Cochrane · systematic review · CD001501
Endometrial resection and ablation techniques for heavy menstrual bleeding
Bofill Rodriguez, M, Lethaby, A, Grigore, M, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
6
current version
GRADE rated
6
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 3 · 50%Low 3 · 50%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyOverall analyses: second‐generation endometrial ablation compared to first‐generation endometrial ablation for heavy menstrual bleeding
Population: heavy menstrual bleeding
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Bleeding Overall analyses: second‐generation endometrial ablation vs first‐generation endometrial ablation | RR 0.99 [0.78, 1.27] | 12 studies · 2145 participants | Very low Downgraded: risk of bias |
Satisfaction rate Overall analyses: second‐generation endometrial ablation vs first‐generation endometrial ablation | RR 1.01 [0.98, 1.04] | 11 studies · 1750 participants | Low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Duration of operation (minutes) Overall analyses: second‐generation endometrial ablation vs first‐generation endometrial ablation | no estimate extracted | 9 studies · 1822 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Proportion given local anaesthesia (%) Overall analyses: second‐generation endometrial ablation vs first‐generation endometrial ablation | RR 2.78 [1.76, 4.4] | 6 studies · 1434 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Complication rate ‐ perforation Overall analyses: second‐generation endometrial ablation vs first‐generation endometrial ablation | RR 0.32 [0.1, 1.01] | 8 studies · 1885 participants | Low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Requirement for additional surgery Overall analyses: second‐generation endometrial ablation vs first‐generation endometrial ablation | RR 0.72 [0.41, 1.26] | 6 studies · 935 participants | Low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Second‐generation endometrial ablation compared to first‐generation endometrial ablation for heavy menstrual bleeding
Population: patients with heavy menstrual bleeding
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Amenorrhoea rate ‐ At 1 year Second‐generation endometrial ablation vs first‐generation endometrial ablation | RR 0.94 [0.74, 1.2] | 12 studies · 2085 participants | Very low Downgraded: imprecision, inconsistency |
Satisfaction rate ‐ At 1 year Second‐generation endometrial ablation vs first‐generation endometrial ablation | RR 1 [0.97, 1.02] | 11 studies · 1690 participants | Moderate |
Success of treatment (PBAC<75 or acceptable improvement) ‐ At 12 months Second‐generation endometrial ablation vs first‐generation endometrial ablation | RR 1.02 [0.97, 1.08] | 6 studies · 1375 participants | High |
Duration of operation (mins) Measured in various ways by clinicians Second‐generation endometrial ablation vs first‐generation endometrial ablation | no estimate extracted | 9 studies · 1762 participants | Low Downgraded: inconsistency |
Proportion having local anaesthesia (%) Hospital staff Second‐generation endometrial ablation vs first‐generation endometrial ablation | RR 2.78 [1.76, 4.4] | 6 studies · 1434 participants | Low Downgraded: inconsistency |
Operative or post‐operative complication rate ‐ Perforation Second‐generation endometrial ablation vs first‐generation endometrial ablation | RR 0.32 [0.1, 1.01] | 8 studies · 1885 participants | Moderate Downgraded: imprecision |
Requirement for any additional surgery ‐ > 5 years Second‐generation endometrial ablation vs first‐generation endometrial ablation | RR 0.69 [0.48, 0.99] | 1 study · 263 participants | Moderate |