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
Observational OA: closed CC0 ⤵ 10 in-corpus citations
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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 OBJECTIVE: To estimate the incidence of and factors associated with hysterectomy subsequent to endometrial ablation. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2). SETTING: Gynecology practice. PATIENTS: Women who underwent endometrial ablation from January 2003 to June 2010, with a minimum follow-up of 9 months. INTERVENTIONS: Endometrial ablation and hysterectomy. MEASUREMENTS AND MAIN RESULTS: Of 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. CONCLUSION: With 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 Adult Age Factors Age Factors Catheter Ablation Catheter Ablation Cesarean Section Cesarean Section Chi-Square Distribution Chi-Square Distribution Cryosurgery Cryosurgery Endometrial Ablation Techniques Endometrial Ablation Techniques Endometriosis Endometriosis

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References (21)

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