Radiofrequency endometrial ablation for the treatment of heavy menstrual bleeding among women at high surgical risk.
OBJECTIVE
To evaluate quality of life (QoL) after radiofrequency endometrial ablation (RFEA) for heavy menstrual bleeding among women at high surgical risk.


METHODS
An observational study was undertaken among women aged at least 18 years who underwent RFEA at Hanover Medical School, Germany, between June 2010 and November 2012. A validated menorrhagia outcomes questionnaire (MOQ) was used to evaluate QoL and global outcomes among patients at high risk and low risk of complications after major surgery. The high-risk group included women with anemia, coagulopathy, anticoagulation, thromboembolism, transplantation, malignancy, severe cardiovascular or pulmonary disease, and obesity.


RESULTS
Overall, 235 women underwent RFEA during the study period. Median follow-up was 13 months (range 3-30). Questionnaire responses were received from 202 (86.0%) women, including 132 (65.3%) high-risk patients. The MOQ total outcome (mean difference 2.0; P = 0.166) and QoL/satisfaction (mean difference 0.8; P = 0.601) scores were similar in the two groups. Success (i.e. symptom relief and no further surgery) was recorded for 119 (90.2%) patients in the high-risk group and 67 (95.7%) patients in the low-risk group (P = 0.155).


CONCLUSIONS
RFEA improved QoL and achieved a high rate of satisfaction for both high- and low-risk patients. RFEA offers a less invasive alternative to hysterectomy and its associated perioperative risks, particularly among high-risk patients.
Clinic for Obstetrics and Gynecology, Hanover Medical School, Hanover, Germany.
Friederike
F
Fischer
Clinic for Obstetrics and Gynecology, Hanover Medical School, Hanover, Germany.
Rüdiger
R
Klapdor
Clinic for Obstetrics and Gynecology, Medical University Frankfurt am Main, Frankfurt am Main, Germany.
Susanne
S
Gruessner
Institute for Biostatistics, Hanover Medical School, Hanover, Germany.
Yvonne
Y
Ziert
Clinic for Obstetrics and Gynecology, Hanover Medical School, Hanover, Germany.
Peter
P
Hillemanns
Clinic for Obstetrics and Gynecology, Hanover Medical School, Hanover, Germany. Electronic address: hertel.hermann@mh-hannover.de.
Hermann
H
Hertel
D000328:Adult; D000368:Aged; D055356:Endometrial Ablation Techniques / Q000379:methods / Q000523:psychology*; D004717:Endometrium / Q000601:surgery; D005260:Female; D005858:Germany; D006801:Humans; D008595:Menorrhagia / Q000523:psychology* / Q000601:surgery; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors
Heavy menstrual bleeding; High surgical risk; Quality of life; Radiofrequency endometrial ablation