Minitouch Endometrial Ablation: The Walsall Manor Experience

Pepper, John; Gulati, Neerja; Parry‐Smith, William

doi:10.1016/j.jmig.2016.08.642

Cited by 1 publication

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“…The search yielded 11 eligible abstracts reporting on the combined treatment of EA + LNG-IUS, including six prospective studies and five retrospective studies. [18][19][20][21][22][23][24][25][26][27][28] Six abstracts described results comparing EA + LNG-IUS with EA alone and five abstracts only described results of the combined treatment. An overview of these abstracts can be seen in Table S2.…”

Section: Additional Abstractsmentioning

confidence: 99%

“…23,26,29 Amenorrhea rate after the combined treatment varied from 25% to 98%, described in 10 of the 11 included abstracts. 18,[20][21][22][23][24][25][26]28,29 Removal of LNG-IUS was difficult in two women and hysteroscopically documented evidence of intrauterine adhesions was found. No difficulties in re-insertion of the device were described.…”

Section: Additional Abstractsmentioning

confidence: 99%

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The combined use of endometrial ablation or resection and levonorgestrel‐releasing intrauterine system in women with heavy menstrual bleeding: A systematic review

Oderkerk

Kar

Zanden

et al. 2021

Acta Obstet Gynecol Scand

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Introduction: Despite endometrial ablation/resection being a very successful treatment for women with heavy menstrual bleeding, re-intervention with additional surgery is needed in 12%-25% of cases. Introducing a levonorgestrel-intrauterine system (LNG-IUS) immediately after ablation could preserve the integrity of the uterine cavity and suppress the regenerated or non-ablated endometrial tissue. Therefore, this combined treatment can perhaps lower the re-intervention rate. The aim of this systematic review was to assess the impact of the combined treatment. Material and methods:The MEDLINE, EMBASE, and Cochrane library were systematically searched. No language restrictions were applied. All types of studies were included reporting on the results of endometrial ablation or resection combined with immediate insertion of LNG-IUS for treatment of heavy menstrual bleeding. The primary outcome was the number of hysterectomies after the ablation procedure.Secondary outcomes included re-intervention rates, removals of LNG-IUS, bleeding pattern, patient satisfaction, adverse effects, and complications. Our protocol was registered in PROSPERO, an international prospective register of systematic reviews under registration number CRD42020151384.Results: Six studies with a retrospective design and one case series with a followup duration varying from 6 to 55 months were included. In total, 427 women were treated with the combined treatment. The studies described a lower hysterectomy and re-intervention rate after combined treatment compared with treatment with endometrial ablation/resection alone. Hysterectomy rate varied from 0% to 11% after combined treatment compared with 9.4% to 24% after endometrial ablation/resection alone. Bleeding patterns and patient satisfaction appeared to be in favor of the combined treatment group. No intra-or post-operative complications or complications in the removal of LNG-IUS were described. The most reported adverse effects after combined treatment were weight gain, mood changes, and headaches. An additional S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section. How to cite this article: Oderkerk TJ, van de Kar MMA, van der Zanden CHM, Geomini PMAJ, Herman MC, Bongers MY. The combined use of endometrial ablation or resection and levonorgestrel-releasing intrauterine system in women with heavy menstrual bleeding: A systematic review. Acta Obstet

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