Hysterectomy compared with endometrial ablation for dysfunctional uterine bleeding: a randomized controlled trial.

Hysterectomy compared with endometrial ablation for dysfunctional uterine bleeding: a randomized controlled trial. Research Abstract Details 

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Hysterectomy compared with endometrial ablation for dysfunctional uterine bleeding: a randomized controlled trial. Abstract Text:

Kay Dickersin,Malcolm G Munro,Melissa Clark,Patricia Langenberg,Roberta Scherer,Kevin Frick,Qi Zhu,Linda Hallock,John Nichols,Tamer M Yalcinkaya, ,Kay Dickersin,Malcolm G Munro,Melissa Clark,Patricia Langenberg,Roberta Scherer,Kevin Frick,Qi Zhu,Linda Hallock,John Nichols,Tamer M Yalcinkaya, ,

OBJECTIVE: To compare the effectiveness of hysterectomy and endometrial ablation in women with dysfunctional uterine bleeding. METHODS: The Surgical Treatments Outcomes Project for Dysfunctional Uterine Bleeding was a multicenter, randomized controlled trial. Eligible women were premenopausal with dysfunctional uterine bleeding and aged 18 years or older. Primary outcomes were problems that led the woman to seek care solved, bleeding, pain, and fatigue at 12 months. Additional outcomes included quality of life, adverse events, reoperation, and others at 24 months and up to 5 years. RESULTS: We randomly assigned 237 women between January 1998 and June 2001. Follow-up ended in June 2003. We completed 24 months of follow-up on 114 of 123 women assigned to endometrial ablation and 111 of 114 assigned to hysterectomy. Approximately 85% of women were aged younger than 45 years; 76.4% classified themselves as white, 18.6% as African American, less than 1% as Asian, 4.6% as American Indian, and 8.4% as Hispanic (classification within more than one category possible). Both endometrial ablation and hysterectomy were effective at 24 months in solving the problem that led women to seek care (84.9% compared with 94.4%), and in relieving bleeding, pain, fatigue, and other symptoms, although hysterectomy was more effective for bleeding. By 48 months, 32 of the 110 women initially receiving endometrial ablation required reoperation. Adverse events were more frequent with hysterectomy. CONCLUSION: Both endometrial ablation and hysterectomy are effective treatments in women with dysfunctional uterine bleeding. Hysterectomy (as the index surgery) was associated with more adverse events and a substantial number of patients receiving endometrial ablation had reoperation. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00114088 LEVEL OF EVIDENCE: I.

Hysterectomy compared with endometrial ablation for dysfunctional uterine bleeding: a randomized controlled trial. Publishing Authors By Initials

K Dickersin,MG Munro,M Clark,P Langenberg,R Scherer,K Frick,Q Zhu,L Hallock,J Nichols,TM Yalcinkaya, ,K Dickersin,MG Munro,M Clark,P Langenberg,R Scherer,K Frick,Q Zhu,L Hallock,J Nichols,TM Yalcinkaya, ,

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Hysterectomy compared with endometrial ablation for dysfunctional uterine bleeding: a randomized controlled trial. Journal Published:

PUBLICATION TYPE: Research Support, N.I.H., Extr

Journal: Obstetrics and gynecology

VOLUME: 110

Page Numbers: 1279-89

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ISSN: 0029-7844

DAY: 6

MONTH: Dec

YEAR: 2007

Hysterectomy compared with endometrial ablation for dysfunctional uterine bleeding: a randomized controlled trial. Information

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LANGUAGE: eng

NlmUniqueID: 401101

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Grant and Affiliation Information for Hysterectomy compared with endometrial ablation for dysfunctional uterine bleeding: a randomized controlled trial.

AFFILIATION: Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA. kdickers@jhsph.edu

Country: United States

AGENCY: United States AHRQ

GRANT: 5U01 HS09506

ACRONYM: HS

MEDLINETA: Obstet Gynecol

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