Background: Abnormal uterine bleeding needs surgical treatment if medical therapy fails. After introduction of non-hysteroscopic endometrial ablation as alternative to hysteroscopic endometrial resection, we aimed to compare short and long-term outcomes for women treated with these two minimally-invasive procedures. A secondary goal was comparing the present cohort to a previous cohort of women treated with hysteroscopic resection only.
Materials And Methods: Historical cohort study of women treated for abnormal uterine bleeding with hysteroscopic resection or endometrial ablation at Haukeland University Hospital during 2006-2014. Similar patient file and patient-reported outcome data were collected from 386 hysteroscopic resections in a previous cohort (1992-1998). Categorical variables were compared by Chi-square or Fisher´s Exact-test, linear variables by Mann-Whitney U-test and time to hysterectomy by the Kaplan-Meier method.
Results: During 2006-2014, 772 women were treated with endometrial resection or ablation, 468 women (61%) consented to study-inclusion; 333 women (71%) were treated with hysteroscopic resection and 135 (29%) with endometrial ablation. Preoperative characteristics were significantly different for women treated with hysteroscopic resection compared to endometrial ablation in the 2006-2014-cohort and between the two time-cohorts regarding menopausal, sterilization and myoma status (p≤0.036). The endometrial ablation group had significantly shorter operation time, median 13 minutes (95% Confidence Interval (CI) 12-14) and a lower complication rate (2%) versus operation time, median 25 minutes (95% CI 23-26) and complication rate (13%) in the hysteroscopy group, all p ≤0.001. The patient-reported rate of satisfaction with treatment was equivalent in both groups (85%, p = 0.955). The endometrial ablation group had lower hysterectomy rate (8% vs 16%, p = 0.024). Patient-reported satisfaction rate was higher (85%) in the 2006-2014-cohort compared with the 1992-1998-cohort (73%), p<0.001.
Conclusions: Endometrial ablation has similar patient satisfaction rate, but shorter operation time and lower complication rate and may be a good alternative to hysteroscopic resection for treatment of abnormal uterine bleeding.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6619760 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0219294 | PLOS |
Publication Analysis
Top Keywords
Similar Publications
Automated assessment of endometrial receptivity for screening recurrent pregnancy loss risk using deep learning-enhanced ultrasound and clinical data.
Front Physiol
December 2024
Department of Obstetrics and Gynecology, Deyang People's Hospital, Deyang, Sichuan, China.
Background: Recurrent pregnancy loss (RPL) poses significant challenges in clinical management due to an unclear etiology in over half the cases. Traditional screening methods, including ultrasonographic evaluation of endometrial receptivity (ER), have been debated for their efficacy in identifying high-risk individuals. Despite the potential of artificial intelligence, notably deep learning (DL), to enhance medical imaging analysis, its application in ER assessment for RPL risk stratification remains underexplored.
View Article and Find Full Text PDFComparison of Surgical Interventions for Endometrioma: A Systematic Review of Their Efficacy in Addressing Infertility.
Biomedicines
December 2024
Third Department of Obstetrics and Gynecology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, 1 Rimini, 124 62 Athens, Greece.
: Endometriosis is characterized by the presence of endometrial tissue outside the uterus. Beyond medical treatment, surgical intervention is also a viable consideration. However, current guidelines do not clearly indicate whether laparoscopic cystectomy, ablative methods (CO laser vaporization, plasma energy), or sclerotherapy is the preferred option.
View Article and Find Full Text PDFLong-term effects of endometrial resection or ablation in combination with levonorgestrel intrauterine device on bleeding patterns.
Arch Gynecol Obstet
December 2024
Department of Obstetrics and Gynecology, Odense University Hospital, Kløvervænget 23, 5000, Odense, Denmark.
Objective: Endometrial resection and ablation are minimal invasive surgeries used to treat women with abnormal uterine bleeding (AUB). Both may be followed by a high reoperation rate up to 24%. However, some studies suggest that this may be improved by adding a levonorgestrel intrauterine device (LNG-IUD) immediately following surgery.
View Article and Find Full Text PDFNational Utilization Trends of Inpatient Procedures for Symptomatic Uterine Fibroids and Adenomyosis: A 10-Year Analysis.
J Am Coll Radiol
December 2024
Assistant Professor, Interventional Radiology Residency Program Director, Division of Vascular and Interventional Radiology, Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Purpose: The aim of this study was to determine changes in procedural utilization for symptomatic uterine fibroids and adenomyosis from 2011 to 2020.
Methods: An institutional review board-exempt retrospective study of the National Inpatient Sample database from 2011 to 2020 was performed using International Classification of Diseases, Ninth Revision, and International Classification of Diseases, 10th Revision, diagnosis and procedural codes for uterine fibroids, adenomyosis, hysterectomy, myomectomy, uterine artery embolization (UAE), and endometrial ablation. Patients with endometriosis, uterine cancer, placenta accreta spectrum, pelvic inflammatory disease, and uterine prolapse were excluded.
Management of endometriosis: a call to multidisciplinary approach.
J Osteopath Med
December 2024
Department of Medical and Surgical Gynecology, Mayo Clinic, Phoenix, AZ, USA.
Article Synopsis
- Endometriosis is characterized by the growth of endometrial-like tissue outside the uterus, classified into three types: superficial, ovarian endometrioma, and deep infiltrating disease, and can affect various areas beyond the pelvis.
- Diagnosis typically involves a combination of symptom assessment, physical exams, imaging tests, and ultimately requires tissue confirmation for a definitive diagnosis.
- Treatment options range from medical management focused on symptom relief to surgical interventions, with a preference for excision of lesions and a multidisciplinary approach for more severe cases to enhance long-term outcomes.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!