Global endometrial ablation for menorrhagia in women with bleeding disorders.
OBJECTIVE
To evaluate the efficacy of global endometrial ablation in women with bleeding disorders who presented with menorrhagia.


METHODS
A records-linkage system was used to construct a retrospective cohort of 41 women with bleeding disorders (coagulopathy) and a reference group of 111 randomly selected women without bleeding disorders from a pool of 943 women who underwent global endometrial ablation (with thermal balloon ablation technology or bipolar radiofrequency ablation technology) for menorrhagia at Mayo Clinic (Rochester, Minnesota) from January 1995 through December 2005. Demographic data, type of global endometrial ablation therapy and reablation, and hysterectomy data were extracted from the database.


RESULTS
There was no significant difference in baseline age, parity, body mass index, uterine size, type of global endometrial ablation therapy, or duration of follow-up between the groups. Two women (5%) in the coagulopathy group had hysterectomy or reablation, compared with 8 (7%) in the reference group (Fisher exact test, P=.728). A Kaplan-Meier plot showed no difference in the time to treatment failure between the groups (log-rank test, P=.534). Procedural-related complications were generally minor and infrequent (9 of 152 [6%]). Complications were equally distributed in the coagulopathy (4 of 41) and reference groups (6 of 111) (Fisher exact test, P=.267).


CONCLUSIONS
Global endometrial ablation is an effective treatment choice for women with coagulopathy presenting with menorrhagia.
El-Nashar
Sherif A
SA
Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Hopkins
Matthew R
MR
Feitoza
Simone S
SS
Pruthi
Rajiv K
RK
Barnes
Sunni A
SA
Gebhart
John B
JB
Cliby
William A
WA
Famuyide
Abimbola O
AO
D000328:Adult; D001778:Blood Coagulation Disorders / Q000139:chemically induced / Q000150:complications* / Q000503:physiopathology; D017115:Catheter Ablation / Q000379:methods*; D015331:Cohort Studies; D004717:Endometrium / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D053208:Kaplan-Meier Estimate; D017075:Laser Coagulation / Q000379:methods*; D008595:Menorrhagia / Q000150:complications / Q000601:surgery*; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome