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Dr. Anita Kant, Chairman & Head Department of Gynae & Obstetrics, Asian Institute of Medical Sciences, Faridabad 27 June 2023
Nearly 13% of women who undergo endometrial ablation for heavy menstrual bleeding are at risk of hysterectomy within 5 years of the procedure, according to a new study reported in the journal Obstetrics & Gynecology.1
Oderkerk et al conducted this systematic review and meta-analysis of published studies on endometrial ablation from 1992 through 2017 to evaluate the risk of hysterectomy after nonresectoscopic endometrial ablation in patients with heavy menstrual bleeding. After a search of the Medline, Embase, Cochrane and ClinicalTrials.gov databases, 53 studies involving 48,071 patients were included in the final analysis. There were 24 randomized controlled trials, 23 prospective studies and six retrospective studies. All studies had a minimum follow-up duration of one year. These studies used different endometrial ablation techniques such as thermal balloon, microwave, radiofrequency or a combination of these.
Results showed that one year after the endometrial ablation in patients with heavy menstrual bleeding, the risk of hysterectomy increased to 4.3%. At 2 years, the risk increased to 8.0%, at 4 years, it was 7.6% and at 5 years, the risk increased to 12. 4%. The rates of hysterectomy did not differ much among the different nonresectoscopic endometrial ablation devices.
This study points out the high probability of hysterectomy after endometrial ablation.. It further suggests that patients must be counselled about the heightened risk of hysterectomy post-endometrial ablation for informed decision-making.
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