title: Ten-year follow-up of a randomised controlled trial comparing bipolar endometrial ablation with balloon ablation for heavy menstrual bleeding.
abstract: OBJECTIVE
  Previously, we have reported that, at both 12months and 5 years after treatment, bipolar endometrial ablation is superior to balloon ablation in the treatment of heavy menstrual bleeding. In this article, we evaluate the results at 10 years after these interventions.
  
  
  METHODS
  Ten-year follow-up of a double-blind randomised controlled trial.
  
  
  METHODS
  A teaching hospital in the Netherlands.
  
  
  METHODS
  Premenopausal women suffering from heavy menstrual bleeding.
  
  
  METHODS
  A follow-up questionnaire was sent to women 10 years after randomisation for bipolar ablation and balloon ablation (2: 1 ratio).
  
  
  METHODS
  Amenorrhoea rates, re-intervention and patient satisfaction.
  
  
  RESULTS
  At 10 years of follow-up, the response rate was 69/83 (83%) in the bipolar group and 35/43 (81%) in the balloon group. Amenorrhoea rates were 50/69 (73%) in the bipolar group and 23/35 (66%) in the balloon group [relative risk, 1.1 (95% CI, 0.83-1.5)]. Further treatment following initial ablation was reported in 21 cases, 14 in the bipolar group and nine in the balloon group [relative risk, 0.9 (95% CI, 0.63-1.3)]. Eight of these women required further treatment after 5 years, including two hysterectomies. Patient satisfaction in the bipolar group was 81% (56/69) compared with 77% (27/35) in the balloon group [relative risk, 1.1 (95% CI, 0.82-1.2)].
  
  
  CONCLUSIONS
  Ten years after treatment, the superiority of bipolar ablation over balloon ablation in the treatment of heavy menstrual bleeding was no longer evident.
authors.affiliation: Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, the Netherlands. m.herman@mmc.nl
authors.forename: M C
authors.initials: MC
authors.lastname: Herman
authors.forename: J P M
authors.initials: JP
authors.lastname: Penninx
authors.forename: B W
authors.initials: BW
authors.lastname: Mol
authors.forename: M Y
authors.initials: MY
authors.lastname: Bongers
mesh_terms: D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D004311:Double-Blind Method; D055356:Endometrial Ablation Techniques / Q000379:methods*; D004717:Endometrium / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008595:Menorrhagia / Q000601:surgery*; D009426:Netherlands; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D017697:Premenopause; D011795:Surveys and Questionnaires; D016896:Treatment Outcome