOWEVER, the data I have researched indicates much more risk with NS vs HTA. My gynecologist wants to do the HTA in the office and claims he has NEVER had a problem. I personally feel more comfortable with the idea of hot water in my uterus than the details of the NS procedure. But you are all scaring me to death!!! I want an honest, non-biased professional answer from as many doctors that are willing to post. Statistically speaking, can anyone provide me with data that shows the pros/cons other than what is obviously posted on the companies websites? I want relief from my extremely bad periods, cramping and misery. I am a teacher and am miserable. I have had to take narcotics to stop the pain. I prefer to NEVER have a period again, without a hysterectomy or any type of hormones. Someone please give me some decent advice......and spare my the bickering and bantering. This is a serious thing for me. I research every medical procedure that I have very thoroughly, and although I am not a doctor, I am extremely intelligent and know a lot about the human body. Statistics, studies? anything that can help me make a decision would be much appreciated. My name is Erin.... so feel free to address me personally, or if you are serious about helping me, I will even give you my email addy. please no spam.

 

oh and by the way...... if anyone actually reads this anytime soon.....and knows an expert that would talk to me. Please let me know.....time is of the essence...
Erin

 

Why not get a 2nd, 3rd opinion from a physician?

 

i"m just worried that if i GO TO ANOTHER PHYSICIAN they have a stake in what procedure they perform due to their deals with the pharmaceutical company.....that is why I was hoping for someone from another state that would tell me honestly what they thought was the safest most effective procedure.....they have nothing to gain or lose....does that make sense?
E

 

Hi Erin,
I work in Med Devices as an engineer - RF devices but not NovaSure (I look at these boards for competitive info). Impedance guided devices are "intelligent" such that the device measures the impedance of the tissue it is running electricity through at the Radio-Frequency level (anything over 100Hz no longer stimulates nerves) and adjusts the amount of energy flowing through the tissue as the impedance rises (as you desiccate tissue - water levels drop - impedance rises). The NovaSure does something similar and thus can deliver energy to desiccate your endometrium but not your myometrium. So far so good - unlike "dumb" heated liquid systems, NovaSure actually knows when it is done ablating.
However, as with any surgical device - that includes learning how to use sutures - there is a learning curve and skill involved. Get a Dr. that has done over 500 NS procedures and has no complaints filed against him/her: Some Drs do 500 procedures and still suck at it, some Drs do 10 and have it down cold. The higher the number of procedures done, the more anatomical weirdness the Dr has come across and knows what to do with.
Also - hematometra is a concern with NS. If any healthy endometrial cells are left behind under the dessicated layer (scar tissue) they will "bleed" and create pockets of blood and can cause pain/cramps. Drs are now placing and IUD (usually a Mirena) right after the NS ablation. The low level of Progesterone can inhibit any left behind endometrial cells. The UK Drs refer to this combo as "belt and braces" (??). Primary concern is the "embedding" of the Mirena in the scar tissue. I'd recommend going under when you get it swapped out.
I have had a NS done and Mirena implanted about a year ago. I still have micro periods (the cells in the cervical canal can survive quite well and will bleed), but they last a day and are not more than some minor spotting. I have no cramps, no pain and can go hiking for two weeks without having to pack in (and out) tampons and pads (bad enough having to crap into a ziplock bag...). Hope this helps.
Melanie

 

My doctor has given me 2 options - the NS along with a tubal or a partial hyst. I am leaning towards the NS with the tubal with all the research I have read to date. I'm just starting my search for information so if anyone has any new info please let me know. Thanks.

 

HTA with rubber seal still takes 10 minutes vs 90 seconds but BSX is finally doing something right. Your hot blonde rep that was in AL the other day- MEEEEOOWWWWZAH. Can't ever get tired of that smile.

 

You mean ProCerva the cervical sealing device? My docs LOVE it and are switching like crazy. 10 min or 90 sec...who had better outcomes? NovaSure sucks. Bottom line.

 

Anybody want to comment on the synechiae caused by Novasure or scalding from HTA? Anybody want to compare paychecks to AMS? It's not even close.

