| Autor: |
Bansi‐Matharu, L, Gurol‐Urganci, I, Mahmood, TA, Templeton, A, Meulen, JH, Cromwell, DA |
| Předmět: |
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| Zdroj: |
BJOG: An International Journal of Obstetrics & Gynaecology; Nov2013, Vol. 120 Issue 12, p1500-1507, 8p, 5 Charts, 1 Graph |
| Abstrakt: |
Objective To assess the risk of further surgery amongst women who had an initial endometrial ablation ( EA) for the treatment of heavy menstrual bleeding ( HMB). Design A retrospective cohort study using a national administrative database. Setting Population-based study of hospital care in the English National Health Service. Population A cohort of 114 910 women who had EA for HMB between January 2000 and December 2011. Methods Multiple Cox regressions were performed to identify the risks of a further procedure, adjusted for age, social deprivation, year and type of initial EA, and presence of fibroids/polyps. Main outcome measures Time to repeat EA or hysterectomy after initial surgery. Results Of 114 910 women undergoing EA, 16.7% had at least one subsequent procedure within 5 years. Higher rates of subsequent surgery were associated with younger age at initial EA, with women aged under 35 years having an adjusted hazard ratio of 2.83 (95% CI 2.67-2.99), compared with women aged over 45 years. Women who had radiofrequency ablation were less likely to have subsequent surgery as compared with first-generation techniques ( HR 0.69, 95% CI 0.63-0.76). The rate of a subsequent hysterectomy within 5 years was 13.5%. Younger women ( OR 0.59, 95% CI 0.51-0.69) and those who had balloon, microwave, or radiofrequency ablation were less likely to have a second EA procedure, rather than a hysterectomy. Conclusions One in six women have further surgery after EA for HMB, which is a higher rate than reported in clinical trials. This risk of further surgery decreases with age. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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