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To compare the efficacy and safety of two different second-generation ablation devices, Novasure impedance control system and microwave endometrial ablation (MEA), in cases of abnormal uterine bleeding (AUB). Materials and Methods: This is a randomized controlled trial that took place in a single Gynecological Department of a University Hospital. Sixty-six women with dysfunctional uterine bleeding (DUB), unresponsive to medical treatment, were included in the trial. The ratio of women allocated to bipolar radio-frequency ablation or MEA was 1:1. Follow-up assessments were carried out at three and 12 months post-ablation. The present main outcome measure was amenorrhea rates 12-months post-treatment. Results: The rate of amenorrhea at 12months post-ablation was significantly higher in women treated by Novasure (25/33; 75.8%) as compared to those treated by MEA (8/33; 24.2%) (rate difference: +51.5%, 95% CI: +27.8 to +67.7). Conclusion: In women with DUB, endometrial ablation with Novasure bipolar radiofrequency impedance-controlled system is associated with increased rates of amenorrhea at 12-months post-treatment as compared to the MEA method.

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Malignant transformation of mature cystic teratomas is uncommon but present in clinical practice. Especially in postmenopausal women, the clinical manifestation of a mature teratoma with undiagnosed malignant transformation as acute abdomen is extremely rare. In these cases, total hysterectomy with bilateral salpingo-oophorectomy is the treatment choice since the chance of malignancy is high. The prognosis is good if the cyst is not ruptured, is completely excised and the cancer does not extend beyond the capsule. In any other case, the prognosis is unfavorable since recurrence is common and the tumor is chemoresistant.