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Hysterectomy, Ablation Both Effective for Uterine Bleeding

Hysterectomy has more adverse outcomes, while endometrial ablation patients have more reoperations

THURSDAY, Dec. 6 (HealthDay News) -- Both hysterectomy and endometrial ablation are effective treatments for dysfunctional uterine bleeding, although hysterectomy is associated with more adverse events and endometrial ablation with more reoperation, researchers report in the December issue of Obstetrics & Gynecology.

Kay Dickersin, Ph.D., of the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues randomly assigned 237 women with dysfunctional uterine bleeding to either endometrial ablation or hysterectomy. The women had presented for treatment at 25 clinical centers in the Surgical Treatments Outcomes Project for Dysfunctional Uterine Bleeding (STOP-DUB) research group. Specific types of hysterectomy or ablation were selected by attending gynecologists.

Both surgical techniques were effective at 12 months in relieving dysfunctional bleeding, pain, fatigue and other symptoms, although hysterectomy was more effective at relieving bleeding (93.2 percent versus 87.9 percent). There were four times as many adverse events and nearly six times as many postoperative infections reported for those receiving hysterectomy as the index surgery. By 60 months, 34 of the 110 women in the endometrial ablation group had undergone reoperations. All but two of these received hysterectomies.

"It is reasonable to recommend that women select the type of surgery they receive for treatment of dysfunctional uterine bleeding based on their individual preferences and situations," the authors conclude.

A center directed by Dickersin has received financial support from various pharmaceutical and surgical companies. Another author of the report has been a consultant for companies that manufacture surgical equipment used in endometrial ablation.

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