Hysterectomy After Endometrial Ablation Is Less Likely in Older Women

Abnormal uterine bleeding is the most common reason for gynecologic visits in the U.S. and is a common indication for hysterectomy. However, endometrial ablation (by any of several techniques) has been promulgated as a reasonable alternative to hysterectomy when medical treatment for abnormal uterine bleeding fails. To evaluate the effectiveness of endometrial ablation, clinicians at a large California-based managed care organization conducted a retrospective cohort analysis of more than 3600 women (age range, 25–60) who underwent endometrial ablation during a 6-year period (30 locations; 344 physicians).

By life-table analysis, the probability of hysterectomy at 8 years after ablation was 26%, with most surgeries occurring within 3 years of…