Our Summary

This research paper is about a study that aimed to find out why the NovaSure endometrial ablation system, a treatment for heavy menstrual bleeding, fails in some cases. The study analyzed data from 486 patients who had this treatment between 2008 and 2014. It discovered that the treatment was more likely to fail in younger patients, those who had a history of sterilization, those who experienced painful periods (dysmenorrhea), and those who had a specific type of fibroid (intramural leiomyoma). It also found that if a special type of internal examination (hysteroscopy) was done before the treatment, it seemed to help prevent failure. The study concluded that these findings can help doctors to give better advice to patients before the treatment and to choose the best treatment for each individual patient.

FAQs

  1. What factors were found to increase the likelihood of NovaSure endometrial ablation treatment failure?
  2. How does pre-treatment hysteroscopy influence the success of the NovaSure endometrial ablation system?
  3. How can the findings from this study help doctors improve patient care before and after NovaSure endometrial ablation treatment?

Doctor’s Tip

One helpful tip a doctor might tell a patient about endometrial ablation is to discuss any previous history of sterilization, painful periods, or fibroids, as these factors may impact the success of the treatment. Additionally, considering a hysteroscopy before the procedure may help prevent failure. It is important for patients to have open communication with their doctor about their medical history and any concerns they may have before undergoing endometrial ablation.

Suitable For

Typically, patients who are recommended for endometrial ablation are those who suffer from heavy menstrual bleeding (menorrhagia) that has not responded to other treatments such as medication or hormonal therapy. Other common characteristics of patients who may be recommended for endometrial ablation include:

  • Women who have completed childbearing and do not wish to have any more children
  • Women who have a normal uterine cavity and do not have any abnormalities such as uterine fibroids or polyps
  • Women who have been thoroughly evaluated by their healthcare provider to rule out any underlying medical conditions that may be causing their heavy menstrual bleeding
  • Women who are not candidates for a hysterectomy (surgical removal of the uterus) due to other health concerns or personal preferences

It is important for patients to discuss their symptoms and medical history with their healthcare provider to determine if endometrial ablation is the right treatment option for them.

Timeline

Before endometrial ablation:

  • Patient experiences heavy, prolonged menstrual bleeding
  • Patient may have tried other treatments such as medication with little success
  • Patient consults with a doctor who recommends endometrial ablation as a possible treatment option
  • Patient undergoes pre-treatment evaluations, including a hysteroscopy in some cases
  • Patient schedules the endometrial ablation procedure

After endometrial ablation:

  • Patient may experience some cramping, discomfort, or spotting immediately after the procedure
  • Patient is advised to rest and avoid strenuous activity for a period of time
  • Patient may experience lighter menstrual bleeding or no menstrual bleeding at all in the following months
  • Patient follows up with doctor for post-procedure evaluations and monitoring
  • In some cases, the treatment may fail, leading to continued heavy menstrual bleeding and further treatment options may be considered

What to Ask Your Doctor

  1. What is endometrial ablation and how does it work?
  2. What are the potential risks and side effects of endometrial ablation?
  3. How successful is endometrial ablation in treating heavy menstrual bleeding?
  4. Are there any factors that may affect the success of endometrial ablation in my case?
  5. Are there any alternative treatments or procedures that may be more suitable for me?
  6. What is the recovery process like after endometrial ablation?
  7. Will I still be able to get pregnant after endometrial ablation?
  8. How long do the effects of endometrial ablation typically last?
  9. What can I do to ensure the best possible outcome from the procedure?
  10. Are there any lifestyle changes or precautions I should take after undergoing endometrial ablation?

Reference

Authors: Lybol C, van der Coelen S, Hamelink A, Bartelink LR, Nieboer TE. Journal: J Minim Invasive Gynecol. 2018 Nov-Dec;25(7):1255-1259. doi: 10.1016/j.jmig.2018.03.006. Epub 2018 Mar 14. PMID: 29550389