Endometrial resection and ablation techniques for heavy menstrual bleeding.

CONCLUSIONS: Approaches to endometrial ablation have evolved from first-generation techniques to newer second- and third-generation approaches. Current evidence suggests that compared to first-generation techniques (endometrial laser ablation, transcervical resection of the endometrium, rollerball endometrial ablation), second-generation approaches (thermal balloon endometrial ablation, microwave endometrial ablation, hydrothermal ablation, bipolar radiofrequency endometrial ablation, endometrial cryotherapy) are of equivalent efficacy for heavy menstrual bleeding, with comparable rates of amenorrhoea and improvement on the PBAC. Second-generation techniques are associated with shorter operating times and are performed more often under local rather than general anaesthesia. It is uncertain whether perforation rates differed between second- and first-generation techniques. Evidence was insufficient to show which second-generation approaches were superior to others and to reveal the efficacy and safety of third-generation approaches versus first- and second-generation techniques.
PMID: 30667064 [PubMed - as supplied by publisher]

Source: Cochrane Database of Systematic Reviews - January 22, 2019 Category: General Medicine Authors: Bofill Rodriguez M, Lethaby A, Grigore M, Brown J, Hickey M, Farquhar C Tags: Cochrane Database Syst Rev Source Type: research