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Endometrial ablation.

Malcolm G Munro1

  • 1Department of Obstetrics & Gynecology, David Geffen School of Medicine at UCLA, Director of Gynecologic Services, Kaiser Permanente, Los Angeles Medical Center, Los Angeles, CA, United States.

Best Practice & Research. Clinical Obstetrics & Gynaecology
|November 13, 2017
PubMed
Summary
This summary is machine-generated.

Endometrial ablation (EA) offers a low-risk alternative to hysterectomy for heavy menstrual bleeding (HMB). This review clarifies EA techniques, dispelling myths about "generation" and "global" devices, and compares outcomes to other treatments.

Keywords:
Abnormal uterine bleedingEndometrial ablationGlobal ablationHeavy menstrual bleedingMenorrhagia

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Area of Science:

  • Gynecology
  • Minimally Invasive Surgery
  • Reproductive Medicine

Background:

  • Endometrial ablation (EA) treats heavy menstrual bleeding (HMB) caused by endometrial or ovulatory disorders.
  • Current terminology mistakenly labels resectoscopic EA as "first generation" and nonresectoscopic EA (NREA) as "second generation".
  • NREA techniques predate resectoscopic methods, and the term "global" is a misleading marketing term.

Purpose of the Study:

  • To review the spectrum of endometrial ablation techniques and devices.
  • To compare clinical outcomes and adverse events of different EA methods.
  • To evaluate the value of EA compared to hysterectomy and medical therapies.

Main Methods:

  • Review of existing literature on endometrial ablation techniques and devices.
  • Analysis of clinical outcomes, including efficacy and adverse events.
  • Comparative assessment of EA against hysterectomy and medical management.

Main Results:

  • Endometrial ablation is a viable alternative to hysterectomy for women no longer desiring fertility.
  • EA procedures carry relatively low risks and are effective in reducing HMB.
  • Misconceptions regarding EA device generations and "global" application exist.

Conclusions:

  • Endometrial ablation is an effective treatment for HMB, offering an alternative to hysterectomy.
  • Clarification of terminology and device capabilities is needed.
  • Further comparative studies are valuable for treatment selection.