Efficacy and safety of endometrial ablation for treating abnormal uterine bleeding in pre- and postmenopausal women with liver cirrhosis

Qing Liu, Xiu-lan Li, Xiu‐lan Li, J. H. LIU, Ji-Juan Liu, Xiao-Hong Song, Xiaohong Song, Xiao-Ying Jiang, Xiao‐Ying Jiang, Wei Li, Hua Zhang, Calvin Q. Pan
Journal of Obstetrics and Gynaecology Research · 2016 · vol. 42(12) , pp. 1753–1760 · doi:10.1111/jog.13124 · PMID:27647778 · W2522378999
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Endometrial ablation with NovaSure therapy effectively treated abnormal uterine bleeding in cirrhotic women, achieving high amenorrhea rates and comparable safety to non-cirrhotic patients.

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Abstract

AIM: Abnormal uterine bleeding (AUB) occurs in 10-30% of women of reproductive age and up to 61% of cirrhotic women. We evaluated the efficacy and safety of endometrial ablation (NovaSure therapy) for AUB in cirrhotic women. METHODS: This prospective, two-arm, observational study enrolled patients for NovaSure treatment, and they were followed for 12 months. Primary measurements were the amenorrhea rate and changes of pictorial blood loss assessment chart (PBLAC) scores at 1-month post-therapy. Key secondary end-points included the longevity of amenorrhea at 12 months, safety profile, and progression of cirrhosis. RESULTS: Among 88 women, 26 were cirrhotic and 62 were non-cirrhotic. At 1-month post-NovaSure treatment, a significant reduction of mean PBLAC scores was observed in cirrhotic patients compared to those at baseline (0.4 ± 1.3 vs 215.2 ± 410.9, P < 0.001), and the amenorrhea rate was 88.5%. The efficacy outcomes of the PBLAC scores and amenorrhea rate were maintained until the end of the 12-month follow-up. A significant improvement in quality of life scores was observed 1-month post-therapy compared to those at baseline (5.4 ± 3.1 vs 20.5 ± 5.5, P < 0.001). Patients' satisfaction rates were 100% and 92.31% at 6 and 12 months, respectively. The aforementioned outcomes were comparable with those in non-cirrhotic patients. No significant progression of cirrhosis or safety concern was reported. CONCLUSION: Cirrhotic patients on NovaSure therapy had a high rate of amenorrhea 1-month post-treatment, which maintained longevity for 12 months. The safety profile was similar to that in non-cirrhotic patients.

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MeSH descriptors

Endometrial Ablation Techniques Liver Cirrhosis Uterine Hemorrhage Adult Amenorrhea Endometrial Ablation Techniques Endometrial Ablation Techniques Female Humans Liver Cirrhosis Middle Aged Patient Satisfaction Postmenopause Premenopause Prospective Studies Quality of Life Treatment Outcome Uterine Hemorrhage Uterine Hemorrhage

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