Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

42 questions · 44 findings · 6 reviews · Gynaecology and Fertility

No studies found 2 · 4.5%GRADE not reported 4 · 9.1%Very low 8 · 18.2%Low 16 · 36.4%Moderate 14 · 31.8%High 0 · 0%

Second‐generation endometrial ablation vs first‐generation endometrial ablation

Proportion given local anaesthesia (%) · heavy menstrual bleeding

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).

1 finding from 1 review

Second‐generation endometrial ablation vs first‐generation endometrial ablation

Complication rate ‐ perforation · heavy menstrual bleeding

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

1 finding from 1 review

Second‐generation endometrial ablation vs first‐generation endometrial ablation

Requirement for additional (surgical) interventions · heavy menstrual bleeding

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

1 finding from 1 review

Endometrial resection or ablation vs unspecified (or at surgeon's discretion) route of hysterectomy

Effectiveness Proportion of women with perception of improvement of bleeding symptoms · heavy menstrual bleeding

Endometrial resection/ablation may leads to lower effectiveness Proportion of women with perception of improvement of… compared with unspecified (or at surgeon's discretion) route of hysterectomy (low certainty).

1 finding from 1 review

Endometrial resection or ablation vs unspecified (or at surgeon's discretion) route of hysterectomy

Proportion with improvement in general health · heavy menstrual bleeding

Endometrial resection/ablation may leads to lower proportion with improvement in general health compared with unspecified (or at surgeon's discretion) route of hysterectomy (low certainty).

1 finding from 1 review

Endometrial resection or ablation vs unspecified (or at surgeon's discretion) route of hysterectomy

Acceptability Proportion satisfied with treatment · heavy menstrual bleeding

Endometrial resection/ablation showed no clear difference in acceptability Proportion satisfied with treatment compared with unspecified (or at surgeon's discretion) route of hysterectomy (moderate certainty).

1 finding from 1 review

Endometrial resection or ablation vs unspecified (or at surgeon's discretion) route of hysterectomy

Safety Any serious adverse event · heavy menstrual bleeding

Endometrial resection/ablation probably leads to lower safety Any serious adverse event compared with unspecified (or at surgeon's discretion) route of hysterectomy (moderate certainty).

1 finding from 1 review

Endometrial resection or ablation vs open hysterectomy

Effectiveness Proportion of women with perception of improvement of bleeding symptoms · HMB

Endometrial resection or ablation probably leads to lower effectiveness Woman's perception (proportion with improvement in… compared with open hysterectomy (moderate certainty).

1 finding from 1 review

Endometrial resection or ablation vs minimally invasive hysterectomy

Acceptability Proportion satisfied with treatment · heavy menstrual bleeding

Endometrial resection or ablation probably leads to lower acceptability Proportion satisfied with treatment compared with minimally invasive hysterectomy (moderate certainty).

1 finding from 1 review