A randomised comparison of microwave endometrial ablation with transcervical resection of the endometrium: follow up at a minimum of 10 years.
OBJECTIVE
To compare outcomes and further operations at a minimum of 10 years following microwave endometrial ablation (MEA) or transcervical resection of the endometrium (TCRE).


METHODS
Follow up of a randomised controlled trial using postal questionnaires and operative databank review.


METHODS
Gynaecology department of a large UK teaching hospital.


METHODS
Women's satisfaction with treatment, menstrual symptoms, changes in health-related quality of life, and additional treatments received.


RESULTS
One-hundred and eighty-nine of the original 263 women returned questionnaires (72%) after a minimum of 10 years post-treatment. Those totally or generally satisfied with treatment numbered 77/129 (60%) in the microwave arm and 70/134 (52%) in the resection arm, the difference is not statistically significant. Bleeding and pain scores were highly significantly reduced and similar following both MEA and TCRE, achieving amenorrhoea rates of 83 and 88% respectively. The hysterectomy rate after 10 years was significantly different with 22 (17%) in the MEA and 38 (28%) in the TCRE arm (95% CI: -0.21, -0.13).


CONCLUSIONS
Both techniques achieve significant and comparable improvements in menstrual symptoms, health-related quality of life and high rates of satisfaction. With the known operative advantages, lower costs and fewer hysterectomies, it is clear that MEA is a more effective and efficient treatment for heavy menstrual loss than TCRE.
Department of Obstetrics and Gynaecology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, UK.
A M
AM
Sambrook
C
C
Bain
D E
DE
Parkin
K G
KG
Cooper
D000328:Adult; D055356:Endometrial Ablation Techniques / Q000379:methods* / Q000523:psychology; D005260:Female; D006801:Humans; D008019:Life Style; D008595:Menorrhagia / Q000523:psychology / Q000601:surgery*; D008872:Microwaves / Q000627:therapeutic use*; D017060:Patient Satisfaction; D011788:Quality of Life