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Microwave Endometrial Ablation Versus Endometrial Resection: A Randomized Controlled Trial

From the Department of Obstetrics and Gynaecology, Aberdeen Royal Infirmary, Aberdeen, Scotland.

Address reprint requests to: Christine Bain, MRCOG, MFFP, Aberdeen Royal Infirmary, Wards 42/43, Foresterhill, Aberdeen, Grampian AB25 2ZN, Scotland; E-mail: bainhouse{at}supanet.com.

OBJECTIVE: To compare menstrual status, satisfaction, and acceptability of microwave endometrial ablation with transcervical endometrial resection for the treatment of heavy menstrual bleeding.

METHODS: Women were randomized to either endometrial ablative method. Menstrual status, satisfaction, acceptability, and changes in health-related quality of life were obtained by a self-completed questionnaire. Case note review and personal communication identified further surgery rates at 2 years after each procedure.

RESULTS: Among the original 263 women who underwent endometrial ablation, 249 (95%) returned questionnaires at 2 years. Menstrual status in both groups was similar, although the amenorrhea rate was higher after microwave endometrial ablation. Seventy-nine percent of women were either completely or generally satisfied after microwave ablation compared with 67% after transcervical endometrial resection. Health-related quality-of-life scores remained higher than at recruitment for both treatments. Hysterectomy rates were similar at 2 years (11.6% after microwave endometrial ablation and 12.7% after transcervical endometrial resection), and no repeat endometrial ablative procedures were required.

CONCLUSION: Microwave endometrial ablation is an effective alternative to transcervical endometrial resection for dysfunctional uterine bleeding.

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