Author(s)

Leonardo Vieira Elias^1*, Daniel Spadoto-Dias¹, Nilton José Leite¹, Flávia Neves Bueloni-Dias¹, Gustavo Filipov Peres¹, Carlos Roberto Padovani², Rogério Dias^1,3

¹Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University—UNESP, São Paulo, Brazil.
²Department of Biostatistics, Botucatu Institute of Biosciences, S São Paulo State University—UNESP, São Paulo, Brazil.
³The Gynecological Endoscopy and Family Planning Sector, Botucatu Medical School Hospital, São Paulo State University—UNESP and Principal Investigator, São Paulo, Brazil.

Objective: To compare clinical outcomes between two first-generation endometrial ablation techniques. Design: Prospective comparative coorte. Setting: Tertiary public hospital, university teaching center. Seventy-three patients with abnormal uterine bleeding unresponsive to clinical treatment submitted to endometrial ablation from October 2011 to September 2013. Methods and Main Outcome Measures: Patients were assigned to either monopolar U-shaped electrode resection with rollerball electrocoagulation (group A, n = 36) or rollerball electrocoagulation alone (group B, n = 37). Mean follow-up length was 359 (280 - 751) and 370 days (305 - 766) in groups A and B, respectively. Bleeding pattern, associated symptoms, failure/success rates were assessed 30, 90, 180 and 360 days post-procedure. Findings: Patient characteristics were similar in both groups (P ≥ 0.05). Surgery duration (mean of 48.5 [±12.0] vs. 31.9 [±5.6] min, P < 0.001) and medium distention use (5.700 mL vs. 3.500 mL, P < 0.01) were decreased in group B. Post-ablation clinical improvement was considerable in both groups. Vaginal discharge incidence after the procedure was lower in group B (30.5% vs. 8.1%, P < 0.05). Hysterectomy rate was 9.6%. Overall success rate was 86.1% and 88.1% in groups A and B, respectively. Conclusions: Endometrial ablation using rollerball electrocoagulation alone may be considered safer than resection with rollerball electrocoagulation, which requires shorter surgical time and less distention medium, and is associated with lower postoperative vaginal discharge incidence. Success rate did not statistically differ between groups, but study parameters in absolute values and percents were superior in group B.

Uterine Bleeding, Hysteroscopy, Surgical Procedures, Endometrial Ablation Techniques, Patient Satisfaction

Elias, L. , Spadoto-Dias, D. , Leite, N. , Bueloni-Dias, F. , Peres, G. , Padovani, C. and Dias, R. (2017) Comparative Study between Endometrial Resection and Electrocoagulation in Patients with Abnormal Uterine Bleeding. Open Journal of Obstetrics and Gynecology, 7, 312-325. doi: 10.4236/ojog.2017.73033.