What do systematic reviews say?

Second‐generation endometrial ablation vs first‐generation endometrial ablation

Overall analyses: second‐generation endometrial ablation showed no clear difference in satisfaction rate compared with first‐generation endometrial ablation (low certainty).

• Endometrial resection and ablation techniques for heavy menstrual bleeding 2019 · Cochrane Headline outcomes only
  RR 1.01 [0.98, 1.04]
  11 studies · 1750 participants
  Low

Second‐generation endometrial ablation vs first‐generation endometrial ablation

• Endometrial resection and ablation techniques for heavy menstrual bleeding 2019 · Cochrane Headline outcomes only
  no estimate extracted
  9 studies · 1822 participants
  Very low

Second‐generation endometrial ablation vs first‐generation endometrial ablation

It is very uncertain whether overall analyses: second‐generation endometrial ablation changes proportion given local anaesthesia (%) compared with first‐generation endometrial ablation (very low certainty).

• Endometrial resection and ablation techniques for heavy menstrual bleeding 2019 · Cochrane Headline outcomes only
  RR 2.78 [1.76, 4.4]
  6 studies · 1434 participants
  Very low

Second‐generation endometrial ablation vs first‐generation endometrial ablation

Overall analyses: second‐generation endometrial ablation showed no clear difference in complication rate ‐ perforation compared with first‐generation endometrial ablation (low certainty).

• Endometrial resection and ablation techniques for heavy menstrual bleeding 2019 · Cochrane Headline outcomes only
  RR 0.32 [0.1, 1.01]
  8 studies · 1885 participants
  Low

Second‐generation endometrial ablation vs first‐generation endometrial ablation

Overall analyses: second‐generation endometrial ablation showed no clear difference in requirement for additional surgery compared with first‐generation endometrial ablation (low certainty).

• Endometrial resection and ablation techniques for heavy menstrual bleeding 2019 · Cochrane Headline outcomes only
  RR 0.72 [0.41, 1.26]
  6 studies · 935 participants
  Low

Surgery vs LNG‐IUS

Surgery may leads to higher subjective control of bleeding: PBAC no more than 75 per cycle… compared with LNG‐IUS (low certainty).

• Surgery versus medical therapy for heavy menstrual bleeding 2016 · Cochrane Headline outcomes only
  RR 1.19 [1.07, 1.32]
  5 studies · 281 participants
  Low