Predicting the Likelihood That Endometrial Ablation Will Fail

In recent decades, endometrial ablation has offered an alternative to hysterectomy for women seeking relief from heavy menstrual bleeding (HMB). Second-generation endometrial ablation devices (which typically do not require hysteroscopy and are suited for in-office use) have emerged as the most common approach in the U.S. to this procedure, and have a rate of failure (i.e., repeat ablation or hysterectomy) ranging from 10% to 20%.

Investigators performed a review and meta-analysis of 21 studies that reported failure rates for second-generation ablation as well as factors associated with failure. Of 10 factors analyzed, younger age (defined using cut-offs of 35, 40, or 45 years) and prior tubal sterilization were found to be modestly associat…