Our Summary

This study looked at two methods used to treat heavy menstrual bleeding: Transcervical Endometrial Resection (TCRE) and Endometrial Ablation (EA). These methods don’t completely remove the lining of the uterus (endometrium), raising concerns about the possibility of the remaining tissue developing into endometrial cancer (EC) later in life. So, the researchers aimed to assess the long-term occurrence of EC after these treatments.

To do this, they used Swedish national health registries to identify women who had undergone these procedures between 1997 and 2017. They then compared the incidence of EC after these treatments to the expected incidence in the general population of Swedish women.

They found that out of 17,296 women who had undergone TCRE or EA, only a small percentage developed EC during the follow-up period. The incidence of EC was significantly lower than expected after EA, suggesting this method could have a protective effect. However, the incidence after TCRE was within the expected range, indicating no significant increase or decrease in risk.

In simpler terms, the study suggests that the EA method of treating heavy menstrual bleeding could potentially reduce the risk of EC, while the TCRE method seemed not to significantly impact the risk.

FAQs

  1. What were the two methods of treating heavy menstrual bleeding discussed in the study?
  2. What was the main goal of the researchers in this study?
  3. Did the study find any significant changes in the risk of endometrial cancer after Transcervical Endometrial Resection (TCRE) or Endometrial Ablation (EA)?

Doctor’s Tip

Therefore, one helpful tip a doctor might tell a patient about endometrial ablation is that it may have a lower risk of developing endometrial cancer compared to other methods of treatment for heavy menstrual bleeding. It’s important to discuss the potential risks and benefits of any procedure with your healthcare provider before making a decision.

Suitable For

Overall, patients who are recommended endometrial ablation are typically those who suffer from heavy menstrual bleeding and have not responded well to other treatment options such as medication or hormonal therapy. Endometrial ablation is often considered for women who have completed childbearing or do not wish to have children in the future.

It is important for patients to discuss their individual medical history and preferences with their healthcare provider to determine if endometrial ablation is the right treatment option for them. Additionally, patients with a history of endometrial cancer or other uterine conditions may not be suitable candidates for endometrial ablation.

Timeline

Overall, the timeline of a patient’s experience before and after endometrial ablation may look something like this:

Before:

  1. Patient experiences heavy menstrual bleeding or other symptoms of abnormal uterine bleeding.
  2. Patient consults with a healthcare provider who recommends endometrial ablation as a treatment option.
  3. Patient undergoes pre-operative evaluations and discussions with their healthcare provider to determine if they are a suitable candidate for the procedure.

After:

  1. Patient undergoes the endometrial ablation procedure, which typically takes less than an hour to perform.
  2. Patient may experience some cramping, spotting, or discharge in the days following the procedure.
  3. Patient is advised to avoid strenuous activities and sexual intercourse for a period of time after the procedure.
  4. Patient follows up with their healthcare provider for post-operative care and monitoring.
  5. Patient experiences a reduction in menstrual bleeding or resolution of symptoms over time.
  6. Patient may undergo follow-up evaluations to assess the effectiveness of the procedure and monitor for any complications.

The study mentioned above provides insight into the long-term outcomes of endometrial ablation in terms of the risk of developing endometrial cancer. It suggests that EA may potentially reduce the risk of EC, while TCRE does not significantly impact the risk. This information can help guide healthcare providers and patients in making informed decisions about their treatment options for heavy menstrual bleeding.

What to Ask Your Doctor

  1. What are the potential risks and side effects of endometrial ablation?
  2. How long does the procedure typically take, and what is the recovery process like?
  3. Will I still be able to have children after undergoing endometrial ablation?
  4. How long can I expect the results of endometrial ablation to last?
  5. What are the chances of needing a repeat procedure in the future?
  6. How will endometrial ablation affect my menstrual cycle and future periods?
  7. Are there any restrictions or lifestyle changes I should make after the procedure?
  8. How will endometrial ablation affect my risk of developing endometrial cancer in the future?
  9. Are there any alternative treatment options for heavy menstrual bleeding that I should consider?
  10. What should I do if I experience any concerning symptoms or complications after the procedure?

Reference

Authors: Flöter Rådestad A, Dahm-Kähler P, Holmberg E, Bjurberg M, Hellman K, Högberg T, Kjölhede P, Marcickiewicz J, Rosenberg P, Stålberg K, Åvall-Lundqvist E, Borgfeldt C. Journal: Acta Obstet Gynecol Scand. 2022 Aug;101(8):923-930. doi: 10.1111/aogs.14385. Epub 2022 May 27. PMID: 35624547