Endometrial ablation increases risk of hysterectomy upto 12 % after five years

In this study, researchers assessed hysterectomy risk after nonresectoscopic endometrial ablation in patients with a history of heavy menstrual bleeding using data from EMBASE, MEDLINE, ClinicalTrials.gov and Cochrane databases. The search terms for endometrial ablation and hysterectomy were used.

The key points of this study are:

• Fifty-three studies met inclusion and exclusion criteria.
• There were six retrospective studies, 24 randomized controlled trials, and 23 prospective studies.
• A total of 48,071 patients underwent endometrial ablation between 1992 and 2017.
• The Follow-up duration varied between 12 and 120 months.
• At 12 months of follow-up, there was a 4.3% hysterectomy rate.
• At 18 months, 24 months, 36 months, 48 months and 60 months, the hysterectomy rate was 11.1%, 8.0%, 10.2%, 7.6% and 12.4%, respectively.
• Two studies reported a mean hysterectomy rate of 10 years after ablation of 21.3%.

They concluded that hysterectomy risk after endometrial ablation increased from 4.3% after one year to 12.4% after five years.

This should be used to counsel patients, they wrote.

Further reading:

https://journals.lww.com/greenjournal/Abstract/9900/Risk_of_Hysterectomy_After_Endometrial_Ablation__A.792.aspx