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Patient Satisfaction 10 Years After Endometrial Ablation

More than 75% of respondents were contented with their outcomes.

Is endometrial ablation an effective way to treat women who experience heavy menstrual bleeding? To address this question, British investigators conducted a 10-year follow-up study, based on survey responses from women who had been randomized to microwave endometrial ablation (MEA) or transcervical resection of the endometrium (TCRE) in a manufacturer-supported trial. Participants had completed their families and had uterine size equivalent to 10 weeks’ gestation with no endometrial atypia.

In all, 189 of 263 women completed the questionnaires (response rate, 72%). Intention-to-treat analysis showed that more than half of the women in each group were satisfied with their outcomes 10 years later — both bleeding and pain had been substantially reduced. When only those women who responded were analyzed, >75% were totally or generally satisfied with their results. Six of eight health-related quality-of-life measures improved over baseline measures. Overall satisfaction was similar between the two groups; however, 38 women in the TCRE group (28%) versus 22 in the MEA group (17%) subsequently underwent hysterectomies.

Comment: This study confirms that many women with heavy menstrual bleeding who undergo endometrial ablation by either of these methods are satisfied with their decisions. The findings probably can be generalized to all methods of endometrial ablation; thus, practitioners can select the approach with which they feel most comfortable. Nonetheless, patients still must be selected carefully, and hormonal therapy (JW Womens Health May 7 2009) or hysterectomy might be a better alternative for some.

— Robert W. Rebar, MD

Published in Journal Watch Women's Health June 18, 2009

Citation(s):

Sambrook AM et al. A randomised comparison of microwave endometrial ablation with transcervical resection of the endometrium: Follow up at a minimum of 10 years. BJOG 2009 Jul; 116:1033.

• Medline abstract (Free)