title: Effect of Radiofrequency Endometrial Ablation on Dysmenorrhea.
abstract: To examine rates of dysmenorrhea after radiofrequency endometrial ablation in patients with and without known dysmenorrhea symptoms prior to the procedure in a diverse population.
  
  
  
  Retrospective cohort study (Canadian Task Force classification II-2).
  
  
  
  Academic gynecology practice.
  
  
  
  A total of 307 women underwent endometrial ablation between 2007 and 2013 at our institution. Patients who had preoperative and postoperative pain symptom assessments as well as a description of pain timing recorded were included in our analysis. Exclusion criteria were age <19 years and operative biopsy findings consistent with complex atypical hyperplasia.
  
  
  
  The difference in preoperative and postoperative rates of dysmenorrhea was evaluated. Demographic information and other outcome variables were used to evaluate factors associated with resolution of dysmenorrhea.
  
  
  
  A total of 307 patients who underwent radiofrequency endometrial ablation were identified. After exclusions, 296 charts were examined, and 144 patients met our enrollment criteria. The mean age of the study cohort was 45.4 ± 6.2 years; 57 patients (40%) were African American, 16 (11%) had a body mass index (BMI) > 40, and 41 (29%) were of normal weight. Preoperative dysmenorrhea was reported by 100 patients (69%); 48 of these patients (48%) experienced resolution of symptoms postoperatively. Only 3 of the 44 patients (7%) without preoperative dysmenorrhea reported new-onset dysmenorrhea postoperatively. Significantly fewer patients had dysmenorrhea after compared to before radiofrequency ablation (55 of 144 [38%] vs 100 of 144 [69%]; p < .001). Resolution of dysmenorrhea after ablation was associated with reduction in bleeding volume (p = .048) but not with a reduction in frequency of bleeding (p = .12).
  
  
  
  Approximately one-half of women who undergo radiofrequency endometrial ablation to treat heavy menstrual bleeding who also have preoperative dysmenorrhea exhibit documented pain resolution after the procedure. Resolution of dysmenorrhea is more likely if menstrual flow volume is decreased postprocedure.
authors: Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Electronic address: Sabrina-Wyatt@ouhsc.edu.
authors: Sabrina N
authors: SN
authors: Wyatt
authors: Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL.
authors: Taylor
authors: T
authors: Banahan
authors: Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL.
authors: Ying
authors: Y
authors: Tang
authors: School of Medicine, University of Alabama at Birmingham, Birmingham, AL.
authors: Kavita
authors: K
authors: Nadendla
authors: Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL; Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL.
authors: Jeff M
authors: JM
authors: Szychowski
authors: Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL.
authors: Todd R
authors: TR
authors: Jenkins
mesh_terms: D000328:Adult; D000407:Alabama; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D015331:Cohort Studies; D004412:Dysmenorrhea / Q000209:etiology*; D055356:Endometrial Ablation Techniques / Q000009:adverse effects / Q000379:methods; D004714:Endometrial Hyperplasia / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Abnormal uterine bleeding; Dysmenorrhea; Endometrial ablation; Heavy menstrual bleeding; Pelvic pain