Prognostic factors that predict success in office endometrial ablation: a retrospective study

Abstract

The objective of the cohort study was to identify clinical factors that influence the rate of further surgical intervention in women who had endometrial ablation. Electronic databases and patient records were scrutinised to obtain examination, investigative and procedural data considered to be potentially predictive of the need for further surgical intervention after endometrial ablation in the office setting. A total of 391 consecutive women were identified who received endometrial ablation in the office setting between July 2005 and December 2012, with an average follow-up of 4.3 years. Univariable and multivariable logistic regressions were used to estimate the influence of these variables on prognosis. Factors predictive of further surgical treatment were dysmenorrhea (odds ratio [OR] 4.01; 95 % CI 1.63 to 9.91) and a uterine cavity length >9 cm (OR 2.65; 95 % CI 1.33 to 5.27). In conclusion, dysmenorrhoea before treatment or a uterine cavity length >9 cm was associated with the need for further surgical interventions after office endometrial ablation. These findings should help inform clinician and patient upon decision-making when considering treatment options for heavy menstrual bleeding.

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Contribution to authorship

PS collected data, performed the analyses and drafted the article. SK collected data and revised the article. TJC produced the original idea, contributed to interpretation and revised the article for important intellectual content.

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Correspondence to Paul P. Smith.

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Compliance with ethical standards

Data collection and storage satisfied local and national regulations. Ethical approval was not required.

Conflict of interest

T. Justin Clark has received research monies from Cytyc (now Hologic) for the administration costs of the thermal balloon compared to bipolar radiofrequency ablation trial. In addition to this, he has received honoraria from Hologic and Gynecare to run training workshops in office hysteroscopy techniques. The other authors did not report any potential conflicts of interest.

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Smith, P.P., Karpate, S. & Clark, T.J. Prognostic factors that predict success in office endometrial ablation: a retrospective study. Gynecol Surg 13, 83–87 (2016). https://doi.org/10.1007/s10397-015-0921-5

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Keywords

  • Endometrial ablation
  • Office endometrial ablation
  • Predictive factors
  • Prognosis