Thiel John A, Briggs M Martha, Pohlman Scott, Rattray Darrien
University of Saskatchewan, Department of Obstetrics, Gynecology and Reproductive Sciences, Regina SK.
Regina Qu'Appelle Health Region, Regina SK.
J Obstet Gynaecol Can. 2014 Jun;36(6):491-497. doi: 10.1016/S1701-2163(15)30562-4.
To evaluate procedure-related adverse events, post-procedure menstrual bleeding status, and surgical re-intervention in women with a sounded uterine length > 10 cm compared to women with a sounded uterine length ≤ 10 cm who underwent the NovaSure endometrial ablation procedure.
We conducted a retrospective cohort study of 188 women from a Canadian community-based gynaecology practice. Eighty-seven women had a sounded uterine length > 10 cm, and 101 patients had a sounded length ≤ 10 cm. Procedure-related adverse events, post-procedure menstrual bleeding status, and surgical re-interventions were compared between groups.
Mean uterine sounding lengths were 11.0 ± 0.6 cm and 8.9 ± 0.8 cm in the > 10 cm and ≤ 10 cm groups, respectively. There were no differences between the groups in demographic characteristics or gynaecologic history, with the exception of higher BMI in the > 10 cm group and a greater prevalence of dysmenorrhea in the ≤ 10 cm group. Overall, 44.1% of all participants had been unsuccessfully treated with hormonal therapy, and 20.7% had failed non-hormonal treatment before the ablation procedure. The remaining 35.2% of participants had declined alternative therapy and proceeded directly to endometrial ablation. No serious procedure-related adverse events occurred in either group. Menstrual bleeding status at follow-up at 30.4 ± 15.3 months (> 10 cm group) and 30.5 ± 15.5 months (≤ 10 cm group) was not different between the groups (P = 0.85). In women who did not undergo surgical re-intervention after the initial ablation, amenorrhea was reported by 51.9% in the > 10 cm group and 65.9% in the ≤ 10 cm group.
The NovaSure endometrial ablation procedure was associated with successful menstrual bleeding outcomes in women with sounded uterine length > 10 cm. No serious procedure-related adverse events occurred, and the need for surgical re-intervention was low. There was no significant difference in bleeding rates between the > 10 cm and ≤ 10 cm uterine length cohorts.
评估与手术相关的不良事件、术后月经出血状况，以及子宫探测长度＞10cm的女性与子宫探测长度≤10cm且接受了NovaSure子宫内膜切除术的女性的再次手术干预情况。
我们对加拿大一个社区妇科诊所的188名女性进行了一项回顾性队列研究。87名女性子宫探测长度＞10cm，101名患者子宫探测长度≤10cm。对两组之间与手术相关的不良事件、术后月经出血状况及再次手术干预情况进行了比较。
子宫探测长度＞10cm组和≤10cm组的平均子宫探测长度分别为11.0±0.6cm和8.9±0.8cm。除了子宫探测长度＞10cm组的BMI较高以及子宫探测长度≤10cm组痛经患病率较高外，两组在人口统计学特征或妇科病史方面无差异。总体而言，所有参与者中有44.1%的人激素治疗未成功，20.7%的人在消融手术前非激素治疗失败。其余35.2%的参与者拒绝了替代治疗并直接进行了子宫内膜消融。两组均未发生严重的与手术相关的不良事件。随访30.4±15.3个月（子宫探测长度＞10cm组）和30.5±15.5个月（子宫探测长度≤1cm组）时，两组的月经出血状况无差异（P=0.85）。在初次消融后未接受再次手术干预的女性中，子宫探测长度＞10cm组有51.9%报告闭经，子宫探测长度≤10cm组有65.9%报告闭经。
NovaSure子宫内膜切除术与子宫探测长度＞10cm的女性成功的月经出血结局相关。未发生严重的与手术相关的不良事件，再次手术干预的需求较低。子宫探测长度＞10cm组和≤10cm组之间的出血率无显著差异。
