Thermal balloon ablation versus laparoscopic supracervical hysterectomy for the surgical treatment of heavy menstrual bleeding: A randomized study

Journal of Obstetrics and Gynaecology Research, 08/08/2011

Sesti F et al. – The effectiveness of thermal balloon ablation (TBA) as a possible treatment of heavy menstrual bleeding (HMB) is confirmed. However, laparoscopic supracervical hysterectomy (LSH) showed a definitive improvement of the symptoms, and a better life quality profile.

Methods

  • Sixty-eight women requiring surgical treatment for HMB were randomly allocated into two treatment arms: TBA (n = 34) and LSH (n = 34).
  • The randomization procedure was based on a computer-generated list.
  • The primary outcome was a comparison of the effects on menstrual bleeding (Pictorial Blood Loss Assessment Chart [PBAC]) between the two procedures.
  • The secondary outcome measures were quality of life, improvement of bleeding patterns, intensity of postoperative pain, and early postoperative complications.
  • Continuous outcome variables were analyzed using Student's t-test.
  • Discrete variables were analyzed with the x2 test or Fisher's exact test.
  • P < 0.05 was considered statistically significant.

Results

  • The PBAC score was significantly reduced in both treatment groups.
  • After LSH all women had amenorrhea. After TBA there was a significant improvement of bleeding frequency and length.
  • The postoperative pain intensity at 24 h was significantly minor in women treated with TBA rather than with LSH.
  • The Medical Outcomes Survey Short Form 36 (SF-36) score improved in both groups.
  • However, LSH showed a negative impact on the emotional state.
  • No intraoperative complications occurred, and no case was returned to the theatre in either group.

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