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Federally-Funded Study Shows More Women Can Avoid Hysterectomy for Common Problem
Date:12/27/2007

trolled trial in the U.S. and Canada involving 237 women at 25 treatment centers. The primary complaint causing women to seek surgery was excessive bleeding that had not been mitigated by medical therapy. These women were randomly assigned to receive either hysterectomy or endometrial ablation, a minimally invasive technique that removes only the lining of the uterus (the lining cells are responsible for the bleeding), not the entire organ.

The primary measure of success in the study was women's satisfaction with their treatment, rather than just a clinical endpoint. After three years of follow-up, the vast majority of patients in both groups (93-95%) reported that their problem was solved. The secondary endpoints of pain and fatigue were also similar between the hysterectomy group and the endometrial ablation group.

"Using women's satisfaction as the study goal, rather than clinical endpoints alone, was very astute from our perspective, because the most important outcome is the woman's opinion, not the doctor's," said Dr. Loffer. "Our view at AAGL is always patient-focused: how much pain will there be, how much trauma, how much time lost, what impact on the quality of life? These are the measures that count."

Advantages of the less invasive procedure include shorter hospital stays (hours instead of days), less blood loss, fewer complications and quicker recovery. In many cases endometrial ablation causes menstrual periods to become much lighter and more regular, rather than eliminating them altogether. Many women consider this to be a satisfactory outcome and would prefer to have normal periods rather than lose their uterus.

"Both endometrial ablation and hysterectomy are effective treatments in women with dysfunctional uterine bleeding. However, hysterectomy was associated with about four times more adverse events and six times as many postoperative infections," said Malcolm Munro, MD, an investigator in the StopDUB Research Group at th
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SOURCE AAGL
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