Comparison of clinical outcomes with low-voltage (cut) versus high-voltage (coag) waveforms during hysteroscopic endometrial ablation with the rollerball: a pilot study.

摘要

STUDY OBJECTIVE: To compare efficacy of rollerball endometrial ablation with low-voltage (cut) versus high-voltage (coag) waveforms. DESIGN: Pilot comparative clinical study (Canadian Task Force Classification II-1). SETTING: University-affiliated teaching hospital. PATIENTS: Fifty premenopausal women with menorrhagia. INTERVENTION: Women with menorrhagia were allocated randomly to thermal destruction of the endometrium by a 5-mm rollerball with unmodulated cutting current or modulated coagulating current. Complication rate, clinical outcomes, and need for reintervention were evaluated. MEASUREMENTS AND MAIN RESULTS: At 2 years of follow-up, the reintervention rate was 26.3% in the cutting waveform group versus 31.4% in the coagulating waveform group. This difference was not statistically significant. Hysterectomy was performed in 3 (14%) women in the cutting waveform group and 5 (20%) women in the coagulating waveform group. There were no complications in either group. CONCLUSION: Both cutting and coagulating waveforms are equally effective for hysteroscopic endometrial ablation with the rollerball.