Brattinga, B. (Baukje) (2016) Is er plaats voor hysteroscopische Rollerball-ablatie bij vrouwen met persisterende klachten na Novasure-ablatie? thesis, Medicine.
![[img]](https://umcg.studenttheses.ub.rug.nl/style/images/fileicons/text.png) |
Text
BrattingaB.pdf Restricted to Registered users only Download (1MB) |
Abstract
Objective: After Novasure ablation 8-10% of women keep complaints of heavy menstrual bleeding or abdominal pain. A reintervention with hysteroscopic Rollerball ablation or hysterectomy is indicated. Daily practice in MCL shows that a lot of women who underwent a reintervention with Rollerball ablation after Novasure ablation keep having complaints of heavy menstrual bleeding and abdominal pain. These patients have an indication for a second reintervention, a hysterectomy. The purpose of this study is to examine whether Rollerball ablation is a good option as a reintervention after failed Novasure ablation, or that the advice should be to directly perform a reintervention by hysterectomy. Method: In this retrospective cross-sectional study, all patients who underwent Rollerball ablation after a technically successful Novasure ablation between January 2009 and December 2015 were included (n=50). Electronical records were analysed. Results: Three months after Rollerball ablation 25/50 (50%) patients were still having complaints of heavy menstrual bleeding, same as before Rollerball ablation. 30/50 (60%) patients were not satisfied after Rollerball ablation. Complications were described at 10/50 (20%) of the included patients and 18/50 (36%) underwent hysterectomy during follow-up after Rollerball ablation. Histopathological changes in the uterus were found in 15/18 (83,3%) of the patients that underwent hysterectomy. Univariate logistic regressionanalysis shows a significant higher rate of hysterectomies when the ablationtime during Novasure ablation is more than 85 seconds. (OR 4,963; CI 1,404-17,549; p=0,013) The third quartile of the factor age (45-49,25 year) has a significant lower rate of hysterectomies. (OR 0,112; CI 0,013-0,959; p=0,046). No significant outcomes were found for the factors age and ablationtime in a multivariate logistic regressionanalysis in search of predictors for undergoing a hysterectomy. Conclusion: Rollerball ablation after technically successful Novasure ablation is not very effective in reducing blood loss and abdominal pain and the patient satisfaction is low. The complication rate is high and there is a high rate of reinterventions after Rollerball ablation. Rollerball ablation doesn’t seem to have much added value in the treatment of women with persistent complaints after Novasure ablation. Rollerball ablation will not be a reintervention option anymore after Novasure-ablation, unless there is a contraindication for hysterectomy.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Afdeling: Gynaecologie & Obstetrie, Medisch Centrum Leeuward and Begeleider: and Perquin, Dr. D.A.M. and gynaecoloog Medisch Centrum Leeuwarden |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:00 |
| Last Modified: | 25 Jun 2020 11:00 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2037 |
Actions (login required)
 |
View Item |