Predictors of a Successful Bipolar Radiofrequency Endometrial Ablation

Eisele, Lilly; Köchli, Lea; Städele, Patricia; Welter, JoEllen; Fehr-Kuhn, Maja; Fehr, Mathias K.

doi:10.1055/a-0733-5798

Cited by 2 publications

(4 citation statements)

References 35 publications

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“…However, since this procedure does not affect intramural and subserosal fibroids, pressure symptoms associated with larger fibroids cannot be addressed. Subsequent pregnancies after endometrial ablation may involve the risk of ectopic pregnancy, prematurity or abnormal placentation [ 59 , 60 , 61 ].…”

Section: Resultsmentioning

confidence: 99%

Currently Available Treatment Modalities for Uterine Fibroids

Micić,

Macura,

Andjić

et al. 2024

Medicina

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Uterine fibroids (leiomyomas and myomas) are the most common benign gynecological condition in patients presenting with abnormal uterine bleeding, pelvic masses causing pressure or pain, infertility and obstetric complications. Almost a third of women with fibroids need treatment due to symptoms. Objectives: In this review we present all currently available treatment modalities for uterine fibroids. Methods: An extensive search for the available data regarding surgical, medical and other treatment options for uterine fibroids was conducted. Review: Nowadays, treatment for fibroids is intended to control symptoms while preserving future fertility. The choice of treatment depends on the patient’s age and fertility and the number, size and location of the fibroids. Current management strategies mainly involve surgical interventions (hysterectomy and myomectomy hysteroscopy, laparoscopy or laparotomy). Other surgical and non-surgical minimally invasive techniques include interventions performed under radiologic or ultrasound guidance (uterine artery embolization and occlusion, myolysis, magnetic resonance-guided focused ultrasound surgery, radiofrequency ablation of fibroids and endometrial ablation). Medical treatment options for fibroids are still restricted and available medications (progestogens, combined oral contraceptives andgonadotropin-releasing hormone agonists and antagonists) are generally used for short-term treatment of fibroid-induced bleeding. Recently, it was shown that SPRMs could be administered intermittently long-term with good results on bleeding and fibroid size reduction. Novel medical treatments are still under investigation but with promising results. Conclusions: Treatment of fibroids must be individualized based on the presence and severity of symptoms and the patient’s desire for definitive treatment or fertility preservation.

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Section: Resultsmentioning

confidence: 99%

Currently Available Treatment Modalities for Uterine Fibroids

Micić,

Macura,

Andjić

et al. 2024

Medicina

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“…Another independent risk factor is the presence of fibroids, irrespective of the number or location; though submucosal fibroids are more commonly responsible for distorting the uterine cavity and reducing the chances of success. It has been shown that the presence of even small intramural fibroids could reduce the chance of success [9].…”

Section: Discussionmentioning

confidence: 99%

“…Beelen et al [8] have shown that younger age, prior tubal ligation, and pre-existing dysmenorrhea were found to be associated with failure of endometrial ablation. Obesity has also been purported to be a cause of failure [9]. Eisele et al [9] showed that bipolar radiofrequency endometrial ablation was highly successful in the absence of an intramural mass (88%).…”

Section: Introductionmentioning

confidence: 99%

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Factors Predicting Failure of Endometrial Ablation

Mukherjee¹

2023

J Gynecol Clin Obstet Reprod Med.

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Objective: To find out the probable reasons for endometrial ablation failure. Study design: This retrospective observational study was conducted in Basildon and Thurrock University Hospitals. Patients undergoing microwave endometrial ablation or radiofrequency ablation but required additional treatment (medical/surgical) after the procedure were included in the study. The patients having the procedure between 2012 to 2019 were followed up and included in the study. Patient’s baseline characteristics including age, BMI, presenting complaint, clinical and sonographic findings including uterine cavity length, and details of the ablation procedure were collected. The endometrial biopsy results, further treatment, and histology in patients who underwent hysterectomy were also noted and appropriate statistical analysis was conducted. Result: Among the 653 patients that underwent endometrial ablation (either radio-frequency/ microwave), from 2012 to 2019, 100 patients had ablation failure. All patients had undergone hysteroscopy and had a normal histopathology examination prior to undergoing ablation. The most common symptom of failure was a recurrence of heavy bleeding. 67% of patients with ablation failure opted for hysterectomy, 15% for repeat ablation, and 18% had medical management. The results showed that increased age, higher BMI, a larger uterine cavity, and the presence of fibroids and/or adenomyosis are associated with a higher risk of endometrial ablation failure. Conclusion: This study provides insight into the salient factors contributing to ablation failure which may guide future decisions toward better patient selection and counseling for endometrial ablation.

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Predictors of a Successful Bipolar Radiofrequency Endometrial Ablation

Cited by 2 publications

References 35 publications

Currently Available Treatment Modalities for Uterine Fibroids

Currently Available Treatment Modalities for Uterine Fibroids

Factors Predicting Failure of Endometrial Ablation

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