The case against endometrial ablation for treatment of heavy menstrual bleeding

  title={The case against endometrial ablation for treatment of heavy menstrual bleeding},
  author={Michelle Louie and Kelly N. Wright and Matthew T. Siedhoff},
  journal={Current Opinion in Obstetrics and Gynecology},
Purpose of review Endometrial ablation is a common treatment for heavy menstrual bleeding, but serious limitations and long-term complications exist. Our purpose is to summarize the use of endometrial ablation devices, potential short-term and long-term complications, cost effectiveness, and quality of life in relation to alternative treatments. Recent findings There is insufficient evidence to strongly recommend one endometrial ablation device over another. Providers should consider and… Expand
Prediction of unsuccessful endometrial ablation: a retrospective study
Two multivariate models to predict the chance of failure and surgical re-intervention within 2 years after endometrial ablation are proposed and could be useful for both the doctor and patient and may contribute to the shared decision-making. Expand
Treatment of menorrhagia due to aplastic anemia by hysteroscopic resection of endometrial functional layer and levonorgestrel-releasing intra-uterine system
For young women with future fertility desire, LNG-IUS following hysteroscopic resection of endometrial functional layer is a safe and effective way against endometrian ablation or hysterectomy. Expand
Prediction of unsuccessful endometrial ablation: random forest vs logistic regression
Background Five percent of pre-menopausal women experience abnormal uterine bleeding. Endometrial ablation (EA) is one of the treatment options for this common problem. However, this technique showsExpand
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The care of a patient who declines blood transfusion may be complex, but gynecologic surgeons can safely and successfully offer a wide variety of therapies depending on the patient's goals and needs. Expand
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Cost‐effectiveness of treatments for heavy menstrual bleeding
Comparing all trade‐offs associated with 4 possible treatments of heavy menstrual bleeding, the levonorgestrel‐releasing intrauterine system was superior to both hysterectomy and endometrial ablation in terms of cost and quality of life. Expand
Endometrial resection and ablation techniques for heavy menstrual bleeding.
There was insufficient evidence to suggest superiority of a particular technique in the pairwise comparisons between individual ablation and resection methods, and in the overall comparison of the newer 'blind' techniques (second-generation) with the gold standard hysteroscopic ablative techniques (first-generation). Expand
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Individual patient data (IPD) meta-analysis of existing randomised controlled trials was used to determine the clinical effectiveness and cost-effectiveness of hysterectomy, first- and second-generation endometrial ablation (EA), and Mirena for the treatment of heavy menstrual bleeding. Expand
Hysterectomy Compared With Endometrial Ablation for Dysfunctional Uterine Bleeding: A Randomized Controlled Trial
Both endometrial ablation and hysterectomy are effective treatments in women with dysfunctional uterine bleeding, and both were effective at 24 months in solving the problem that led women to seek care, and in relieving bleeding, pain, fatigue, and other symptoms. Expand
Preoperative uterine bleeding pattern and risk of endometrial ablation failure.
Preoperative bleeding pattern did not appear to affect failure rates or the need for gynecological procedures after endometrial ablation, and other risk factors for ablation failure identified included preoperative dysmenorrhea, prior tubal ligation, and obesity. Expand
Prognostic factors for the success of endometrial ablation in the treatment of menorrhagia with special reference to previous cesarean section.
A previous Cesarean delivery is not associated with an increased risk of failure of endometrial ablation, but dysmenorrhea, a submucous myoma and longer uterine depth are. Expand
Endometrial Ablation in Women With Abnormal Uterine Bleeding Related to Ovulatory Dysfunction: A Cohort Study.
Estate of endometrial ablation is effective in women with AUB-O and can be used as an alternative to hysterectomy or in patients with contraindications to medical management of Aub-O. Expand
Randomised trial of hysterectomy, endometrial laser ablation, and transcervical endometrial resection for dysfunctional uterine bleeding
Women treated by hysteroscopic surgery had less early morbidity and a significantly shorter recovery period than those treated by hysterectomy, and Hysteroscopic surgery can be recommended as an alternative to hystEREctomy for dysfunctional uterine bleeding. Expand
Endometrial cancer after endometrial ablation vs medical management of abnormal uterine bleeding.
No difference was observed in endometrial cancer rates, and there was no delay in diagnosis when comparingendometrial ablation vs medical management, according to Cox models. Expand
Endometrial ablation: postoperative complications.
  • H. Sharp
  • Medicine
  • American journal of obstetrics and gynecology
  • 2012
Physicians performing endometrial ablation should be aware of postoperative complications and be able to diagnose and provide treatment for these conditions. Expand