 

look @ the market share............................. this debate is over............docs have spoken loud and clear

 

ACOG May 2007 supplement states minimal depth of necrosis for sucessful GEA treatment 4-6mm. a typical endometrium is 4-6mm and even thicker during the luteal phase of a women's cycle. HTA label clearly states their depth of necrosis from treatment is only 3-4mm. Oh, and that 3-4mm depth of necrosis requires at least one dose of Lupron pretreatemnt which we all know that no Gyn who is stupid enough to still use HTA ever requires of their patients pre-ablation. Hmmm, NovaSure impedence controlled ablation ablates to a preprogramed depth of 5-7mm in EVERY patient...with no pretreatment required. Now take that new cervical plug and shove it up your ass. Go play in the pelvic floor sandbox where you have a chance, loser!

 

HTA burns 3-4mm into the myometrium (muscle layer) of the uterus, completely obliterating the endometrium. Studies have shown no significance difference in efficacy with cycle timing, OC's, and Lupron. Pretreating the uterine cavity is for ease of use mainly so the physician can see, being that it is a hysteroscopic procedure. Both products have positives and negatives. One major negative of HTA is that many OB/GYN's do not value looking at the uterus with a scope. So they are not as comfortable with hysteroscopy. Most physicians don't look at the uterus after the Novasure. And many don't even look before inserting the metal array into the uterus through the cervix. Before this new cervical sealing system, another downfall of HTA was the risk of vaginal burn. I am glad to hear that Boston Scientific has finally taken care of that issue. For a normal uterus, I am sure that the Novasure will work fine. And it is nice that it really doesn't take much surgical skill. And it is very fast which physicians really like. Novasure should not be used on an abnormal cavity as intestinal injuries have been reported. And obviously it is a metal device that needs to be in contact with the entire cavity, so it is less effective in an abnormally shaped uterus. It can accomplish this in a uterine cavity that is between 4 and 6 cm with no submucosal firboids, septums, major polyps, or severe anteverstion or retroversion. Also the cornuas need to be at least 2.5cm apart to avoid perforation. An abnormal cavity is hard to detect before the surgery as most OB/GYN's do not have a hysteroscope in their office. They usually use an ultrasound which is highly variable in showing potential abnormalities. The uterine walls are collapsed on themselves in the ultrasound picture. A saline infused ultrasound is much better, but still not as precise as hysteroscopy. If a physician is comfortable with hysteroscopy and doesn't mind a little longer procedure, the HTA is probably the more prudent device due to potential abnormalities in the uterus. But real world is that OB/GYN's are very attracted to the quick and easy procedure of Novasure. Their focus is delivering babies and doing hysterectomies. So Novasure has done very well in marketing the quick and easy factor to this phsycian specialty. Bottom line, if you are going to have an HTA done, make sure your phsycian is a competent hysteroscopist. If you are going to have a Novasure, make sure that you have a diagnostic hysteroscopy to ensure that your uterus is normal. And please quit the bickering between the sales reps. It really makes you look extremely immature.

 

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Hi, I had the NovaSure procedure done in 12/08. I was sent home and the next day was in the emergency room. I had emergency surgery and needed a complete Hysterectomy, Appendectomy, and small bowel resection. I was septic and was in a pretty bad situation. I know I am one of the small percentage of women that have had a serious complication with the NovaSure procedure, but it was life changing for me. Please research the procedure and your doctor's credentials. Also, ask friends, family and get second and third opinions. I am just glad to be here. Thanks for reading this.

 

All of you need to stop pretending like your doctors with your couple weeks of training as sales reps. This one is better, that one is better, who cares!!!! Both have data it's all up to the doctor. One can burn worst case one can cause death worst case....

 

Your market share is not that hard of a thing to do when there are typically 5-7 Novasure reps to 1 BSC rep. get real. When you grow up maybe your company will let you sell something other than a treatment. You bitches are entry level at best.

 

[I had the HTA and during my procedure the solution leaked out through my fallopian tubes and caused peritinitis! I would not recommend this procedure to anyone!