Fewer hysterectomies after MEA than resection: randomized trial: outcomes evaluated after 5-7 years.

LAS VEGAS -- Women with menorrhagia who underwent microwave endometrial ablation reported greater satisfaction with the procedure and fewer hysterectomies 5-7 years after treatment than did those who had endometrial resection in a randomized trial of 236 patients.

The data comprise the longest follow-up of any randomized trial of microwave endometrial ablation (MEA), Dr. David E. Parkin said during the annual meeting of the American Association of Gynecologic Laparoscopists.

Ninety percent of the original cohort of 263 patients answered mailed questionnaires--129 women in the MEA group and 134 women treated by transcervical resection of the endometrium, reported Dr. Parkin of Aberdeen (Scotland) Royal Infirmary.

Quality-of-life scores improved significantly from baseline in both groups. The MEA group reported significantly higher scores for total or general satisfaction and acceptability of the results, compared with the resection group.

A smaller percentage of women in the MEA group underwent subsequent hysterectomy after ablation than in the resection group (18% vs. 28%).

The difference in hysterectomy rates affected amenorrhea rates. In an intention-to-treat analysis that included all patients, amenorrhea rates were higher in the resection group. Among patients who did not undergo hysterectomy, however, women in the MEA group were more likely to report amenorrhea (47% vs. 40%).

The results differed somewhat from previously published 2-year follow-up data, Dr. Parkin added. At the 2-year mark, 12% in each group had undergone hysterectomy, and ...