Our Summary

This research paper looked at the effectiveness of a treatment called bipolar radiofrequency endometrial ablation for women suffering from abnormal menstrual bleeding. The treatment was carried out on 195 women between 2009 and 2016. The researchers then collected data from these women after their treatment, on average 17.5 months later.

The results showed that this treatment was successful in stopping or reducing menstrual bleeding in about 86% of the cases. However, 5% of the women had to have a hysterectomy (removal of the uterus) afterwards - 6 of these due to heavy bleeding, 3 because of prolapse (uterus dropping into the vagina), and 1 due to painful menstruation.

Interestingly, the researchers found that the presence of intramural masses (tumors within the muscular wall of the uterus) in women under 45 significantly increased the chance of the treatment not working. Women in this group were also nearly 8 times more likely to need a hysterectomy.

In conclusion, bipolar radiofrequency endometrial ablation is a very successful treatment for abnormal menstrual bleeding, but not so much if the woman has intramural masses. Therefore, an ultrasound before the treatment is recommended to check for these. If such masses are present, women under 45 are at a higher risk of needing a hysterectomy.

FAQs

  1. What is bipolar radiofrequency endometrial ablation and what is it used for?
  2. Based on the research, how effective is bipolar radiofrequency endometrial ablation in treating abnormal menstrual bleeding?
  3. Why is an ultrasound recommended before undergoing bipolar radiofrequency endometrial ablation?

Doctor’s Tip

A helpful tip a doctor might tell a patient about endometrial ablation is to discuss the possibility of intramural masses and the increased risk of needing a hysterectomy, especially for women under 45. It is important to have an ultrasound before the treatment to check for these masses and discuss any potential risks with your doctor.

Suitable For

Patients who are typically recommended for endometrial ablation are those who suffer from abnormal menstrual bleeding that is not responsive to other treatments such as medications or hormone therapy. Endometrial ablation is often recommended for women who have heavy periods, irregular periods, or bleeding between periods. It is also recommended for women who have completed their childbearing and do not wish to have any more children.

In this study, it was found that bipolar radiofrequency endometrial ablation was effective in treating abnormal menstrual bleeding in the majority of cases. However, the presence of intramural masses in women under 45 significantly decreased the success rate of the treatment and increased the likelihood of needing a hysterectomy. Therefore, it is important for healthcare providers to assess for the presence of intramural masses before recommending endometrial ablation, especially in younger women.

Timeline

Before endometrial ablation:

  1. Patient experiences heavy, prolonged, or irregular menstrual bleeding.
  2. Patient consults with a healthcare provider to discuss treatment options.
  3. Patient undergoes diagnostic tests, such as ultrasound, to determine the cause of the abnormal bleeding.
  4. Healthcare provider recommends endometrial ablation as a potential treatment option.

After endometrial ablation:

  1. Patient undergoes bipolar radiofrequency endometrial ablation procedure.
  2. Patient experiences a reduction or cessation of menstrual bleeding in about 86% of cases.
  3. Follow-up appointments are scheduled to monitor the effectiveness of the treatment.
  4. In some cases, further interventions may be necessary, such as a hysterectomy, due to complications or unsuccessful treatment.
  5. Research shows that the presence of intramural masses can impact the success of the treatment, especially in women under 45 years old.
  6. Regular monitoring and follow-up care are recommended for patients who undergo endometrial ablation.

What to Ask Your Doctor

Questions a patient should ask their doctor about endometrial ablation:

  1. What is bipolar radiofrequency endometrial ablation and how does it work?
  2. What are the potential risks and complications associated with this treatment?
  3. How successful is this treatment in stopping or reducing menstrual bleeding?
  4. Are there any factors that may affect the effectiveness of the treatment, such as age or the presence of intramural masses?
  5. What are the alternatives to endometrial ablation if this treatment is not suitable for me?
  6. What is the recovery process like after the procedure?
  7. How long can I expect the results of the treatment to last?
  8. Will I still be able to have children after undergoing endometrial ablation?
  9. How often will I need follow-up appointments after the procedure?
  10. Are there any lifestyle changes or precautions I should take after the treatment to ensure its success?

Reference

Authors: Eisele L, Köchli L, Städele P, Welter J, Fehr-Kuhn M, Fehr MK. Journal: Geburtshilfe Frauenheilkd. 2019 Mar;79(3):286-292. doi: 10.1055/a-0733-5798. Epub 2019 Mar 12. PMID: 30880827