title: Outcomes of monopolar versus bipolar endometrial ablation on uterine bleeding and psychophysical wellbeing.
abstract: BACKGROUND
  To compare outcomes of endometrial ablation with monopolar versus bipolar resection on uterine bleeding and psychophysical wellbeing.
  
  
  METHODS
  In a prospective randomized study, 100 perimenopausal patients, without desire of pregnancy and with no response to pharmacological treatment, underwent endometrial ablation from 2012 to 2014. They were randomly divided in two groups: 50 patients treated with monopolar electrode resection loop (group A) and 50 patients treated with bipolar electrode resection loop (group B). Operative parameters were immediately assessed. Menstrual outcome parameters and psycho-physical well-being parameters were evaluated after 12 months.
  
  
  RESULTS
  No significant difference in operating time was recorded between the two groups. No serious hysteroscopic complication occurred with a similar immediate cumulative complication rate but two cases of intravasation were recorded in group A. The late cumulative complication rate was higher in group A than group B (44% vs. 24%). Cycle was overall controlled in over the 80% of the cases in the two groups without significant difference. The analysis of Short Form-36 showed an improvement of all assessed items after the endometrial ablation without significant difference.
  
  
  CONCLUSIONS
  Hysteroscopic endometrial ablation performed with bipolar loop electrode is as effective as resectoscopy with unipolar loop electrode regarding menstrual and psychophysical wellbeing outcomes. Endometrial ablation with bipolar electrode loop is safer but more expansive than monopolar electrode loop.
authors.affiliation: Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Naples, Italy - pasquale.defranciscis@unina2.it.
authors.forename: Pasquale
authors.initials: P
authors.lastname: DE Franciscis
authors.affiliation: Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Naples, Italy.
authors.forename: Flavio
authors.initials: F
authors.lastname: Grauso
authors.affiliation: Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Naples, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Cobellis
authors.affiliation: Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Naples, Italy.
authors.forename: Enrico M
authors.initials: EM
authors.lastname: Messalli
authors.affiliation: Department of Health Promotion Sciences and Mother-Child Care, University of Palermo, Palermo, Italy.
authors.forename: Gaspare
authors.initials: G
authors.lastname: Cucinella
authors.affiliation: Department of Health Promotion Sciences and Mother-Child Care, University of Palermo, Palermo, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Perino
authors.affiliation: Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Naples, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Colacurci
authors.affiliation: Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Naples, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Torella
mesh_terms: D004566:Electrodes; D055356:Endometrial Ablation Techniques / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D008875:Middle Aged; D061646:Operative Time; D047648:Perimenopause; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000601:surgery*