Geburtshilfe Frauenheilkd 2014; 74 - PO_Gyn_Uro01_04
DOI: 10.1055/s-0034-1388247

Treatment of menorrhagia with biopolar radiofrequency endometrial ablation in patients at high surgical risk: quality of live, global outcome and comparison to low risk population

F Fischer 1, R Klapdor 1, S Grüssner 2, Y Ziert 3, P Hillemanns 1, H Hertel 1
  • 1Medizinische Hochschule Hannover, Klinik für Frauenheilkunde und Geburtshilfe, Hannover, Germany
  • 2Universitätsklinikum Frankfurt am Main, Klinik für Frauenheilkunde und Geburtshilfe, Frankfurt am Main, Germany
  • 3Medizinische Hochschule Hannover, Zentrum Biometrie, Hannover, Germany

Objective: To evaluate the quality of life (QoL) following bipolar radiofrequency endometrial ablation (RFEA) for treatment of menorrhagia in a high surgical risk population compared to low risk patients.

Methods: Observational study of women treated with RFEA (Novasure®). Validated menorrhagia outcomes questionnaire (MOQ) was sent to the patients and used to receive QoL and global outcome data. Surgical risk factors were defined as: coagulopathy, severe cardiovascular or pulmonary disease, anaemia, obesity and history of thrombosis, embolism, malignancy or transplantation.

Results: 235 women were treated between June 2010 and November 2012. MOQ response rate was 202 (86%). Mean age and parity of all responders was 46.1 years (27 – 70) and 1.7 (0 – 7). Median follow-up time was 13 months (range 3 – 30). The overall success rate of all responders, including the improvement of symptoms and the lack of need for further surgery was 91%, being 95.7% in the low risk group (n = 67 patients) and 90% in the high risk group (n = 135 patients) (p = 0.155). No significant difference between the low risk and high risk group are shown either for the total outcome score (mean difference: 2.00 (CI95 -0.97 – 4.97)) nor for the QoL/Satisfaction Score (mean difference: 0.60 (CI95 -2.38 – 3.58)), thereby indicating that the outcome of the high risk cohort is indeed as good as of the low risk group.

Conclusion: RFEA is highly effective in treatment of menorrhagia and has a high QoL/Satisfaction Score. Thus, particularly for women with elevated surgical risk, RFEA is an important alternative to hysterectomy and its associated perioperative morbidity.