Long-term incidence of hysterectomy following endometrial resection or endometrial ablation for heavy menstrual bleeding

Abstract

Objective: To estimate the incidence of hysterectomy following endometrial resection or endometrial ablation (ERA).

Methods: The present retrospective study enrolled women who underwent ERA for benign heavy menstrual bleeding (HMB) at Aberdeen Royal Infirmary, UK, between February 1, 1990, and December 31, 1997; follow-up data to the end of 2015 were included from the pathology laboratory report system from the single pathology laboratory in the region. Data were compared between patients who did or did not require a hysterectomy after ERA.

Results: There were 901 patients who underwent ERA for HMB during the study period. The mean age of patients was 42.3 ± 5.7 years; of the patients included, 206 (22.9%) women underwent hysterectomy and these patients had a mean age of 40.1 years. Of the patients who had hysterectomies, 155 (75.2%) did so in the first 5 years following ERA, 31 (15.0%) did within 6-10 years, 11 (5.3%) did within 11-15 years, and 9 (4.4%) did within 16-20 years. In total, 51 (24.8%) of these patients had hysterectomies within 6-25 years of ERA.

Conclusions: A significant majority of women who underwent ERA for HMB did not require hysterectomy up to 25 years after the procedure.

Keywords: Endometrial ablation; Endometrial resection; Heavy menstrual bleeding; Hysterectomy incidence; Menorrhagia.