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Meta‐analysis of bipolar radiofrequency endometrial ablation versus thermal balloon endometrial ablation for the treatment of heavy menstrual bleeding
Author(s) -
Zhai Yan,
Zhang Zihan,
Wang Wei,
Zheng Tingping,
Zhang Huili
Publication year - 2018
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12340
Subject(s) - medicine , endometrial ablation , balloon , ablation , menstrual bleeding , endometrium , radiofrequency ablation , gynecology , radiology , obstetrics , surgery
Background Heavy menstrual bleeding is a common problem that can severely affect quality of life. Objectives To compare bipolar radiofrequency endometrial ablation and thermal balloon ablation for heavy menstrual bleeding in terms of efficacy and health‐related quality of life ( HRQ oL). Search strategy Online registries were systematically searched using relevant terms without language restriction from inception to November 24, 2016. Selection criteria Randomized control trials or cohort studies of women with heavy menstrual bleeding comparing the efficacy of two treatments were eligible. Data collection and analysis Data were extracted. Results were expressed as risk ratios ( RR s) or weighted mean differences ( WMD s) with 95% confidence intervals ( CI s). Main results Six studies involving 901 patients were included. Amenorrhea rate at 12 months was significantly higher after bipolar radiofrequency endometrial ablation than after thermal balloon ablation ( RR 2.73, 95% CI 2.00–3.73). However, no difference at 12 months was noted for dysmenorrhea ( RR 1.04, 95% CI 0.68–1.58) or treatment failure ( RR 0.78, 95% CI 0.38–1.60). The only significant difference for HRQ oL outcomes was for change in SAQ pleasure score (12 months: WMD −3.51, 95% CI −5.42 to −1.60). Conclusions Bipolar radiofrequency endometrial ablation and thermal balloon ablation reduce menstrual loss and improve quality of life. However, bipolar radiofrequency endometrial ablation is more effective in terms of amenorrhea rate and SAQ pleasure.