• Alexis N Hokenstad, Sherif A El-Nashar, Zaraq Khan, Matthew R Hopkins, and Abimbola O Famuyide.
• Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota.
• J Minim Invasive Gynecol. 2015 Nov 1; 22 (7): 1225-30.

Study ObjectiveTo evaluate the efficacy and safety of endometrial ablation (EA) for the treatment of abnormal uterine bleeding (AUB) associated with ovulatory dysfunction.DesignA retrospective cohort study (Canadian Task Force classification II-2).SettingAn academic medical center.PatientsWomen with AUB who underwent EA during an 8-year period.InterventionsEA by radiofrequency or thermal balloon ablation techniques.Measurements And Main ResultsWomen with AUB were divided into 2 groups: irregular bleeding with ovulatory dysfunction (AUB-O) or regular heavy bleeding related to a primary endometrial disorder (AUB-E). Outcome measures included rates of amenorrhea and treatment failure (ie, need for reablation or hysterectomy). Outcomes were compared between groups using survival analyses and chi-square tests. Known confounders were adjusted for using Cox and logistic regression models. Five-year cumulative treatment failure rates were 11.7% (95% confidence interval [CI], 6.5%-16.9%) for AUB-O and 12.3% (95% CI, 8.4%-16.2%) for AUB-E (p = .62). The unadjusted hazard ratio for treatment failure was 0.87 (95% CI, 0.72-1.05, p = .16). After adjusting for known risk factors for failure, the hazard ratio was 1.48 (95% CI, 0.82-2.65, p = .19). The rates of amenorrhea were 11.8% for AUB-O and 13.8% for AUB-E with an unadjusted odds ratio of 0.84 (95% CI, 0.48-1.48, p = .55). After adjusting for factors for amenorrhea after EA, the odds ratio was 1.08 (95% CI, 0.62-1.84, p =.78). No pregnancies or endometrial cancers occurred after EA.ConclusionEA is effective in women with AUB-O and can be used as an alternative to hysterectomy or in patients with contraindications to medical management of AUB-O.Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

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