Trends in endometrial ablation and hysterectomy for dysfunctional uterine bleeding, in Mersey region


S.A. Bridgman 22 Sparks Lane, Thingwall, Wirral L61 7XG, UK.


The objectives of this study were to describe the trends in National Health Service hysterectomies and endometrial ablations for dysfunctional uterine bleeding (DUB) in Mersey Regional Health Authority residents. Data were extracted from routine hospital statistics. The proportion of patients with DUB treated surgically by endometrial ablation increased from 0 to 30% between 1988/9 and 1992/3. Contrary to expectations of proponents of endometrial ablation, there was little change in the number of hysterectomies performed for DUB. Conversely the life-chances of a Mersey woman receiving an operation for DUB increased from 6.5 to 11%. While theoretically there are several reasons for the trend of increased operative rates for DUB, a lower threshold for operation with the advent of endometrial ablation was considered most likely to be the strongest factor. It was also noted to be of concern that a novel operation was widely introduced in the UK without there being any obligation for systematic study of medium- and long-term effects.