title: Evaluation of the NovaSure endometrial ablation procedure in women with uterine cavity length over 10 cm.
abstract: OBJECTIVE
  To evaluate procedure-related adverse events, post-procedure menstrual bleeding status, and surgical re-intervention in women with a sounded uterine length > 10 cm compared to women with a sounded uterine length ≤ 10 cm who underwent the NovaSure endometrial ablation procedure.
  
  
  METHODS
  We conducted a retrospective cohort study of 188 women from a Canadian community-based gynaecology practice. Eighty-seven women had a sounded uterine length > 10 cm, and 101 patients had a sounded length ≤ 10 cm. Procedure-related adverse events, post-procedure menstrual bleeding status, and surgical re-interventions were compared between groups.
  
  
  RESULTS
  Mean uterine sounding lengths were 11.0 ± 0.6 cm and 8.9 ± 0.8 cm in the > 10 cm and ≤ 10 cm groups, respectively. There were no differences between the groups in demographic characteristics or gynaecologic history, with the exception of higher BMI in the > 10 cm group and a greater prevalence of dysmenorrhea in the ≤ 10 cm group. Overall, 44.1% of all participants had been unsuccessfully treated with hormonal therapy, and 20.7% had failed non-hormonal treatment before the ablation procedure. The remaining 35.2% of participants had declined alternative therapy and proceeded directly to endometrial ablation. No serious procedure-related adverse events occurred in either group. Menstrual bleeding status at follow-up at 30.4 ± 15.3 months (> 10 cm group) and 30.5 ± 15.5 months (≤ 10 cm group) was not different between the groups (P = 0.85). In women who did not undergo surgical re-intervention after the initial ablation, amenorrhea was reported by 51.9% in the > 10 cm group and 65.9% in the ≤ 10 cm group.
  
  
  CONCLUSIONS
  The NovaSure endometrial ablation procedure was associated with successful menstrual bleeding outcomes in women with sounded uterine length > 10 cm. No serious procedure-related adverse events occurred, and the need for surgical re-intervention was low. There was no significant difference in bleeding rates between the > 10 cm and ≤ 10 cm uterine length cohorts.
authors.affiliation: University of Saskatchewan, Department of Obstetrics, Gynecology and Reproductive Sciences, Regina SK.
authors.forename: John A
authors.initials: JA
authors.lastname: Thiel
authors.affiliation: Regina Qu'Appelle Health Region, Regina SK.
authors.forename: M Martha
authors.initials: MM
authors.lastname: Briggs
authors.affiliation: Hologic Inc, Marlborough MA.
authors.forename: Scott
authors.initials: S
authors.lastname: Pohlman
authors.affiliation: University of Saskatchewan, Department of Obstetrics, Gynecology and Reproductive Sciences, Regina SK.
authors.forename: Darrien
authors.initials: D
authors.lastname: Rattray
mesh_terms: D000328:Adult; D015331:Cohort Studies; D055356:Endometrial Ablation Techniques / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D009929:Organ Size; D012086:Reoperation; D012189:Retrospective Studies; D014599:Uterus / Q000033:anatomy & histology* / Q000601:surgery*
keywords: NovaSure; endometrial ablation; large uteri; menorrhagia; uterine sound