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Comparison of clinical outcomes with low-voltage (cut) versus high-voltage (coag) waveforms during hysteroscopic
Paul T Chang1, George A Vilos, Basim Abu-Rafea
1St Joseph's Health Care, Obstetrics and Gynaecology, London, Ontario, Canada. pticog@gmail.com
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.
