Your Family Physician

For the treatment of women with heavy menstrual loss, microwave endometrial ablation (MEA) has "many advantages" over transcervical resection of the endometrium (TCRE), clinicians from the UK conclude based on results of a long-term follow-up study.

"Not only is MEA as effective at reducing menstrual symptoms, it achieves higher levels of satisfaction and acceptability, is simple to learn, faster to perform, less expensive, and is acceptable under local anesthetic and acceptable for use in the outpatient setting," they note in the July issue of BJOG: An International Journal of Obstetrics and Gynaecology.

In the paper, Dr. Kevin G. Cooper and colleagues from Aberdeen Royal Infirmary, UK, report outcomes at a minimum of 10 years post-procedure in 129 women who underwent MEA and 134 who underwent TCRE for heavy menstrual loss. All of the women had similar baseline characteristics.

According to the report, 77 MEA-treated women (60%) and 70 TCRE-treated women (52%) reported being "totally or generally" satisfied with treatment; "the difference is not statistically significant," the study team notes.

Bleeding and pain scores were highly significantly reduced and similar following both MEA and TCRE, achieving amenorrhea rates of 85% and 88%, respectively.

After 10 years, significantly fewer women in the MEA arm than the TCRE arm had had a hysterectomy (17% versus 28%).

"With the known operative advantages, lower costs and fewer hysterectomies, it is clear that MEA is more effective and efficient treatment for heavy menstrual loss than TCRE," Dr. Cooper and colleagues conclude.

"Although not quite as versatile as TCRE," they note, "it can also treat the majority of endometrial cavities including those with cavities up to 12 cm and those with nonobstructing submucosal fibroids."

Source : http://www.medscape.com/viewarticle/705481?src=mpnews&spon=34&uac=133298AG