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Menstrual Bleeding Treatment Safer Than Thought

Ablation technique is a less invasive alternative to hysterectomy, researchers note

FRIDAY, Jan. 23 (HealthDay News) -- Far fewer women than previously thought need additional surgery to stop excessive or prolonged menstrual bleeding after undergoing an alternative to hysterectomy called global endometrial ablation (GEA), a new study finds.

GEA, a relatively new procedure, has been regarded as being just as effective as hysterectomies while being less invasive with slightly lower complication rates and costs. During the surgery, heat, cold, microwave or radiofrequency energy is used to destroy only the uterine lining while keeping the uterus intact. Scar tissue then forms and monthly menstrual flow and its pain typically decrease.

The Mayo Clinic study, published in the January issue of Obstetrics and Gynecology, found that about 16 percent -- nearly half of past estimates -- of women required a hysterectomy to treat excessive bleeding in the first five years following an ablation.

"We've known for the past five to six years that global endometrial ablation devices are very effective," Mayo Clinic gynecologic surgeon Abimbola Famuyide, one of the study's authors, said in a news release issued by the facility. "But some physicians have observed that up to 30 percent of patients may require additional treatment five years and beyond after undergoing ablation."

More susceptible to a lack of permanent symptom relief, according to the the team, were GEA patients younger than 45 who had a tubal ligation to prevent pregnancy or had debilitating menstrual pain prior to the procedure.

Excessive or prolonged menstrual bleeding affects an estimated one in five women at some time in their lives, often during the onset of menopause.

The low failure rate, the researchers suggested, might also mean that the study sample contained many patients properly counseled to have realistic expectations for the procedure and symptom relief. "For example, patients who are seeking complete cessation of menstrual bleeding after GEA are more likely to undergo hysterectomy later to treat bleeding symptoms of any severity," Famuyide said.

The team also noted that previous studies of GEA failure were small or imprecise in defining failure. The Mayo team studied the medical records of more than 800 women had GEA procedures over an eight-year period.

More information

The National Women's Health Resource Center has more about menstrual disorders.

-- Kevin McKeever

SOURCE: Mayo Clinc, news release, Jan. 6, 2009

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