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Endometrial resection and ablation versus hysterectomy for heavy menstrual bleeding

  1. Rosalie J Fergusson1,
  2. Anne Lethaby2,*,
  3. Sasha Shepperd3,
  4. Cindy Farquhar4

Editorial Group: Cochrane Gynaecology and Fertility Group

Published Online: 29 NOV 2013

Assessed as up-to-date: 30 OCT 2013

DOI: 10.1002/14651858.CD000329.pub2


How to Cite

Fergusson RJ, Lethaby A, Shepperd S, Farquhar C. Endometrial resection and ablation versus hysterectomy for heavy menstrual bleeding. Cochrane Database of Systematic Reviews 2013, Issue 11. Art. No.: CD000329. DOI: 10.1002/14651858.CD000329.pub2.

Author Information

  1. 1

    Auckland District Health Board, Obstetrics and Gynaecology, Auckland City Hospital, Auckland, New Zealand

  2. 2

    University of Auckland, Department of Obstetrics and Gynaecology, Auckland, New Zealand

  3. 3

    University of Oxford, Nuffield Department of Population Health, Oxford, Oxfordshire, UK

  4. 4

    University of Auckland, Obstetrics and Gynaecology, Auckland, New Zealand

*Anne Lethaby, Department of Obstetrics and Gynaecology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand. a.lethaby@auckland.ac.nz.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 29 NOV 2013

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[Figure 1]
Figure 1. Study screening and selection process (2008 to 2013).
[Figure 2]
Figure 2. Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
[Figure 3]
Figure 3. Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
[Figure 4]
Figure 4. Forest plot of comparison: 1 Endometrial resection/ablation versus hysterectomy, outcome: 1.1 Woman's perception (proportion with improvement in bleeding symptoms).
[Figure 5]
Figure 5. Forest plot of comparison: 1 Endometrial resection/ablation versus hysterectomy, outcome: 1.3 Proportion requiring further surgery for HMB.
[Figure 6]
Figure 6. Forest plot of comparison: 1 Endometrial resection/ablation versus hysterectomy, outcome: 1.4 Proportion satisfied with treatment.
[Figure 7]
Figure 7. Forest plot of comparison: 1 Endometrial resection/ablation versus hysterectomy, outcome: 1.5 Adverse events—short term (intraoperative and immediate postoperative).
[Figure 8]
Figure 8. Forest plot of comparison: 1 Endometrial resection/ablation versus hysterectomy, outcome: 1.6 Adverse events—long term (after hospital discharge).
[Figure 9]
Figure 9. Forest plot of comparison: 1 Endometrial resection/ablation versus hysterectomy, outcome: 1.7 Quality of life scores (continuous data).
[Analysis 1.1]
Analysis 1.1. Comparison 1 Endometrial resection/ablation versus hysterectomy, Outcome 1 Woman's perception (proportion with improvement in bleeding symptoms).
[Analysis 1.2]
Analysis 1.2. Comparison 1 Endometrial resection/ablation versus hysterectomy, Outcome 2 PBAC score (continuous data).
[Analysis 1.3]
Analysis 1.3. Comparison 1 Endometrial resection/ablation versus hysterectomy, Outcome 3 Proportion requiring further surgery for HMB.
[Analysis 1.4]
Analysis 1.4. Comparison 1 Endometrial resection/ablation versus hysterectomy, Outcome 4 Proportion satisfied with treatment.
[Analysis 1.5]
Analysis 1.5. Comparison 1 Endometrial resection/ablation versus hysterectomy, Outcome 5 Adverse events—short term (intraoperative and immediate postoperative).
[Analysis 1.6]
Analysis 1.6. Comparison 1 Endometrial resection/ablation versus hysterectomy, Outcome 6 Adverse events—long term (after hospital discharge).
[Analysis 1.7]
Analysis 1.7. Comparison 1 Endometrial resection/ablation versus hysterectomy, Outcome 7 Quality of life scores (continuous data).
[Analysis 1.8]
Analysis 1.8. Comparison 1 Endometrial resection/ablation versus hysterectomy, Outcome 8 Quality of life (proportion with improvement).
[Analysis 1.9]
Analysis 1.9. Comparison 1 Endometrial resection/ablation versus hysterectomy, Outcome 9 Duration of surgery (minutes).
[Analysis 1.10]
Analysis 1.10. Comparison 1 Endometrial resection/ablation versus hysterectomy, Outcome 10 Time to return to work (weeks).
[Analysis 1.11]
Analysis 1.11. Comparison 1 Endometrial resection/ablation versus hysterectomy, Outcome 11 Time to return to normal activity (days).
[Analysis 1.12]
Analysis 1.12. Comparison 1 Endometrial resection/ablation versus hysterectomy, Outcome 12 Duration of hospital stay (days).
[Analysis 1.13]
Analysis 1.13. Comparison 1 Endometrial resection/ablation versus hysterectomy, Outcome 13 Total health service cost per woman.
[Analysis 1.14]
Analysis 1.14. Comparison 1 Endometrial resection/ablation versus hysterectomy, Outcome 14 Total individual cost per woman.