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Saturday, July 26, 2014
Trailers (89): A randomized controlled trial of endometrial ablation in the office

Smith et al. Bipolar radiofrequency compared with thermal balloon ablation in the office: a randomized controlled trial.

Why should you read about this topic?

Randomized controlled trials of commonly used surgical techniques are always welcome, especially those with 5 year follow-up

What were the authors trying to do?

Compare the efficacy at 5-year follow-up of bipolar radiofrequency ablation with thermal balloon ablation of the endometrium in the office for treatment of heavy menstrual bleeding

Who participated and in what setting?

Women (N=81) >25 years old with heavy menstrual bleeding and a normally configured uterine lumen at Birmingham Women’s Hospital in the UK

What was the study design?

Follow-up questionnaire study of a single-masked randomized controlled trial

What were the main outcome measures?

Amenorrhea.  Secondary outcomes included global and disease-specific quality of life questionnaires.

What were the results?

Amenorrhea rates and satisfaction with treatment outcomes scores were not different between groups.  Re-operation rates were not different, either, although the study sample size was too small to detect meaningful differences.  Quality of life measures were not different between groups.

What is the most interesting image in the paper?

Table 2

What were the study strengths and weaknesses?

Strengths:  randomized controlled trial. Weaknesses: postal questionnaire; very small study at a single institution.

What does the study contribute for your practice?

Whether it’s Thermachoice III or NovaSure, the results are the same 5 years later.

About the Author

William C. Dodson, MD
William C. Dodson, MD, is Professor of Obstetrics and Gynecology and Director of the Division of Reproductive Endocrinology and Infertility at Penn State College of Medicine. He completed his fellowship in reproductive endocrinology at Duke University. His research and clinical areas of focus include treatment of infertility, especially ovulation induction. He was previously on the Editorial Board of Obstetrics & Gynecology and has served as the Consultant Web Editor for Obstetrics & Gynecology since 2008.

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