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Microwave endometrial ablation versus endometrial resection: a randomized controlled trial
Christine Bain1, Kevin G Cooper, David E Parkin
1Department of Obstetrics and Gynaecology, Aberdeen Royal Infirmary, Scotland, Aberdeen, UK. bainhouse@supanet.com
Objective:
To compare menstrual status, satisfaction, and acceptability of microwave endometrial ablation with transcervical endometrial resection for the treatment of heavy menstrual bleeding.
Methods:
Women were randomized to either endometrial ablative method. Menstrual status, satisfaction, acceptability, and changes in health-related quality of life were obtained by a self-completed questionnaire. Case note review and personal communication identified further surgery rates at 2 years after each procedure.
Results:
Among the original 263 women who underwent endometrial ablation, 249 (95%) returned questionnaires at 2 years. Menstrual status in both groups was similar, although the amenorrhea rate was higher after microwave endometrial ablation. Seventy-nine percent of women were either completely or generally satisfied after microwave ablation compared with 67% after transcervical endometrial resection. Health-related quality-of-life scores remained higher than at recruitment for both treatments. Hysterectomy rates were similar at 2 years (11.6% after microwave endometrial ablation and 12.7% after transcervical endometrial resection), and no repeat endometrial ablative procedures were required.
Conclusion:
Microwave endometrial ablation is an effective alternative to transcervical endometrial resection for dysfunctional uterine bleeding.