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CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2019; 79(03): 286-292
DOI: 10.1055/a-0733-5798
GebFra Science
Original Article/Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

Predictors of a Successful Bipolar Radiofrequency Endometrial Ablation

Artikel in mehreren Sprachen: English | deutsch
Lilly Eisele
Frauenklinik, Kantonsspital Frauenfeld, Frauenfeld, Switzerland
,
Lea Köchli
Frauenklinik, Kantonsspital Frauenfeld, Frauenfeld, Switzerland
,
Patricia Städele
Frauenklinik, Kantonsspital Frauenfeld, Frauenfeld, Switzerland
,
JoEllen Welter
Frauenklinik, Kantonsspital Frauenfeld, Frauenfeld, Switzerland
,
Maja Fehr-Kuhn
Frauenklinik, Kantonsspital Frauenfeld, Frauenfeld, Switzerland
,
Mathias K. Fehr
Frauenklinik, Kantonsspital Frauenfeld, Frauenfeld, Switzerland
› Institutsangaben
Weitere Informationen

Publikationsverlauf

received 25. März 2018
revised 09. August 2018

accepted 07. September 2018

Publikationsdatum:
12. März 2019 (online)

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Abstract

Introduction The studyʼs objectives were to determine the success rate following radiofrequency endometrial ablation to treat abnormal menstrual bleeding and to assess risk factors for failure of the method.

Materials and Methods 195 women who were treated with bipolar radiofrequency endometrial ablation between 01/2009 and 06/2016 were included in this prospective cohort study. Postoperative data from 187 women were collected at a median of 17.5 months (IQR 4.5–34.9; 1–82). Multivariate analyses of risk factors were performed. Success was defined as amenorrhoea or spotting.

Results Patient characteristics were as follows: mean age 44 years (SD ± 5), median parity 2 (IQR 2–3), median hysterometer 8.7 cm (SD ± 1.1), and median BMI 23.5 kg/m2 (IQR 21–27). 30 patients (19.5%) had intramural masses that could be measured with ultrasound. Postoperative success rate was 86.1%. 10 patients (5%) had a hysterectomy postoperatively – 6 for heavy bleeding, 3 due to prolapse, and 1 due to dysmenorrhoea. Multivariate analyses showed the presence of intramural masses in women < 45 years was a significant risk factor for therapeutic failure (p = 0.033; 95% CI 1.08–12.57), with an increased risk of hysterectomy (OR 7.9, 95% CI 1.2–52.7, p = 0.033).

Conclusion Bipolar radio frequency endometrial ablation was highly successful in the absence of an intramural mass (88%). Even smaller intramural fibroids (DD: adenomyomas of a median of 15 mm) reduce the success rate (76%), which is why preoperative ultrasound is recommended. In the presence of intramural masses, the risk of a hysterectomy for women < 45 years increases eightfold.

Key words

radiofrequency endometrial ablation - hypermenorrhea - menorrhagia - fibroids
 

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