Newer Endometrial Ablation Techniques for Heavy Menstrual Bleeding

Endometrial ablation is a common surgical treatment for heavy menstrual bleeding unresponsive to medical therapy. Several second-generation, nonhysteroscopic techniques have been developed — but which of these methods, if any, are preferable? To address this question, investigators performed a meta-analysis of 19 randomized controlled trials involving 3287 women.

Compared with thermal balloon ablation, bipolar radiofrequency ablation and microwave ablation were both associated with higher rates of amenorrhea (odds ratios, 2.5; P<0.001, and 1.7; P=0.05, respectively). Compared with bipolar radiofrequency or microwave ablation, cryoablation was less effective for achieving amenorrhea. Compared with bipolar radiofrequency ablation, free-fluid a…