Objective: To provide an update of the current evidence-based guideline on the techniques and technologies used in endometrial ablation, a minimally invasive technique for the management of abnormal uterine bleeding of benign origin.
Target Population: Women of reproductive age with abnormal uterine bleeding and benign pathology with or without structural abnormalities.
Benefits, Harms, And Costs: Implementation of the guideline recommendations will improve the provision of endometrial ablation as an effective treatment for abnormal uterine bleeding. Following these recommendations would allow the surgical procedure to be performed safely and maximize success for patients.
Evidence: The guideline was updated with published literature retrieved through searches of Medline and the Cochrane Library from January 2014 to April 2023, using appropriate controlled vocabulary and keywords (endometrial ablation, hysteroscopy, menorrhagia, heavy menstrual bleeding, abnormal uterine bleeding, hysterectomy). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies written in English. Grey (unpublished) literature was retrieved from the Association of Obstetricians and Gynecologists of Quebec (AOGQ) in 2023.
Validation Methods: The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See Appendix A (Tables A1 for definitions and A2 for interpretations of strong and conditional [weak] recommendations).
Intended Audience: Obstetricians, gynaecologists, and primary care providers.
Social Media Abstract: This is an updated version of the 2015 SOGC Endometrial Ablation guideline. The authors discuss special considerations, update evidence, and make new fluid deficit recommendations.
Summary Statements: RECOMMENDATIONS.
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| http://dx.doi.org/10.1016/j.jogc.2024.102641 | DOI Listing |
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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.
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