The long-term effectiveness of endometrial laser ablation: a survival analysis.
OBJECTIVE
To assess the long-term effectiveness of endometrial laser ablation and factors that predict long-term outcome.


METHODS
A university teaching hospital.


METHODS
Postal questionnaires were sent to all women who underwent endometrial laser ablation between 1992 and 1998.


RESULTS
Of 215 patients who underwent endometrial laser ablation, 174 (80.9%) returned the questionnaire. Duration of follow-up was 1.5-9 years. The procedure was reported as a success by 138 (79.3%) and a failure by 36 (20.7%). Twenty-four patients (13.8%) subsequently underwent hysterectomy for excessive bleeding. Using survival curve estimates the percentage that remained free of failure was 95.3% at 1 year and 76.2% at 4 years. Increasing patient age was significantly associated with reduced risk of failure (hazard ratio 0.91 for every year increase in age). An inexperienced operator significantly increased the hazard of failure.


CONCLUSIONS
Endometrial laser ablation is effective in the long-term in the majority (76.2%) of patients. Older women can expect to have a lower risk of failure.
Shankar
Meena
M
Department of Obstetrics and Gynecology, Leicester Royal Infirmary, Leicester LE2 5WW, UK.
Naftalin
Nicholas J
NJ
Taub
Nick
N
Habiba
Marwan
M
D000328:Adult; D000367:Age Factors; D004717:Endometrium / Q000601:surgery*; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008599:Menstruation Disturbances / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D012086:Reoperation; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000473:pathology / Q000601:surgery; D014599:Uterus / Q000473:pathology