title: Efficacy and safety of endometrial ablation for treating abnormal uterine bleeding in pre- and postmenopausal women with liver cirrhosis.
abstract: OBJECTIVE
  Abnormal uterine bleeding (AUB) occurs in 10-30% of women of reproductive age and up to 61% of cirrhotic women. We evaluated the efficacy and safety of endometrial ablation (NovaSure therapy) for AUB in cirrhotic women.
  
  
  METHODS
  This prospective, two-arm, observational study enrolled patients for NovaSure treatment, and they were followed for 12 months. Primary measurements were the amenorrhea rate and changes of pictorial blood loss assessment chart (PBLAC) scores at 1-month post-therapy. Key secondary end-points included the longevity of amenorrhea at 12 months, safety profile, and progression of cirrhosis.
  
  
  RESULTS
  Among 88 women, 26 were cirrhotic and 62 were non-cirrhotic. At 1-month post-NovaSure treatment, a significant reduction of mean PBLAC scores was observed in cirrhotic patients compared to those at baseline (0.4 ± 1.3 vs 215.2 ± 410.9, P < 0.001), and the amenorrhea rate was 88.5%. The efficacy outcomes of the PBLAC scores and amenorrhea rate were maintained until the end of the 12-month follow-up. A significant improvement in quality of life scores was observed 1-month post-therapy compared to those at baseline (5.4 ± 3.1 vs 20.5 ± 5.5, P < 0.001). Patients' satisfaction rates were 100% and 92.31% at 6 and 12 months, respectively. The aforementioned outcomes were comparable with those in non-cirrhotic patients. No significant progression of cirrhosis or safety concern was reported.
  
  
  CONCLUSIONS
  Cirrhotic patients on NovaSure therapy had a high rate of amenorrhea 1-month post-treatment, which maintained longevity for 12 months. The safety profile was similar to that in non-cirrhotic patients.
authors.affiliation: Department of Obstetrics and Gynecology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of Obstetrics and Gynecology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
authors.forename: Xiu-Lan
authors.initials: XL
authors.lastname: Li
authors.affiliation: Department of Obstetrics and Gynecology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
authors.forename: Ji-Juan
authors.initials: JJ
authors.lastname: Liu
authors.affiliation: Department of Obstetrics and Gynecology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
authors.forename: Xiao-Hong
authors.initials: XH
authors.lastname: Song
authors.affiliation: Department of Obstetrics and Gynecology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
authors.forename: Xiao-Ying
authors.initials: XY
authors.lastname: Jiang
authors.affiliation: Department of Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Obstetrics and Gynecology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Center for Major Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.|Division of Gastroenterology and Hepatology, Department of Medicine, NYU Langone Medical Center, New York University School of Medicine, New York, USA.
authors.forename: Calvin Q
authors.initials: CQ
authors.lastname: Pan
mesh_terms: D000328:Adult; D000568:Amenorrhea; D055356:Endometrial Ablation Techniques / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008875:Middle Aged; D017060:Patient Satisfaction; D017698:Postmenopause; D017697:Premenopause; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000150:complications / Q000601:surgery*
keywords: NovaSure; abnormal uterine bleeding; endometrial ablation; hepatic cirrhosis