Retrospective analysis of outcome after endometrial ablation with the NovaSure device: A German single-center experience

Oliver M Schleicher, Heindl F, Felix Heindl, Julia Gocke, Gocke J, Katharina Keller, Keller K, Lothar Häberle, Häberle L, Alaa Hamzeh, Hamzeh A, Matek C, Christian Matek, Beckmann MW, Matthias W. Beckmann, Julius Emons, Emons J
International Journal of Gynecology & Obstetrics · 2026 · doi:10.1002/ijgo.71224 · PMID:42538793 · W7172117090
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This single-center analysis of 330 patients found NovaSure endometrial ablation to have a 2.4% failure rate and 5.7% complication rate, with adenomyosis potentially predicting failure, but remaining safe and cost-effective.

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Abstract

OBJECTIVE: Evaluation of retrospective outcomes of NovaSure treatment in patients with abnormal uterine bleeding, including safety and cost-effectiveness, and risk factors related to therapeutic outcomes. Subgroup analysis was conducted for patients who underwent concomitant surgical procedures, required subsequent interventions, and were stratified by menopausal status and multimorbidity. METHODS: Retrospective analysis of 330 patients who underwent NovaSure treatment at our center between January 2020 and November 2023. Follow-up was conducted until January 2025. Demographic and clinical parameters were evaluated using descriptive and comparative analyses. RESULTS: Ablation failure occurred in eight of 330 patients (2.4%). Concomitant procedures (65 of 330, 19.7%) or multimorbidity (34 of 330, 10.3%) were not associated with increased complication or failure rates. Recurrent bleeding led to representation in 32 of 330 patients (9.7%). No malignancies or premalignant lesions were found in the postmenopausal subgroup. The overall complication rate was 5.7%. A preoperative sonographic suspicion of adenomyosis showed a nonsignificant trend toward treatment failure. Histopathological examination of hysterectomy specimens suggests reduced thermal alterations in areas containing adenomyotic foci. An adjusted cost analysis showed lower overall costs and lower complication rates for NovaSure compared with hysterectomy, including subsequent interventions due to treatment failure. CONCLUSION: This study provides a comprehensive evaluation of patients, including detailed clinical parameters, and demonstrates a favorable safety profile among relevant subcohorts. Adenomyosis may represent a predictor of treatment failure. Overall, the data support NovaSure as a safe and cost-effective treatment option for a broad range of patients.

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