The effect of increasing age on the outcome of hysteroscopic endometrial resection for management of dysfunctional uterine bleeding

Seidman, Daniel S.; Bitman, G.; Mashiach, Shlomo; Hart, Shraga; Goldenberg, Mordechai

doi:10.1016/s1074-3804(00)80020-1

Cited by 29 publications

(6 citation statements)

References 21 publications

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“…The existence of uterine myomas at the time of ablation can be considered a risk factor for the subsequent need for hysterectomy [12]. It has previously been shown that the success rate of EA declines with the length of follow-up [12,13]. In our study, a complete clinical examination was done and we did not include any cases with large uterine size (larger than the size at 12 weeks’ gestation) and pelvic-adnexal pathology.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Study of Rollerball Endometrial Ablation in the Management of Refractory Recurrent Symptomatic Endometrial Hyperplasia without Atypia

Avci

Sadık²,

Uçar

2012

Gynecol Obstet Invest

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Backgrounds: Menorrhagia – heavy, extended or irregular menstruations – may be associated with endometrial hyperplasia. The aim of this study was to evaluate the clinical efficacy and safety of transcervical rollerball endometrial ablation (EA-R) and to discuss surgical outcomes in patients with simple endometrial hyperplasia without atypia who have had a history of medical treatment failure or recurrence. Methods: A prospective study was designed. Thirty women underwent EA-R. Preoperative and postoperative menstrual status, sexual activity, and satisfaction with the procedure were assessed. Complications, clinical outcomes, and need for re-intervention were evaluated. Results: No major complications occurred. All patients were discharged from hospital within 24 h. A reduction of menorrhagia was observed in patients as follows: 17 patients (56.67%) had amenorrhea, 10 (33.33%) hypomenorrhea, and 2 (6.67%) eumenorrhea. Hysterectomy was performed only in 1 patient who was unresponsive to ablation treatment. Conclusions: In selected patients who have persistent uterine bleeding not responsive to conservative therapy, low risk for future endometrial cancer, and wish to retain their uterus, EA-R treatment is safe, effective, and might be an alternative to hysterectomy with good toleration and high rate of patient satisfaction. The advantages of EA-R include low incidence of complications, lower morbidity, shorter hospitalization, and faster recovery.

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Section: Discussionmentioning

confidence: 99%

A Prospective Study of Rollerball Endometrial Ablation in the Management of Refractory Recurrent Symptomatic Endometrial Hyperplasia without Atypia

Avci

Sadık²,

Uçar

2012

Gynecol Obstet Invest

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“…147 Women over the age of 45 are less likely to have subsequent hysterectomy and more likely to be amenorrheic and satisfied with their outcome. 148,149 Experience and/or ability may be important as the hysterectomy rate has been reported at 12.6% when endometrial resection was performed exclusively by the consultant surgeon compared with 38% if all or part of the ablation was done by a trainee. 148 Adenomyosis has been associated with an increased risk of REA failure 150 and has been found frequently in hysterectomy specimens.…”

Section: Randomized Trials Comparingmentioning

confidence: 99%

Management of Heavy Menstrual Bleeding: Is Hysterectomy the Radical Mastectomy of Gynecology?

Munro¹

2007

Clinical Obstetrics &Amp; Gynecology

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Both hysterectomy for heavy menstrual bleeding and radical mastectomy for breast cancer are steeped in the history of surgery and have recently been challenged as being too radical for the disorder at hand. Radical mastectomy has largely been replaced with local removal of the tumor with subsequent radiation and/or chemotherapy. Alternatives to hysterectomy include a number of medical interventions, most notably intrauterine progestin-releasing systems, and endometrial ablation, a procedure that has a relatively high success rate and one that is now feasible for many women in an office or procedure room setting. However, although radical mastectomy rates have dropped precipitously, hysterectomy rates, at least in the United States remain relatively stable. Determining the proportion of hysterectomies that are done for heavy menstrual bleeding is difficult, largely because of coding issues, so it is difficult to measure the impact of new medical and minimally invasive surgical procedures. Nevertheless, it seems clear that many women are not exposed to the plethora of options to hysterectomy, a fact that may reflect a number of issues that may include training, skill, and financial incentives or disincentives. Clearly, options to hysterectomy are not a panacea, but if women are empowered to select from all of the options available, the rate of hysterectomy for bleeding should decrease while maintaining, or even enhancing the patient's satisfaction with care.

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“…Women over the age of 45 are less likely to have subsequent hysterectomy and more likely to be amenorrheic and satisfied with their outcome [30,31]. Surgeon experience and/or ability may also be important, as in one study the hysterectomy rate was reported to be 12.6% when endometrial resection was performed exclusively by the consultant surgeon compared to 38% if all or part of the ablation was done by a trainee [30].…”

Section: Complications Of Resectoscopic Endometrial Ablationmentioning

confidence: 99%

Endometrial ablation for heavy menstrual bleeding

Munro

2005

Current Opinion in Obstetrics and Gynecology

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The effect of increasing age on the outcome of hysteroscopic endometrial resection for management of dysfunctional uterine bleeding

Cited by 29 publications

References 21 publications

A Prospective Study of Rollerball Endometrial Ablation in the Management of Refractory Recurrent Symptomatic Endometrial Hyperplasia without Atypia

A Prospective Study of Rollerball Endometrial Ablation in the Management of Refractory Recurrent Symptomatic Endometrial Hyperplasia without Atypia

Management of Heavy Menstrual Bleeding: Is Hysterectomy the Radical Mastectomy of Gynecology?

Endometrial ablation for heavy menstrual bleeding

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