Randomised Trial of Endometrial Laser Ablation [ELA], Transcervical Resection of the Endometrium [TCRE], and Thermal Balloon Ablation [TBA] for the treatment of menorrhagia

A randomised controlled trial was set up to compare the safety and clinical efficacy of endometrial ablation in the treatment of menorrhagia, performed either with ELA, TCRE or TBA. A total of 120 women with menorrhagia were selected and randomly allocated to ELA [GI], TCRE [GII] or TBA [GIII]. The main outcome measures were operative complications, post-operative recovery, relief of, menstrual and other symptoms, need for further surgical treatment, satisfaction with treatment at 6 and 12 months, postoperatively. It was found that the operating and theatre times were significantly shorter in TBA, than ELA or TCRE. However, there was no significant difference between the three groups as regard the complication rates, concomitant surgery, morbidity and duration of hospital stay. Also, it was found that there was significant improvement in bleeding and pain scores dysmenorrhoea and premenstrual symptoms at 6 and 12 months, in each group. Overall satisfaction levels were high. It was concluded that endometrial ablation is a reliable, safe alternative to hysterectomy for the treatment of monorrhagia. TBA is a safe and effective option. The procedure is simple, allowing the learing curve to be almost negligible