Hysterectomy Subsequent to Endometrial Ablation

Valerie I. Shavell, Michael Peter Diamond, James P. Senter, Michael L. Kruger, D. Alan Johns

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Study Objective: To estimate the incidence of and factors associated with hysterectomy subsequent to endometrial ablation. Design: Retrospective cohort study (Canadian Task Force classification II-2). Setting: Gynecology practice. Patients: Women who underwent endometrial ablation from January 2003 to June 2010, with a minimum follow-up of 9 months. Interventions: Endometrial ablation and hysterectomy. Measurements and Main Results: Of 1169 women, 157 (13.4%) underwent hysterectomy subsequent to endometrial ablation. Women who underwent subsequent hysterectomy were significantly younger at ablation (mean [SD; 95% CI] 39.0 [6.8; 38.0-40.1] years vs 41.4 [7.0; 41.0-41.9] years; p < .001) and were more likely to have previously delivered via cesarean section (26.3 vs 18.1%; p = .02). The rate of hysterectomy was significantly associated with the type of ablation performed: 33.0% for rollerball vs 16.5% for thermal balloon (p = .003), 11.0% for radiofrequency (p < .001), and 9.8% for cryoablation (p < .001). Time to hysterectomy also differed significantly based on the type of ablation performed (p = .006). Adenomyosis was present in 44.4% of hysterectomy specimens. Conclusion: With a mean follow-up of 39 months, 13.4% of women underwent hysterectomy subsequent to ablation. Women who were younger at ablation had an increased likelihood of hysterectomy. Rate and time to hysterectomy were associated with the type of ablation performed.

Original languageEnglish (US)
Pages (from-to)459-464
Number of pages6
JournalJournal of Minimally Invasive Gynecology
Volume19
Issue number4
DOIs
StatePublished - Jul 1 2012
Externally publishedYes

Fingerprint

Endometrial Ablation Techniques
Hysterectomy
Adenomyosis
Cryosurgery
Advisory Committees
Gynecology
Cesarean Section
Cohort Studies
Retrospective Studies
Hot Temperature

Keywords

  • Adenomyosis
  • Cryoablation
  • Endometrial ablation
  • Hysterectomy
  • Radiofrequency
  • Rollerball
  • Thermal balloon

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Hysterectomy Subsequent to Endometrial Ablation. / Shavell, Valerie I.; Diamond, Michael Peter; Senter, James P.; Kruger, Michael L.; Johns, D. Alan.

In: Journal of Minimally Invasive Gynecology, Vol. 19, No. 4, 01.07.2012, p. 459-464.

Research output: Contribution to journalArticle

Shavell, Valerie I. ; Diamond, Michael Peter ; Senter, James P. ; Kruger, Michael L. ; Johns, D. Alan. / Hysterectomy Subsequent to Endometrial Ablation. In: Journal of Minimally Invasive Gynecology. 2012 ; Vol. 19, No. 4. pp. 459-464.
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abstract = "Study Objective: To estimate the incidence of and factors associated with hysterectomy subsequent to endometrial ablation. Design: Retrospective cohort study (Canadian Task Force classification II-2). Setting: Gynecology practice. Patients: Women who underwent endometrial ablation from January 2003 to June 2010, with a minimum follow-up of 9 months. Interventions: Endometrial ablation and hysterectomy. Measurements and Main Results: Of 1169 women, 157 (13.4{\%}) underwent hysterectomy subsequent to endometrial ablation. Women who underwent subsequent hysterectomy were significantly younger at ablation (mean [SD; 95{\%} CI] 39.0 [6.8; 38.0-40.1] years vs 41.4 [7.0; 41.0-41.9] years; p < .001) and were more likely to have previously delivered via cesarean section (26.3 vs 18.1{\%}; p = .02). The rate of hysterectomy was significantly associated with the type of ablation performed: 33.0{\%} for rollerball vs 16.5{\%} for thermal balloon (p = .003), 11.0{\%} for radiofrequency (p < .001), and 9.8{\%} for cryoablation (p < .001). Time to hysterectomy also differed significantly based on the type of ablation performed (p = .006). Adenomyosis was present in 44.4{\%} of hysterectomy specimens. Conclusion: With a mean follow-up of 39 months, 13.4{\%} of women underwent hysterectomy subsequent to ablation. Women who were younger at ablation had an increased likelihood of hysterectomy. Rate and time to hysterectomy were associated with the type of ablation performed.",
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AB - Study Objective: To estimate the incidence of and factors associated with hysterectomy subsequent to endometrial ablation. Design: Retrospective cohort study (Canadian Task Force classification II-2). Setting: Gynecology practice. Patients: Women who underwent endometrial ablation from January 2003 to June 2010, with a minimum follow-up of 9 months. Interventions: Endometrial ablation and hysterectomy. Measurements and Main Results: Of 1169 women, 157 (13.4%) underwent hysterectomy subsequent to endometrial ablation. Women who underwent subsequent hysterectomy were significantly younger at ablation (mean [SD; 95% CI] 39.0 [6.8; 38.0-40.1] years vs 41.4 [7.0; 41.0-41.9] years; p < .001) and were more likely to have previously delivered via cesarean section (26.3 vs 18.1%; p = .02). The rate of hysterectomy was significantly associated with the type of ablation performed: 33.0% for rollerball vs 16.5% for thermal balloon (p = .003), 11.0% for radiofrequency (p < .001), and 9.8% for cryoablation (p < .001). Time to hysterectomy also differed significantly based on the type of ablation performed (p = .006). Adenomyosis was present in 44.4% of hysterectomy specimens. Conclusion: With a mean follow-up of 39 months, 13.4% of women underwent hysterectomy subsequent to ablation. Women who were younger at ablation had an increased likelihood of hysterectomy. Rate and time to hysterectomy were associated with the type of ablation performed.

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