Reinders I M A, van de Kar M R D, Geomini P M A J, Leemans J C, Maas J W M, Bongers M Y
Facts Views Vis Obgyn. 2022 Dec;14(4):299-307. doi: 10.52054/FVVO.14.4.042.
Endometrial ablation is a frequently performed treatment for heavy menstrual bleeding, but detailed information about recovery to help inform patients is lacking.
To gain more insight into the short-term recovery after NovaSure® endometrial ablation, with the goal of improving preprocedural counselling.
A total of 61 women who underwent endometrial ablation between March 2019 and November 2021 in a teaching hospital in the Netherlands were included in this prospective cohort study.
Short-term recovery was investigated through questionnaires in the first week after the procedure. The primary outcome was the Recovery Index (RI-10). Secondary outcomes included health-related quality of life (EQ-5D-5L), pain intensity, use of analgesics, nausea, vaginal discharge, capability of performing activities (domestic chores, sports, work), self-rated health (EQ-VAS) and the feeling of full recovery.
A total of 33 women underwent the procedure under local anaesthesia and 28 women under procedural sedation. The RI-10 increased in the first week; median scores on day one, two and seven were 34 (IQR 28.5-41.5), 38.5 (IQR 31-47), and 42 (IQR 37.5-48), respectively. The median time for full recovery was five days. However, 23% of all women were not fully recovered within seven days. Women needed a median time of two days for returning to their work and 5.5 days for sporting activities. There were no differences in recovery between both anaesthesia techniques.
Women undergoing endometrial ablation can be informed that most will fully recover within the first week of the procedure and that there is no difference in expected recovery time according to whether the procedure is undertaken with local anaesthesia or conscious sedation.
WHAT IS NEW?: The short-term recovery after endometrial ablation has been mapped in this trial. This information can be used in counselling women with heavy menstrual bleeding.
子宫内膜消融术是治疗月经过多的常用方法，但缺乏有助于患者了解恢复情况的详细信息。
深入了解诺舒子宫内膜消融术后的短期恢复情况，以改善术前咨询。
本前瞻性队列研究纳入了2019年3月至2021年11月在荷兰一家教学医院接受子宫内膜消融术的61名女性。
术后第一周通过问卷调查研究短期恢复情况。主要结局指标是恢复指数（RI-10）。次要结局指标包括健康相关生活质量（EQ-5D-5L）、疼痛强度、镇痛药使用情况、恶心、阴道分泌物、进行活动（家务、运动、工作）的能力、自我健康评分（EQ-VAS）以及完全恢复的感觉。
共有33名女性在局部麻醉下接受手术，28名女性在术中镇静下接受手术。RI-10在第一周有所增加；第1天、第2天和第7天的中位数得分分别为34（四分位间距28.5 - 41.5）、38.5（四分位间距31 - 47）和42（四分位间距37.5 - 48）。完全恢复的中位时间为5天。然而，23%的女性在7天内未完全恢复。女性恢复工作的中位时间为2天，恢复体育活动的中位时间为5.5天。两种麻醉技术在恢复方面没有差异。
可以告知接受子宫内膜消融术的女性，大多数人将在术后第一周内完全恢复，并且根据手术是在局部麻醉还是清醒镇静下进行，预期恢复时间没有差异。
本试验已描绘了子宫内膜消融术后的短期恢复情况。这些信息可用于为月经过多的女性提供咨询。
