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Endometrial ablation is a less invasive surgery for refractory dysfunctional uterine bleeding than hysterectomy. However, studies have found that most women treated with ablation eventually require hysterectomy. (See JWWH Mar, 1997, p. 22 and Am J Obstet Gynecol, 1996, 175:1423.) This U.K. trial reports four-year follow-up data on 151 of 197 women randomized to one of the two procedures.
About 40% of the endometrial ablation group required further surgical intervention (ablation or hysterectomy) by one, four, and five years (29%, 36%, and 40%, cumulatively); the corresponding likelihood of hysterectomy was 14%, 24%, and 30%. The women had similar anxiety and depression scores and satisfaction rates; 80% and 89%, respectively, of those random…