Partial Endometrial Ablation: A 10–20-Year Follow-Up of Impact on Bleeding, Pain, and Quality of Life

Abstract

Background: In an attempt to prevent delayed complications of minimally invasive surgical treatments for heavy menstrual bleeding, the current total or global ablation technique was modified to a partial ablation teachnique (PEA) to successfully treat HMB without causing intrauterine scarring. PEA is defined as ablating or resecting only the anterior or posterior endometrial wall. Objective: The aim of this research was to demonstrate that PEA has the potential for treating abnormal uterine bleeding (AUB) successfully. Design: The study involved 269 patients who underwent PEA. Study questionnaires were sent to those patients and their charts were reviewed. Materials and Methods: This study was conducted in Sacramento, CA. It was a retrospective study consisting of chart reviews and answers to patient questionnaires. Data for pre- and post-PEA bleeding, pain and quality of life (QoL) scores were analyzed using IBM SPSS 21.0. Pre- and post-PEA blood loss during menses was measured by reported clot size. Pre- and post-PEA pain during menses was quantified by type of analgesia required for relief. Impact on QoL scores were measured as well. Patient satisfaction with the procedure was also examined. Results: There was a statistically significant decrease in clot size and pain scores. Eight percent required hysterectomy during the 17-year follow-up. In addition, there was significant improvement in QoL scores. Patient satisfaction was >95%. No hysterectomies included an indication for pain. Conclusions: PEA is a minimally invasive surgical procedure that appears to provide patients with improved QoL scores, long-term satisfaction, low hysterectomy rates, and no known long-term complications. Larger controlled studies should be conducted to assess the viability of this procedure. (J GYNECOL SURG 32:230)