When second-generation endometrial ablation fails—a review of 200 cases of endometrial ablation

Abstract

Menorrhagia is the most common reason for gynaecological consultation in the UK [1]. Historically, when medical therapy for menorrhagia failed, hysterectomywas the primary surgical option. Endometrial ablation has emerged as a minimally invasive alternative to hysterectomy. Newer ‘second-generat ion ’ endomet r i a l ab la t ion techn iques such as THERMACHOICE® and NovaSure® have been developed. Published reports focus primarily on first-generation methods and describe a wide range of hysterectomy rates ranging from 8–29 % [2–9]. To improve our knowledge of how to best counsel patients considering endometrial ablation, we conducted a retrospective review analysis of patients who underwent second-generation endometrial ablation. Our goal was to estimate the relative importance of age of onset of menorrhagia, BMI, parity, presence of dysmenorrhoea, previous normal vaginal deliveries/caesarean sections, and type of endometrial ablation in predicting endometrial ablation failure as defined by subsequent hysterectomy.