Postablation Risk Factors for Pain and Subsequent Hysterectomy

Abstract

Patient characteristics should be considered when counseling patients about the possible outcomes of endometrial ablation. A significant portion of ablations are complicated by postablation pain.

Long-term Follow-up After Endometrial Ablation in Finland

“…In several studies, young age at endometrial ablation is a significant risk factor for hysterectomy (19)(20)(21)(22). Leiomyomas were a significant risk factor for hysterectomy in our study as well as in a large study from England (22) and in a smaller US study (23). We also found that women with postablation hysterectomy were more likely to have prior cesarean deliveries, a finding already reported (20,23).…”

“…Leiomyomas were a significant risk factor for hysterectomy in our study as well as in a large study from England (22) and in a smaller US study (23). We also found that women with postablation hysterectomy were more likely to have prior cesarean deliveries, a finding already reported (20,23). In our study, majority of women with endometrial ablation were sterilized, which reflects the contraception policy; in Finland sterilization is strongly recommended before endometrial ablation.…”

One-Year Follow-Up Results of a Multicenter, Single-Arm, Objective Performance Criteria–Controlled International Clinical Study of the Safety and Efficacy of the Minerva Endometrial Ablation System

“…Recent US data indicate that the hysterectomy rate has remained relatively constant at 600 000 cases/year [17]. There are also concerns about the interval surgical interventions, such as reablation and/or hysterectomy, performed for recurrent menorrhagia and/or new pelvic pain [18][19][20].…”

A Randomized Controlled Multicenter US Food and Drug Administration Trial of the Safety and Efficacy of the Minerva Endometrial Ablation System: One-Year Follow-Up Results

“…Questions and concerns have been raised about high subsequent additional surgical reintervention rates, such as reablation and/or hysterectomy performed for recurrent HMB and/or new pelvic pain. These rates are reported to range between 16% and 24% [17][18][19][20][21].…”