Intraoperative Predictors of Long-term Outcomes After Radiofrequency Endometrial Ablation

Sherif A M Shazly, Abimbola O. Famuyide, Sherif A. El-Nashar, Daniel M. Breitkopf, Matthew R. Hopkins, Shannon K Laughlin-Tommaso

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Study Objective: To identify intraoperative predictors of radiofrequency ablation (RFA) failure after adjusting for clinical risk factors. Design: A cohort study (Canadian Task Force II-2). Setting: An academic institution in the Upper Midwest. Patients: Data were retrospectively collected from medical records of women who underwent RFA and who had a postprocedure gynecologic assessment between April 1998 and December 2011. Interventions: RFA. Measurements and Main Results: The primary outcome was RFA failure, which was defined as hysterectomy, repeat ablation, synechiolysis, or treatment with gonadotropin-releasing hormone analogue for postablation pain or bleeding. Cox proportional hazards regression was used to test the predictability of intraoperative variables on RFA failure with adjustment for baseline predictors. We created an RFA index to capture the procedure duration divided by the uterine surface area. One thousand one hundred seventy-eight women were eligible. The median age at ablation was 44 years (interquartile range, 40-48 years), and the median parity was 2 (interquartile range, 2-3). Dysmenorrhea and prior tubal ligation were reported in 37.1% and 37.2% of women, respectively. After adjustment for baseline characteristics, intraoperative predictors of failure were uterine sounding length >10.5 cm (adjusted hazard ratio [HR] = 2.58; 95% confidence interval [CI], 1.31-5.05), uterine cavity length >6 cm (adjusted HR = 2.06; 95% CI, 1.30-3.27), uterine width >4.5 cm (adjusted HR = 2.06; 95% CI, 1.29-3.28), surface area >25 cm2 (adjusted HR = 2.02; 95% CI, 1.26-3.23), procedure time

Original languageEnglish (US)
JournalJournal of Minimally Invasive Gynecology
DOIs
StateAccepted/In press - Nov 3 2015

Fingerprint

Endometrial Ablation Techniques
Confidence Intervals
Tubal Sterilization
Dysmenorrhea
Advisory Committees
Parity
Hysterectomy
Gonadotropin-Releasing Hormone
Medical Records
Cohort Studies
Hemorrhage
Pain

Keywords

  • Endometrial ablation
  • Hysterectomy
  • NovaSure
  • Uterine bleeding

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Intraoperative Predictors of Long-term Outcomes After Radiofrequency Endometrial Ablation. / Shazly, Sherif A M; Famuyide, Abimbola O.; El-Nashar, Sherif A.; Breitkopf, Daniel M.; Hopkins, Matthew R.; Laughlin-Tommaso, Shannon K.

In: Journal of Minimally Invasive Gynecology, 03.11.2015.

Research output: Contribution to journalArticle

Shazly, Sherif A M ; Famuyide, Abimbola O. ; El-Nashar, Sherif A. ; Breitkopf, Daniel M. ; Hopkins, Matthew R. ; Laughlin-Tommaso, Shannon K. / Intraoperative Predictors of Long-term Outcomes After Radiofrequency Endometrial Ablation. In: Journal of Minimally Invasive Gynecology. 2015.
@article{887f729ea49c434b8c97f0f3843c8dc9,
title = "Intraoperative Predictors of Long-term Outcomes After Radiofrequency Endometrial Ablation",
abstract = "Study Objective: To identify intraoperative predictors of radiofrequency ablation (RFA) failure after adjusting for clinical risk factors. Design: A cohort study (Canadian Task Force II-2). Setting: An academic institution in the Upper Midwest. Patients: Data were retrospectively collected from medical records of women who underwent RFA and who had a postprocedure gynecologic assessment between April 1998 and December 2011. Interventions: RFA. Measurements and Main Results: The primary outcome was RFA failure, which was defined as hysterectomy, repeat ablation, synechiolysis, or treatment with gonadotropin-releasing hormone analogue for postablation pain or bleeding. Cox proportional hazards regression was used to test the predictability of intraoperative variables on RFA failure with adjustment for baseline predictors. We created an RFA index to capture the procedure duration divided by the uterine surface area. One thousand one hundred seventy-eight women were eligible. The median age at ablation was 44 years (interquartile range, 40-48 years), and the median parity was 2 (interquartile range, 2-3). Dysmenorrhea and prior tubal ligation were reported in 37.1{\%} and 37.2{\%} of women, respectively. After adjustment for baseline characteristics, intraoperative predictors of failure were uterine sounding length >10.5 cm (adjusted hazard ratio [HR] = 2.58; 95{\%} confidence interval [CI], 1.31-5.05), uterine cavity length >6 cm (adjusted HR = 2.06; 95{\%} CI, 1.30-3.27), uterine width >4.5 cm (adjusted HR = 2.06; 95{\%} CI, 1.29-3.28), surface area >25 cm2 (adjusted HR = 2.02; 95{\%} CI, 1.26-3.23), procedure time",
keywords = "Endometrial ablation, Hysterectomy, NovaSure, Uterine bleeding",
author = "Shazly, {Sherif A M} and Famuyide, {Abimbola O.} and El-Nashar, {Sherif A.} and Breitkopf, {Daniel M.} and Hopkins, {Matthew R.} and Laughlin-Tommaso, {Shannon K}",
year = "2015",
month = "11",
day = "3",
doi = "10.1016/j.jmig.2016.02.002",
language = "English (US)",
journal = "Journal of Minimally Invasive Gynecology",
issn = "1553-4650",
publisher = "Elsevier",

