Comparison of clinical outcomes with low-voltage (cut) versus high-voltage (coag) waveforms during hysteroscopic endometrial ablation with the rollerball: a pilot study.

Study Objective: To compare efficacy of rollerball endometrial ablation with low-voltage (cut) versus high-voltage (coag) waveforms.

Design: Pilot comparative clinical study (Canadian Task Force Classification II-1).

Setting: University-affiliated teaching hospital.

Patients: Fifty premenopausal women with menorrhagia.

Intervention: Women with menorrhagia were allocated randomly to thermal destruction of the endometrium by a 5-mm rollerball with unmodulated cutting current or modulated coagulating current. Complication rate, clinical outcomes, and need for reintervention were evaluated.

Measurements And Main Results: At 2 years of follow-up, the reintervention rate was 26.3% in the cutting waveform group versus 31.4% in the coagulating waveform group. This difference was not statistically significant. Hysterectomy was performed in 3 (14%) women in the cutting waveform group and 5 (20%) women in the coagulating waveform group. There were no complications in either group.

Conclusion: Both cutting and coagulating waveforms are equally effective for hysteroscopic endometrial ablation with the rollerball.