Ten-Year Follow-Up of a Randomized Controlled Trial Comparing Bipolar Endometrial Ablation With Balloon Ablation for Heavy Menstrual Bleeding

Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, the Netherlands.
BJOG An International Journal of Obstetrics & Gynaecology (Impact Factor: 3.45). 07/2013; 120(8):966-70. DOI: 10.1111/1471-0528.12213
Source: PubMed


Previously, we have reported that, at both 12 months and 5 years after treatment, bipolar endometrial ablation is superior to balloon ablation in the treatment of heavy menstrual bleeding. In this article, we evaluate the results at 10 years after these interventions.
Ten-year follow-up of a double-blind randomised controlled trial.
A teaching hospital in the Netherlands.
Premenopausal women suffering from heavy menstrual bleeding.
A follow-up questionnaire was sent to women 10 yearsafter randomisation for bipolar ablation and balloon ablation (2 : 1 ratio).
Amenorrhoea rates, re-intervention and patient satisfaction.
At 10 years of follow-up, the response rate was 69/83 (83%) in the bipolar group and 35/43 (81%) in the balloon group. Amenorrhoea rates were 50/69 (73%) in the bipolar group and 23/35 (66%) in the balloon group [relative risk, 1.1 (95% CI, 0.83-1.5)]. Further treatment following initial ablation was reported in 21 cases, 14 in the bipolar group and nine in the balloon group [relative risk, 0.9 (95% CI, 0.63-1.3)]. Eight of these women required further treatment after 5 years, including two hysterectomies. Patient satisfaction in the bipolar group was 81% (56/69) compared with 77% (27/35) in the balloon group [relative risk, 1.1 (95% CI, 0.82-1.2)].
Ten years after treatment, the superiority of bipolarablation over balloon ablation in the treatment of heavy menstrual bleeding was no longer evident.

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    • "Technical skill requirements are another potential barrier to the use of resectoscopic ablation, since, currently, many surgeons are less experienced with these techniques. . Bipolar radiofrequency was compared with heated liquid filled balloon ablation in a randomized trial of 126 women[7]. There were no operative complications in either group. "

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