A survey of preferences and practices of endometrial ablation/resection for menorrhagia in the United Kingdom.
OBJECTIVE
To survey the preferences and variations in the current use of first- and second-generation endometrial ablative techniques for menorrhagia among the consultant gynecologists in the United Kingdom, given the call for further studies to systematically compare the clinical effectiveness of the various endometrial ablation techniques.


METHODS
Postal questionnaire survey.


METHODS
One thousand, four hundred sixty consultant gynecologists in the United Kingdom.


METHODS
Preferred endometrial ablation/resection method and variations in the current practices.


RESULTS
Six hundred ten (41%) consultants responded. Of these, 449 (73%) performed endometrial ablation/resection. Thermal balloon ablation (32.1%) was the preferred method, followed by microwave endometrial ablation (29.8%), transcervical resection of the endometrial alone or combined with roller ball diathermy (18.5%), Novasure (9.8%), hydrotherm ablation (6.9%), roller ball (2%), and laser (0.9%). Patient response to treatment was assessed using clinical history (64.3%), menstrual calendar (7.6%), clinical history and menstrual calendar (21.3%), questionnaires (5.8%), and pictorial blood loss assessment charts (0.4%). A total of 52.2% used gonadotrophin releasing hormone analogues preoperatively. Variations in techniques for transcervical resection of the endometrial included methods used to treat the uterine fundus and cornuae, fluid management, and operating pressures.


CONCLUSIONS
Second-generation endometrial ablation devices were preferred to first-generation devices for the management of menorrhagia. Thermal balloon ablation was the most preferred method. However, variations in surgical practices will make assessment of clinical efficacy a challenge.
Deb
Shilpa
S
Department of Obstetrics and Gynecology, Nottingham University Hospitals, Queens Medical Centre Campus, Nottingham, United Kingdom. shilpadeb@yahoo.com
Flora
Kulwant
K
Atiomo
William
W
D001291:Attitude of Health Personnel; D003253:Consultants / Q000523:psychology / Q000706:statistics & numerical data; D003972:Diathermy; D055356:Endometrial Ablation Techniques / Q000379:methods / Q000706:statistics & numerical data; D004717:Endometrium / Q000601:surgery*; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D053685:Laser Therapy; D008595:Menorrhagia / Q000601:surgery*; D008872:Microwaves / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D006113:United Kingdom