Evaluation of the NovaSure Endometrial Ablation Procedure in Women With Uterine Cavity Length Over 10 cm

Abstract

ObjectiveTo evaluate procedure-related adverse events, post-procedure menstrual bleeding status, and surgical re-intervention in women with a sounded uterine length>10cm compared to women with a sounded uterine length≤10cm who underwent the NovaSure endometrial ablation procedure. MethodsWe conducted a retrospective cohort study of 188 women from a Canadian community-based gynaecology practice. Eighty-seven women had a sounded uterine length>10cm, and 101 patients had a sounded length≤10cm. Procedure-related adverse events, post-procedure menstrual bleeding status, and surgical re-interventions were compared between groups. ResultsMean uterine sounding lengths were 11.0±0.6cm and 8.9±0.8cm in the>10cm and≤10cm groups, respectively. There were no differences between the groups in demographic characteristics or gynaecologic history, with the exception of higher BMI in the>10cm group and a greater prevalence of dysmenorrhea in the≤10cm group. Overall, 44.1% of all participants had been unsuccessfully treated with hormonal therapy, and 20.7% had failed non-hormonal treatment before the ablation procedure. The remaining 35.2% of participants had declined alternative therapy and proceeded directly to endometrial ablation. No serious procedure-related adverse events occurred in either group. Menstrual bleeding status at follow-up at 30.4±15.3months (>10cm group) and 30.5±15.5months (≤10cm group) was not different between the groups (P=0.85). In women who did not undergo surgical re-intervention after the initial ablation, amenorrhea was reported by 51.9% in the>10cm group and 65.9% in the≤10cm group. ConclusionThe NovaSure endometrial ablation procedure was associated with successful menstrual bleeding outcomes in women with sounded uterine length>10cm. No serious procedure-related adverse events occurred, and the need for surgical re-intervention was low. There was no significant difference in bleeding rates between the>10cm and≤10cm uterine length cohorts.