Comprehensive analysis of NovaSure® endometrial ablation in patients with heavy menstrual bleeding: Identifying success rate and predictive factors for post-NovaSure® hysterectomy

Kristien Meijer, Meijer K, Dune Wouters, Wouters D, Koopman K, Karen Koopman, Bijron JG, Jonathan G Bijron, Jorien M Woolderink, Woolderink JM
European journal of obstetrics, gynecology, and reproductive biology · 2025 · vol. 310 , pp. 113941 · doi:10.1016/j.ejogrb.2025.113941 · PMID:40188681
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This retrospective single-center cohort study analyzed outcomes of 469 patients with heavy menstrual bleeding undergoing NovaSure endometrial ablation, focusing on the success rate and factors predicting subsequent hysterectomy. Among 446 with successful ablation, 82.9% reported satisfaction after 3 months, with 37.3% reporting amenorrhea at that time, and 11.4% underwent hysterectomy over a mean follow-up of 18.5 months. Shorter ablation procedure duration, higher BMI, and a larger uterine cavity were significantly associated with hysterectomy, and pathology showed adenomyosis in 52.9% of removed uteri; the authors reported complications in 2.9% of procedures. This paper is centrally about endometriosis and/or adenomyosis — specifically, it reports adenomyosis presence in hysterectomy specimens following NovaSure in patients with heavy menstrual bleeding.

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Abstract

OBJECTIVE: To analyze success rate and predictive factors for post-NovaSure hysterectomy in patients with heavy menstrual bleeding. STUDY DESIGN: 469 patients undergoing NovaSure endometrial ablation (NEA) were included in this retrospective single center cohort study at Martini Hospital Groningen, the Netherlands. The outcomes of these procedures and predictive factors for undergoing additional post-Novasure hysterectomy were analyzed. RESULTS: Of 446 patients undergoing successful NEA ablation 82.9 % were satisfied with the results after 3 months. At this time point 37.3 % of patients reported an amenorrhea. 51 patients (11.4 %) underwent a hysterectomy during the follow-up period with a mean number of 18.5 months after NEA. A shorter duration of the ablation procedure was significantly associated with undergoing a hysterectomy (p = 0.034). Patients with a higher BMI also underwent a hysterectomy more often (p = 0.017) as well as patients with a large uterine cavity (p = 0.041). Pathology results revealed that in 27 (52.9 %) of removed uteruses adenomyosis was present. Complications occurred in 2.9 % of procedures. CONCLUSION: This study highlights the effectiveness of NEA in the setting of a large general teaching hospital and multiple characteristics associated with failure of treatment. The results of our study reaffirm the place of NEA as a safe and effective treatment for patients with menorrhagia.
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Abstract

Objective: To analyze success rate and predictive factors for post-NovaSure hysterectomy in patients with heavy menstrual bleeding. Study design: 469 patients undergoing NovaSure endometrial ablation (NEA) were included in this retrospective single center cohort study at Martini Hospital Groningen, the Netherlands. The outcomes of these procedures and predictive factors for undergoing additional post-Novasure hysterectomy were analyzed.

Results

Of 446 patients undergoing successful NEA ablation 82.9 % were satisfied with the results after 3 months. At this time point 37.3 % of patients reported an amenorrhea. 51 patients (11.4 %) underwent a hysterectomy during the follow-up period with a mean number of 18.5 months after NEA. A shorter duration of the ablation procedure was significantly associated with undergoing a hysterectomy (p = 0.034). Patients with a higher BMI also underwent a hysterectomy more often (p = 0.017) as well as patients with a large uterine cavity (p = 0.041). Pathology results revealed that in 27 (52.9 %) of removed uteruses adenomyosis was present. Complications occurred in 2.9 % of procedures.

Conclusion

This study highlights the effectiveness of NEA in the setting of a large general teaching hospital and multiple characteristics associated with failure of treatment. The results of our study reaffirm the place of NEA as a safe and effective treatment for patients with menorrhagia. | Original language | English | |---|---| | Article number | 113941 | | Number of pages | 4 | | Journal | European Journal of Obstetrics and Gynecology and Reproductive Biology | | Volume | 310 | | DOIs | | | Publication status | Published - Jun-2025 |

Keywords

- Heavy menstrual bleeding - Hysterectomy - Novasure® - Predictive factors - Success rate Fingerprint Dive into the research topics of 'Comprehensive analysis of NovaSure® endometrial ablation in patients with heavy menstrual bleeding: Identifying success rate and predictive factors for post-NovaSure® hysterectomy'. Together they form a unique fingerprint.Cite this - APA - Author - BIBTEX - Harvard - Standard - RIS - Vancouver

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Condition tags

adenomyosis

MeSH descriptors

Endometrial Ablation Techniques Endometrial Ablation Techniques Endometrial Ablation Techniques Endometrial Ablation Techniques Endometrial Ablation Techniques Endometrial Ablation Techniques Endometrial Ablation Techniques Endometrial Ablation Techniques Endometrial Ablation Techniques Endometrial Ablation Techniques Endometrial Ablation Techniques Endometrial Ablation Techniques Endometrial Ablation Techniques Endometrial Ablation Techniques Endometrial Ablation Techniques Endometrial Ablation Techniques Endometrial Ablation Techniques Endometrial Ablation Techniques Endometrial Ablation Techniques Endometrial Ablation Techniques

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