Abstract

Aim To assess the outcome of Novasure endometrial ablation procedure in patients with heavy menstrual bleeding, with or without dysmenorrhea including women with uterine cavity length greater than 6.5 cm. Methods A retrospective cohort study analysing the outcomes of the procedure in 100 women over a four-year period. The primary outcomes were amenorrhea, reduced menstrual bleeding, persistence of heavy periods and hysterectomy. Success rates were compared with published literature. Results The Novasure procedure was performed in 100 women; 91 with uterine cavity length of 4-6.5 cm (group A) and 9 women with uterine cavity length > 6.5 cm (group B). Three women in group A were lost to follow up. Dysmenorrhea was reported in 29 (32.9%) women in group A and in 5 (55.6%) women in group B. In group A the rate of amenorrhea, lighter periods and hysterectomy were 89.8%, 9.1% and 1.1% respectively compared to 55.6%, 22.2% and 22.2% in group B. Two out of the 3 women who required hysterectomy had dysmenorrhea. The failure rate in women presenting with heavy periods without dysmenorrhea was 1/63 (1.59%) compared to 2/34 (5.9%) in women with heavy periods and dysmenorrhea. Conclusions The Novasure endometrial ablation procedure is a very effective treatment for heavy menstrual bleeding with and without dysmenorrhea in women who have completed their family. Although the success rate was lower in women with uterine cavity length marginally greater than 6.5 cm, the outcome was still acceptable.

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