NEW YORK (Reuters Health) – At 5 years, bipolar radiofrequency (RF) endometrial ablation is more effective than hydrothermablation for controlling menorrhagia, according to a Dutch study reported in the December issue of Obstetrics & Gynecology.

“Overall, more women were satisfied in the bipolar group compared with the hydrotherm group,” the authors comment.

Although hysterectomy remains the preferred cost-effective strategy for treating heavy menstrual bleeding, several endometrial ablation techniques have been established as common practice, the authors point out.

Dr. Josien P. M. Penninx from Maxima Medical Centre, Veldhoven, The Netherlands and colleagues compared bipolar radiofrequency impedance-controlled endometrial ablation with hydrothermablation in a randomized controlled trial of 160 women with menorrhagia. Five-year follow-up results were available for 139 of the women.

At 5 years, 41 of 74 (55.4%) women in the RF ablation group were amenorrheic, compared with 23 of 65 (35.4%) women in the hydrotherm group. Dysmenorrhea was absent in 69% and 52% of the two groups, respectively.

Persistent menorrhagia led to reinterventions in 14 women in the RF group and 29 women in the hydrotherm group. The reinterventions were surgical in 11 women in the RF group and in 23 women in the hydrotherm group.

Satisfaction rates were significantly higher in the bipolar RF ablation group (80.6%) than in the hydrotherm group (48.4%), although satisfaction rates in both groups were lower at 5 years than they were at 12 months.

“The results from this follow-up study showed that bipolar ablation has many advantages over hydrotherm ablation,” Dr. Penninx and colleagues conclude. “Higher amenorrhea rate, less reinterventions, and higher levels of satisfaction were shown. So, the bipolar radiofrequency endometrial ablation system is more effective than hydrotherm ablation in the treatment of menorrhagia.”

Source: Obstet Gynecol 2011;118:1287-1292.