Ten-year follow-up of endometrial ablation.
BACKGROUND
This paper presents a ten-year follow-up of a randomized, controlled trial which gives the long-term hysterectomy rate and patient satisfaction rate of transcervical hysteroscopic endometrial ablation in the treatment of heavy dysfunctional bleeding.


METHODS
There were 120 women enrolled in the study, from June 10, 1993 to August 31, 1995, all requiring endometrial ablation for the treatment of heavy dysfunctional bleeding. All patients were offered a clinical examination two years postoperatively. Long-term outcome was assessed by completion of a questionnaire five and ten years after initial treatment. Any new symptomatology and need for further treatment or a hysterectomy was registered. A bleeding index and the patients' satisfaction rate and acceptability of the treatment method were stated.


RESULTS
Sixty-one patients were treated by endometrial coagulation, and 59 by endometrial resection. No significant difference in the number of hysterectomies or satisfaction rate between the two groups was observed. At a ten-year follow-up, 63% of patients only had one ablation, 11% were treated twice, and 22% had a hysterectomy. Only 3% were lost to follow-up. For the group of patients above 40 years of age, only 17% had a hysterectomy. Since the two-year follow-up only six patients with one hysteroscopic treatment have had further intervention. Ninety-four percent of the women would recommend the treatment to their best female friend.


CONCLUSIONS
The long-term results show that an ablation for heavy dysfunctional bleeding is an excellent treatment. Overall 22% of patients had a hysterectomy. If the patient had no further intervention at the two-year clinical control, there was only a 6% risk of hysterectomy after a period of at least ten years.
Fürst
Stine Nymann
SN
The Department of Obstetrics and Gynaecology, Holbaek County Hospital, Smedelundsgade 60, Holbaek, DK-4300. Denmark.
Philipsen
Torben
T
Joergensen
Joergen Christian
JC
D000328:Adult; D017115:Catheter Ablation; D004717:Endometrium / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D017075:Laser Coagulation; D008595:Menorrhagia / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction; D012086:Reoperation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D016896:Treatment Outcome