Endometrial ablation for heavy menstrual bleeding

Munro, Malcolm G.

doi:10.1097/01.gco.0000175356.25932.c0

Cited by 8 publications

(5 citation statements)

References 77 publications

(75 reference statements)

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“…The coexistence of other gynaecological pathology, such as adenomyosis or myomas, is associated with increased failure rates. The most important effect is that of age: women over the age of 45 are least likely to need further surgery after endometrial ablation and are probably the ideal candidates for this approach 52 …”

Section: Factors Affecting the Success Of Endometrial Ablationmentioning

confidence: 99%

“…The most important effect is that of age: women over the age of 45 are least likely to need further surgery after endometrial ablation and are probably the ideal candidates for this approach. 52 Cost implications for the National Health Service NICE 53 estimates that if all hysterectomies were to be replaced by endometrial ablation using secondgeneration devices, the NHS would save £32 million per year. NICE concedes that this assumption is simplistic, as some women will invariably need or prefer hysterectomy.…”

Section: Factors Affecting the Success Of Endometrial Ablationmentioning

confidence: 99%

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Current minimal access techniques in the treatment of heavy menstrual bleeding

Justin

Ibraheim

Bagtharia

et al. 2007

The Obstetric & Gynaecologis

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Key content Heavy menstrual bleeding remains a major problem for some women. Hysterectomy is the leading treatment for this condition but it is recognised to have some serious complications. First‐generation endometrial ablation techniques have a steep learning curve and are carried out under hysteroscopic visualisation. Second‐generation techniques are simpler and have lower complication rates, lower analgesia requirements and potential for outpatient use. Individual assessment is important in deciding the route and method of treatment for heavy menstrual bleeding, taking clinical factors into consideration. Learning objectives To know about the various options currently available for endometrial ablation. To learn about the clinical application, advantages and limitations of various methods of endometrial ablation. To be able to make an informed choice when deciding which modality to use. Ethical issues Intense competition will continue to drive device manufacturers to make claims of effectiveness based on poor‐quality evidence. All users have a responsibility to be well informed and to offer evidence‐based advice to women. Please cite this article as: Justin W, Ibraheim M, Bagtharia S, Haloob R. Current minimal access techniques in the treatment of heavy menstrual bleeding. The Obstetrician & Gynaecologist 2007;9:223–232.

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Section: Factors Affecting the Success Of Endometrial Ablationmentioning

confidence: 99%

Section: Factors Affecting the Success Of Endometrial Ablationmentioning

confidence: 99%

Current minimal access techniques in the treatment of heavy menstrual bleeding

Justin

Ibraheim

Bagtharia

et al. 2007

The Obstetric & Gynaecologis

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“…7,12 Factores que pueden afectar los resultados de la ablación endometrial Las mujeres mayores de 45 años parecen ser menos propensas a una histerectomía posterior y es más probable conseguir la amenorrea y un resultado satisfactorio que en las menores de 45 años. 26,27 La experiencia y/o la habilidad del cirujano también son consideradas importantes en el resultado de la cirugía. Se ha descrito que la tasa de histerectomía posterior a la ablación puede ser de 12,6%, cuando la resección endometrial es llevada a cabo por un cirujano experimentado, en comparación con el 38% si la totalidad o parte del procedimiento no es realizado por el experto.…”

Section: Complicacionesunclassified

Ablación endometrial: Tipos, técnicas y evidencias de su utilidad. revisión de la literatura

Daza¹,

Miranda²,

Aguilar³

2014

Repert. Med. Cir.

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La ablación endometrial se introdujo como alternativa a la histerectomía en el manejo de la menorragia, problema muy común e incapacitante, con afectación en la calidad de vida de las mujeres en edad reproductiva. Consiste en remover o destruir todo el espesor del endometrio, con el fin de lograr la oligo o amenorrea. Se han descrito dos generaciones de técnicas: las de primera generación eliminan el espesor completo del endometrio bajo visualización directa con un instrumental electroquirúrgico. Las de segunda generación dependen de un dispositivo que se inserta en la cavidad uterina y libera energía térmica para destruir el endometrio. Aunque son procedimientos conocidos a nivel mundial, en nuestro país existen pocos estudios y la técnica no ha sido muy difundida. Se realiza la revisión de la literatura acerca del estado del arte de las técnicas de ablación endometrial, con una explicación, indicaciones, complicaciones y ventajas. Se plantean estrategias para futuros estudios que puedan ser de utilidad en la práctica de los servicios de ginecología en Colombia.

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“…Another group [46] compared clinical outcomes and quality of life questionnaires between three second-generation techniques and laser ablation in a descriptive cohort study. The reader may also seek additional information on first-generation ablation devices from a recent review on the subject [48 ]. A recent systematic review [47 ] assessed MEA with Thermachoice 1, and concluded that as no head-to-head trials have been performed between the two techniques, there was not enough evidence of differences in terms of clinical effectiveness to recommend one over another.…”

Section: Comparisons Between Techniquesmentioning

confidence: 99%

Clinical and health service implications of second generation endometrial ablation devices

Amso¹

2006

Current Opinion in Obstetrics &Amp; Gynecology

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Where appropriate, second-generation devices are rapidly becoming the first-line surgical choice for the management of heavy menstrual bleeding. This has both cost-savings and negative implications for the health service. There is also emerging evidence that improvement in quality of life is more relevant to women than amenorrhoea rates. What has come to light from this review is the lack of accurate data on adverse events rate, and the urgent need for a better appreciation of the frequency and nature of complications.

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Endometrial ablation for heavy menstrual bleeding

Abstract: Both REA and NREA provide at least short- to intermediate-term options to hysterectomy for patients with heavy menstrual bleeding and normal or near-normal endometrial cavities. Consequently, the ideal candidates are likely those who are within 5 years of menopause.

Cited by 8 publications

References 77 publications

Current minimal access techniques in the treatment of heavy menstrual bleeding

Current minimal access techniques in the treatment of heavy menstrual bleeding

Ablación endometrial: Tipos, técnicas y evidencias de su utilidad. revisión de la literatura

Clinical and health service implications of second generation endometrial ablation devices

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