Hysterectomy Subsequent to Endometrial Ablation

Shavell VI, Valerie I. Shavell, Michael P. Diamond, James P. Senter, Michael Krüger, Kruger ML, Michael L Kruger, D. Alan Johns, Johns DA
Journal of Minimally Invasive Gynecology · 2012 · vol. 19(4) , pp. 459–464 · doi:10.1016/j.jmig.2012.03.013 · PMID:22658475 · W2116812484
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This paper reviews the indications, outcomes, and complications associated with hysterectomy performed after endometrial ablation.

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Abstract

Study objectiveTo estimate the incidence of and factors associated with hysterectomy subsequent to endometrial ablation.DesignRetrospective cohort study (Canadian Task Force classification II-2).SettingGynecology practice.PatientsWomen who underwent endometrial ablation from January 2003 to June 2010, with a minimum follow-up of 9 months.InterventionsEndometrial ablation and hysterectomy.Measurements and main resultsOf 1169 women, 157 (13.4%) underwent hysterectomy subsequent to endometrial ablation. Women who underwent subsequent hysterectomy were significantly younger at ablation (mean [SD; 95% CI] 39.0 [6.8; 38.0-40.1] years vs 41.4 [7.0; 41.0-41.9] years; p < .001) and were more likely to have previously delivered via cesarean section (26.3 vs 18.1%; p = .02). The rate of hysterectomy was significantly associated with the type of ablation performed: 33.0% for rollerball vs 16.5% for thermal balloon (p = .003), 11.0% for radiofrequency (p < .001), and 9.8% for cryoablation (p < .001). Time to hysterectomy also differed significantly based on the type of ablation performed (p = .006). Adenomyosis was present in 44.4% of hysterectomy specimens.ConclusionWith a mean follow-up of 39 months, 13.4% of women underwent hysterectomy subsequent to ablation. Women who were younger at ablation had an increased likelihood of hysterectomy. Rate and time to hysterectomy were associated with the type of ablation performed.

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Condition tags

endometriosis

MeSH descriptors

Endometrial Ablation Techniques Endometriosis Hysterectomy Uterine Diseases Adult Age Factors Catheter Ablation Cesarean Section Chi-Square Distribution Cryosurgery Endometrial Ablation Techniques Endometriosis Female Humans Hysterectomy Kaplan-Meier Estimate Menorrhagia Menorrhagia Middle Aged Proportional Hazards Models

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