Endometrial Ablation in Women With Abnormal Uterine Bleeding Related to Ovulatory Dysfunction: A Cohort Study.
J Minim Invasive Gynecol
; 22(7): 1225-30, 2015.
Article
em En
| MEDLINE
| ID: mdl-26149205
ABSTRACT
STUDY OBJECTIVE:
To evaluate the efficacy and safety of endometrial ablation (EA) for the treatment of abnormal uterine bleeding (AUB) associated with ovulatory dysfunction.DESIGN:
A retrospective cohort study (Canadian Task Force classification II-2).SETTING:
An academic medical center. PATIENTS Women with AUB who underwent EA during an 8-year period.INTERVENTIONS:
EA by radiofrequency or thermal balloon ablation techniques. MEASUREMENTS AND MAINRESULTS:
Women with AUB were divided into 2 groups irregular bleeding with ovulatory dysfunction (AUB-O) or regular heavy bleeding related to a primary endometrial disorder (AUB-E). Outcome measures included rates of amenorrhea and treatment failure (ie, need for reablation or hysterectomy). Outcomes were compared between groups using survival analyses and chi-square tests. Known confounders were adjusted for using Cox and logistic regression models. Five-year cumulative treatment failure rates were 11.7% (95% confidence interval [CI], 6.5%-16.9%) for AUB-O and 12.3% (95% CI, 8.4%-16.2%) for AUB-E (p = .62). The unadjusted hazard ratio for treatment failure was 0.87 (95% CI, 0.72-1.05, p = .16). After adjusting for known risk factors for failure, the hazard ratio was 1.48 (95% CI, 0.82-2.65, p = .19). The rates of amenorrhea were 11.8% for AUB-O and 13.8% for AUB-E with an unadjusted odds ratio of 0.84 (95% CI, 0.48-1.48, p = .55). After adjusting for factors for amenorrhea after EA, the odds ratio was 1.08 (95% CI, 0.62-1.84, p =.78). No pregnancies or endometrial cancers occurred after EA.CONCLUSION:
EA is effective in women with AUB-O and can be used as an alternative to hysterectomy or in patients with contraindications to medical management of AUB-O.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doenças Ovarianas
/
Dismenorreia
/
Técnicas de Ablação Endometrial
/
Amenorreia
/
Histerectomia
/
Menorragia
Tipo de estudo:
Etiology_studies
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Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Female
/
Humans
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Middle aged
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article