COMPARISON OF TWO METHOD TREATMENTS OF ENDOMETRIAL ABLATION, THERMAL BALLOON ABLATION, AND HYSTEROSCOPY RESECTION, FOR PATIENTS WITH HEAVY MENSTRUAL BLEEDING

Background: Heavy menstrual bleeding (HMB) is a common gynecological problem. Many women do not like the continuous use of hormones; neither do they prefer a rigorous treatment such as hysterectomy. Endometrial resection and ablation are intermediate treatments for heavy menstrual bleeding. Endometrial ablation with hysteroscopy resection requires a skilled surgeon. Surgery time is less in thermal balloon ablation (TBA), as a more recent technique of endometrial ablation and it also is simpler than old surgery techniques. The aim of this study was to compare two methods of treatment for endometrial ablation (hysteroscopy and TBA) for patients with menorrhagia.
Methods: This quasi experimental study was conducted during 2011–2013 on women with a history of menorrhagia referred to Babol Ayatollah Rouhani and Tehran Emam Hossein Hospitals (group A) and Shiraz Shahid Faghihi Hospital (group B),who were unresponsive to hormone therapy or were not candidates for hysterectomy. All women underwent endometrial ablation using TBA (group A) or hysteroscopy resection (group B). Relevant clinical data and complications were abstracted from medical records and the two procedures were then compared.
Results: The mean age of patients in groups A and B was 43.38±5.91 and 38.5±4.21 years, respectively. Surgery complications were not seen in any of the patients in either group. Amenorrhea was more in the TBA group compared with hysteroscopyy resection and this difference was statistically significant (P=0.006), but hypomenorrhea was less in the TBA group than the hysteroscopy resection (P=0.021).
Success rate of treatment results after 12 months of endometrial ablation in TBA and hysteroscopy resection groups was 46(88.5%) and 52(92.9%), respectively, which was not statistically significant (P=0.51). In this study, the satisfaction of surgery with abnormal uterine bleeding 12 months after surgery in hysteroscopy resection and TBA groups, was not statistically significant (P=0.27).
Conclusion: The findings of this research indicate that outcomes with TBA and hysteroscopy resection were equally good for women with menorrhagia. However, there was not a difference in the success rate and satisfaction of surgery after one-year follow-up of treatment in the two groups.