Thermal balloon ablation versus laparoscopic supracervical hysterectomy for the surgical treatment of heavy menstrual bleeding: A randomized study

Abstract

The effectiveness of TBA as a possible treatment of HMB is confirmed. However, LSH showed a definitive improvement of the symptoms, and a better life quality profile. Further controlled prospective studies are required for identifying the best surgical approach in women with HMB.

Randomized controlled trial of thermal balloon ablation versus vaginal hysterectomy for leiomyoma-induced heavy menstrual bleeding

“…The present study showed similar postoperative pain patterns in both groups at all timepoints, but the pain score was significantly higher in the VH group. Soysal et al [10] showed a linear pain score at 12 hours (3.1 ± 1.7) for both TBA and roller ball ablation, and a similar observation was made by Sesti et al [18], who reported that postoperative pain intensity at 24 hours was significantly lower in women treated with TBA than in those who underwent laparoscopic supracervical hysterectomy. Lakeman et al [21] compared the effects of electric bipolar vessel sealing and conventional suturing on postoperative pain and reported less pain on the evening after vessel sealing surgery (4.5 vs 5.7), with subsequent similar pain scores.…”

“…Dickersin et al [14] compared hysterectomy with roller ball ablation and TBA among women with a normal‐sized uterus without any organic pathology, and found that endometrial ablation had an 84.9% efficacy in resolving dysfunctional uterine bleeding, compared with 94.4% for hysterectomy. Sesti et al [18] performed a randomized study among women with HMB allocated to TBA or laparoscopic supracervical hysterectomy, and confirmed the effectiveness of TBA as a possible treatment for HMB. A Cochrane review [11] compared various endometrial destruction techniques with hysterectomy for HMB treatment among premenopausal women and concluded that endometrial resection and ablation are alternatives to hysterectomy because both procedures are effective and have high satisfaction rates.…”

Meta‐analysis of bipolar radiofrequency endometrial ablation versus thermal balloon endometrial ablation for the treatment of heavy menstrual bleeding

“…). One study did not include data of interest and six compared thermal balloon ablation with other surgical techniques. Therefore, six studies, involving 901 patients, were included in the present meta‐analysis.…”

Laparoscopic supracervical hysterectomy compared with second-generation endometrial ablation for heavy menstrual bleeding: the HEALTH RCT

“…8 Two small randomised trials have suggested that a less invasive form of hysterectomy, LASH, is superior to EA but with similar morbidity and recovery. 12,13 Our large, pragmatic, randomised trial was designed to determine whether or not LASH was more effective than EA without incurring additional risks or recovery time.…”

“…The procedure is quick, minimally invasive, relatively easy to learn and associated with a low risk of complications, short hospital stay (< 24 hours) and rapid recovery. 12,13 Before this technique is incorporated into routine clinical practice, it is important that it is subjected to robust evaluation. The authors of two small RCTs comparing LASH with a first-generation EA (endometrial resection 13 or second-generation EA) thermal balloon 12 suggest that LASH could lead to a better QoL, but emphasised the need for larger evaluative studies to confirm this.…”