Hysterectomy subsequent to endometrial ablation.
OBJECTIVE
To estimate the incidence of and factors associated with hysterectomy subsequent to endometrial ablation.


METHODS
Retrospective cohort study (Canadian Task Force classification II-2).


METHODS
Gynecology practice.


METHODS
Women who underwent endometrial ablation from January 2003 to June 2010, with a minimum follow-up of 9 months.


METHODS
Endometrial ablation and hysterectomy.


RESULTS
Of 1169 women, 157 (13.4%) underwent hysterectomy subsequent to endometrial ablation. Women who underwent subsequent hysterectomy were significantly younger at ablation (mean [SD; 95% CI] 39.0 [6.8; 38.0-40.1] years vs 41.4 [7.0; 41.0-41.9] years; p < .001) and were more likely to have previously delivered via cesarean section (26.3 vs 18.1%; p = .02). The rate of hysterectomy was significantly associated with the type of ablation performed: 33.0% for rollerball vs 16.5% for thermal balloon (p = .003), 11.0% for radiofrequency (p < .001), and 9.8% for cryoablation (p < .001). Time to hysterectomy also differed significantly based on the type of ablation performed (p = .006). Adenomyosis was present in 44.4% of hysterectomy specimens.


CONCLUSIONS
With a mean follow-up of 39 months, 13.4% of women underwent hysterectomy subsequent to ablation. Women who were younger at ablation had an increased likelihood of hysterectomy. Rate and time to hysterectomy were associated with the type of ablation performed.
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit Medical Center, Detroit, Michigan 48201, USA. vshavell@med.wayne.edu
Valerie I
VI
Shavell
Michael P
MP
Diamond
James P
JP
Senter
Michael L
ML
Kruger
D Alan
DA
Johns
D000328:Adult; D000367:Age Factors; D017115:Catheter Ablation; D002585:Cesarean Section; D016009:Chi-Square Distribution; D003452:Cryosurgery; D055356:Endometrial Ablation Techniques / Q000706:statistics & numerical data*; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D053208:Kaplan-Meier Estimate; D008595:Menorrhagia / Q000601:surgery; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014591:Uterine Diseases / Q000601:surgery*