Clinical Study Of Using Novasure Endometrial Ablation To Treat Abnormal Uterine Bleeding

BackgroundAUB is the abnormal uterine bleeding, it shows such as long menstrual duration, volume too much, too frequency, menstrual extension, menstruation interphase bleeding, or postmenopausal bleeding. General treatment often use drugs or uterine curettage method, if the treatment is invalid, then they often need hysterectomies. In the1980s removing the endometrium by TCRE made good clinical effect, women got the method that can replace hysterectomy therapy. With the improving of surgical instruments and technology, the second generation endometrial ablation appears now, which is representative of the technology is Novasure endometrial ablation. This review focuses on the application of treating the AUB with second generation Novasure endometrial ablation, about its preoperative, during and after, and the clinical situation analysis.ObjectiveTo investigate the clinical significance of Novasure endometrial ablation on the treatment of AUB.Materials and MethodsSubjects:nineteen patients with menorrhagia who have undergone operation at second hospital of Shandong university from early January2011to January2012was selected.And they were as study group. Twenty-seven cases who had undergone TCRE were as control group. Both of groups had no birth plan. None of the patients have smoking or excessive.Methods:1. Operation:all patients with invalid medical treatment.1.1. Novasure endometrial ablation: Surgical indications:(1) menorrhagia and don’t have fertility requirements;(2)exclude endometrial malignant lesions;(3)depth of uterine cavity is from4cm to10cm;(4) The diameter of pathology organization is not bigger than2cm.Operation contraindication:(1) Pregnancy or to plan to make;(2) Patients with endometrial carcinoma or pre-cancerous;(3) Uterine wall is too weak;(4) The acute genital or urinary tract infection;(5)With the IUD in the cavity;(6) Uterine cavity depth less than4cm or more than10cm, or width less than2.5cm;(7)Patients with acute pelvic inflammation.1.2. TCRESurgical indications:(1) invalid medical treatment or have contraindication, intolerance to hysterectomy;(2) no fertility requirements;(3) Uterine cavity depth is less than12cm, smaller than12weeks gestational age at size;(4) without endometrial malignant lesions.Operation contraindication(1) have pregnancy plan;(2) endometrial malignant lesions;(3) Uterine cavity depth is more than12cm, biggger than12weeks gestational age at size;(4) cervical scar;(5) Uterine flexor too much;(6) the acute phase of the heart, liver or kidney failure;(7) acute phase of reproductive tract infection.2. Surgical methods:In study group,19patients received Novasure endometrial ablation;in control group,27patients received TCRE.3. SPSS16.0was used for statistics analysis:(1) Measurement data such as period with disease.operation time, amount of bleeding, postoperative hospitalization days on average, et al, and the result is measured by mean±standard deviation;(2) Use PBAC to score postoperative amenorrhoea rate, menstrual quantity reduce rate, menstrual improvement, etc. Results1.Analysis of clinical information:There were no significant difference between the groups in the general situation, for example, age, period of suffer disease (P>0.05);2. Preoperative examine:There were not uterine cavity deformity or other large organic changes, and there were not endometrial malignant lesions3. Information on the operation:3.1. Uterine cavity size:There was no significant difference between the groups (P>0.05);3.2. Operation time:The average operation time of study group was1.55±0.24min, and the average operation time of control group was31.00±7.23min. There was significant difference of operation time between study group and the control group (P<0.05).4. The situation after operation4.1.Mean post-operation:The average time of study group was1.19±0.36days, and the average time of control group was4.50±1.03days There was significant difference of in-hospital time between study group and the control group.4.2. The complications of postoperative:both groups had not the complications;5. Curative effect evaluation:Use PBAC to evaluate, rating system, if PBAC score was0, it was postoperative amenorrhoea, if PBAC score was less than or equal to75, it was surgical effective treatment.5.1. Amenorrhoea rate:The amenorrhoea rate of study group was36.8%, and the control group was40.2%. There was no significant difference of amenorrhoea rate between the study group and the control group.5.2. Effective rate:Both of groups effective rate were100%. There was no significant difference between the study group and the control group.5.3.Inefficiency rate:There was no one. Conclusion1. Novasure endometrial ablation is an effective methods to treat AUB.2. As a new surgical technique, Novasure can make up for the deficiency of the first generation of operation method better, especially operation technology is easy to grasp, do not need to prepare for the operation, and the operation time is shorter, less bleeding and pain, postoperative recover is quick, its short-term curative effect is distinct.