Effect of Radiofrequency Endometrial Ablation on Dysmenorrhea

Wyatt, Sabrina N.; Banahan, Taylor; Tang, Ying; Nadendla, Kavita; Szychowski, Jeff M.; Jenkins, Todd R.

doi:10.1016/j.jmig.2016.08.825

Cited by 11 publications

(6 citation statements)

References 12 publications

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“…33 Furthermore, Wyatt et al described that 38% of all women obtained reduction of dysmenorrhea after EA and 7% of the women who underwent EA reported new-onset dysmenorrhea postoperatively. 34 Together with the observations in our current study, dysmenorrhea should not be neglected as potential risk factor in patients with a (suspected) bleeding disorder.…”

Section: Discussionsupporting

confidence: 81%

The ISTH‐BAT score and outcomes after endometrial ablation in women with heavy menstrual bleeding

Eising,

Punt,

Schermer

et al. 2023

Haemophilia

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BackgroundThe International Society on Thrombosis and Haemostasis bleeding assessment tool (ISTH‐BAT), is used during the diagnostic workup of bleeding disorders. Data on ISTH‐BAT scores in women with heavy menstrual bleeding (HMB) undergoing endometrial ablation (EA) could be essential in optimizing HMB counselling.ObjectiveTo investigate the postsurgical incidence of amenorrhea, dysmenorrhea, quality of life, re‐intervention after EA, and ISTH‐BAT score.MethodsThis study included women who have undergone EA because of HMB. During a follow‐up of 2 to 5 years, ISTH‐BAT, pictorial blood assessment chart (PBAC), and Short Form‐36 survey (SF‐36) were administered. At 10 years of follow‐up surgical re‐interventions were evaluated.ResultsSeventy‐one women were included of whom 77% (n = 55) had an ISTH‐BAT score < 6, versus 23% (n = 16) ISTH‐BAT score ≥6 (mean age 46.3 versus 42.3, p = 0.004). In the ISTH‐BAT ≥6 group versus < 6 group, amenorrhea occurred in 63% (10/16) versus 82% (45/55) (p = 0.111), dysmenorrhea in 38% (6/16) versus 18% (10/55) (p = 0.111), and surgical re‐intervention in 19% (3/16) versus 25% (14/55) (p = 0.582). SF‐36 item (Bodily) pain was lower in the ISTH‐BAT ≥6 group versus < 6 (median score 58.7 vs. 80.0, p = 0.104).ConclusionsAn ISTH‐BAT score ≥6 may be related to a lower amenorrhea incidence and higher dysmenorrhea rate after EA.

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Section: Discussionsupporting

confidence: 81%

The ISTH‐BAT score and outcomes after endometrial ablation in women with heavy menstrual bleeding

Eising,

Punt,

Schermer

et al. 2023

Haemophilia

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“…Research indicates a satisfaction rate exceeding 85% after 2 years for this indication, with a subsequent hysterectomy rate of 19% 11 . However, limited data indicate an effectiveness of only 50% when used for dysmenorrhea 25 . Given that endometrial ablation is used more often for dysmenorrhea, increased use would not result in a substitution effect for hysterectomy.…”

Section: Discussionmentioning

confidence: 99%

Regional practice variation in hysterectomy and the implementation of less invasive surgical procedures: A register‐based study in the Netherlands

Vink,

Portrait,

Hehenkamp

et al. 2024

Acta Obstet Gynecol Scand

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IntroductionMany women experience bleeding disorders that may have an anatomical or unexplained origin. Although hysterectomy is the most definitive and common treatment, it is highly invasive and resource‐intensive. Less invasive therapies are therefore advised before hysterectomy for women with fibroids or bleeding disorders. This study has two aims related to treating bleeding disorders and uterine fibroids in the Netherlands: (1) to evaluate the regional variations in prevalence and surgical approaches; and (2) to assess the associations between regional rates of hysterectomies and less invasive surgical techniques to analyze whether hysterectomy can be replaced in routine practice.Material and methodsWe completed a register‐based study of claims data for bleeding disorders and fibroids in women between 2016 and 2020 using data from Statistics Netherlands for case‐mix adjustment. Crude and case‐mix adjusted regional hysterectomy rates were examined overall and by surgical approach. Coefficients of variation were used to measure regional variation and regression analyses were used to evaluate the association between hysterectomy and less invasive procedure rates across regions.ResultsOverall, 14 186 and 8821 hysterectomies were performed for bleeding disorders and fibroids, respectively. Laparoscopic approaches predominated (bleeding disorders 65%, fibroids 49%), followed by vaginal (bleeding disorders 24%, fibroids 5%) and abdominal (bleeding disorders 11%, fibroids 46%) approaches. Substantial regional differences were noted in both hysterectomy rates and the surgical approaches. For bleeding disorders, regional hysterectomy rates were positively associated with endometrial ablation rates (β = 0.11; P = 0.21) and therapeutic hysteroscopy rates (β = 0.14; P = 0.31). For fibroids, regional hysterectomy rates were positively associated with therapeutic hysteroscopy rates (β = 0.10; P = 0.34) and negatively associated with both embolization rates (β = −0.08; P = 0.08) and myomectomy rates (β = −0.03; P = 0.82).ConclusionsRegional variation exists in the rates of hysterectomy and minimally invasive techniques. The absence of a significant substitution effect provides no clear evidence that minimally invasive techniques have replaced hysterectomy in clinical practice. However, although the result was not significant, embolization could be an exception based on its stronger negative association.

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“…In these studies, the presence of dysmenorrhoea prior to endometrial ablation was found to be a risk factor for the presence of post-ablation pain (OR 3.38, 95% CI 1.47-7.76) (Supplementary data Figure S2) 38,54,62 .…”

Section: Sourcesmentioning

confidence: 97%

“…In nine studies dysmenorrhoea was analysed as a prognostic factor for surgical reintervention (Table S5) 23,25,32,35,38,41,55,57,62 . In these studies pre-existing dysmenorrhoea was either examined through a questionnaire (dysmenorrhoea present yes/no) or with the use of a visual analogue scale.…”

Section: Sourcesmentioning

confidence: 99%

“…In these studies pre-existing dysmenorrhoea was either examined through a questionnaire (dysmenorrhoea present yes/no) or with the use of a visual analogue scale. Pooled data of seven of these studies showed that pre-existing dysmenorrhoea is a predictive factor for a surgical reintervention (OR 2.12, 95% CI 1.41-3.19) (Table 1, Figure 5) 25,32,35,41,55,57,62 . Four studies reported an adjusted OR, of which the pooled OR was comparable with the pooled result of the unadjusted OR (OR 2.52, 95% CI 1.35-4.71) (Figure S1) 32,35,38,57 .…”

Section: Sourcesmentioning

confidence: 99%

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Improving care for women suffering from abnormal uterine bleeding

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Effect of Radiofrequency Endometrial Ablation on Dysmenorrhea

Cited by 11 publications

References 12 publications

The ISTH‐BAT score and outcomes after endometrial ablation in women with heavy menstrual bleeding

The ISTH‐BAT score and outcomes after endometrial ablation in women with heavy menstrual bleeding

Regional practice variation in hysterectomy and the implementation of less invasive surgical procedures: A register‐based study in the Netherlands

Improving care for women suffering from abnormal uterine bleeding

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