}

TY - JOUR

T1 - Intraoperative Predictors of Long-term Outcomes After Radiofrequency Endometrial Ablation

AU - Shazly, Sherif A M

AU - Famuyide, Abimbola O.

AU - El-Nashar, Sherif A.

AU - Breitkopf, Daniel M.

AU - Hopkins, Matthew R.

AU - Laughlin-Tommaso, Shannon K

PY - 2015/11/3

Y1 - 2015/11/3

N2 - Study Objective: To identify intraoperative predictors of radiofrequency ablation (RFA) failure after adjusting for clinical risk factors. Design: A cohort study (Canadian Task Force II-2). Setting: An academic institution in the Upper Midwest. Patients: Data were retrospectively collected from medical records of women who underwent RFA and who had a postprocedure gynecologic assessment between April 1998 and December 2011. Interventions: RFA. Measurements and Main Results: The primary outcome was RFA failure, which was defined as hysterectomy, repeat ablation, synechiolysis, or treatment with gonadotropin-releasing hormone analogue for postablation pain or bleeding. Cox proportional hazards regression was used to test the predictability of intraoperative variables on RFA failure with adjustment for baseline predictors. We created an RFA index to capture the procedure duration divided by the uterine surface area. One thousand one hundred seventy-eight women were eligible. The median age at ablation was 44 years (interquartile range, 40-48 years), and the median parity was 2 (interquartile range, 2-3). Dysmenorrhea and prior tubal ligation were reported in 37.1% and 37.2% of women, respectively. After adjustment for baseline characteristics, intraoperative predictors of failure were uterine sounding length >10.5 cm (adjusted hazard ratio [HR] = 2.58; 95% confidence interval [CI], 1.31-5.05), uterine cavity length >6 cm (adjusted HR = 2.06; 95% CI, 1.30-3.27), uterine width >4.5 cm (adjusted HR = 2.06; 95% CI, 1.29-3.28), surface area >25 cm2 (adjusted HR = 2.02; 95% CI, 1.26-3.23), procedure time

AB - Study Objective: To identify intraoperative predictors of radiofrequency ablation (RFA) failure after adjusting for clinical risk factors. Design: A cohort study (Canadian Task Force II-2). Setting: An academic institution in the Upper Midwest. Patients: Data were retrospectively collected from medical records of women who underwent RFA and who had a postprocedure gynecologic assessment between April 1998 and December 2011. Interventions: RFA. Measurements and Main Results: The primary outcome was RFA failure, which was defined as hysterectomy, repeat ablation, synechiolysis, or treatment with gonadotropin-releasing hormone analogue for postablation pain or bleeding. Cox proportional hazards regression was used to test the predictability of intraoperative variables on RFA failure with adjustment for baseline predictors. We created an RFA index to capture the procedure duration divided by the uterine surface area. One thousand one hundred seventy-eight women were eligible. The median age at ablation was 44 years (interquartile range, 40-48 years), and the median parity was 2 (interquartile range, 2-3). Dysmenorrhea and prior tubal ligation were reported in 37.1% and 37.2% of women, respectively. After adjustment for baseline characteristics, intraoperative predictors of failure were uterine sounding length >10.5 cm (adjusted hazard ratio [HR] = 2.58; 95% confidence interval [CI], 1.31-5.05), uterine cavity length >6 cm (adjusted HR = 2.06; 95% CI, 1.30-3.27), uterine width >4.5 cm (adjusted HR = 2.06; 95% CI, 1.29-3.28), surface area >25 cm2 (adjusted HR = 2.02; 95% CI, 1.26-3.23), procedure time

KW - Endometrial ablation

KW - Hysterectomy

KW - NovaSure

KW - Uterine bleeding

UR - http://www.scopus.com/inward/record.url?scp=84961226671&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84961226671&partnerID=8YFLogxK

U2 - 10.1016/j.jmig.2016.02.002

DO - 10.1016/j.jmig.2016.02.002

M3 - Article

JO - Journal of Minimally Invasive Gynecology

JF - Journal of Minimally Invasive Gynecology

SN - 1553-4650

ER -