Background: In an attempt to prevent delayed complications of minimally invasive surgical treatments for heavy menstrual bleeding, the current total or global ablation technique was modified to a partial ablation teachnique (PEA) to successfully treat HMB without causing intrauterine scarring. PEA is defined as ablating or resecting only the anterior or posterior endometrial wall. Objective: The aim of this research was to demonstrate that PEA has the potential for treating abnormal uterine bleeding (AUB) successfully. Design: The study involved 269 patients who underwent PEA. Study questionnaires were sent to those patients and their charts were reviewed. Materials and Methods: This study was conducted in Sacramento, CA. It was a retrospective study consisting of chart reviews and answers to patient questionnaires. Data for pre- and post-PEA bleeding, pain and quality of life (QoL) scores were analyzed using IBM SPSS 21.0. Pre- and post-PEA blood loss during menses was measured by reported clot size. Pre- and post-PEA pain during menses was quantified by type of analgesia required for relief. Impact on QoL scores were measured as well. Patient satisfaction with the procedure was also examined. Results: There was a statistically significant decrease in clot size and pain scores. Eight percent required hysterectomy during the 17-year follow-up. In addition, there was significant improvement in QoL scores. Patient satisfaction was >95%. No hysterectomies included an indication for pain. Conclusions: PEA is a minimally invasive surgical procedure that appears to provide patients with improved QoL scores, long-term satisfaction, low hysterectomy rates, and no known long-term complications. Larger controlled studies should be conducted to assess the viability of this procedure. (J GYNECOL SURG 32:230)
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References
1.
McCauslandAM, McCauslandVM. Long-term complications of endometrial ablation: Cause, diagnosis, treatment, and prevention. J Minim Invasive Gynecol, 2007; 14:399.
McCauslandAM, McCauslandVM. Partial rollerball endometrial ablation: A modification of total ablation to treat menorrhagia without causing complications from intrauterine adhesions. Am J Obstet Gynecol, 1999; 180(6[pt1]):1512.
5.
ShawRW, BrickleyMR, EvansL, EdwardsMJ. Perceptions of women on the impact of menorrhagia on their health using multi-attribute utility assessment. Br J Obstet Gynaecol, 1998; 105:1155.
6.
BushnellDM, MartinKA, MooreKA, RichterHE, RubinA, PatrickDL. Menorrhagia Impact Questionnaire: Assessing the influence of heavy menstrual bleeding on quality of life. Curr Med Res Opin, 2010, 26:2745.
7.
NilesA. Women's preferences for AUB treatment and their definition of a successful outcome compared to ob/gyn recommendations. J Minim Invasive Gynecol, 2005; 12(5):S24.
8.
LonginottiMK, JacobsonGF, HungYY, LearmanLA. Probability of hysterectomy after endometrial ablation. Obstet Gynecol, 2008; 112:1214.
9.
LittaP, NappiL, PasqualeF. Proposal of a modified transcervical endometrial resection (TCER) technique for menorrhagia: Feasibility, efficacy, and patients' acceptability. Gynecol Surg, 2014; 11:165.
10.
LabergePY. Serious and deadly complications from pregnancy after endometrial ablation: Two case reports and review of the literature. J Gynecol Obstet Biol Reprod (Paris), 2008; 37:609.
11.
XiaE, LiTC, YuD, HuangX, ZhengJ, LiuY, ZhangM. The occurrence and outcome of 39 pregnancies after 1621 cases of transcervical resection of endometrium. Hum Reprod, 2006; 21:3282.
