The effectiveness of endometrial ablation with the Hydro ThermAblator (HTA) for abnormal uterine bleeding.

Abstract

We sought to determine the overall effectiveness and risk factors for failure of hydrothermal ablation in the management of abnormal uterine bleeding. We performed a retrospective cohort analysis of patients who underwent hydrothermal ablation for abnormal uterine bleeding at our institution from July 2005 through February 2008. Variables analyzed included patient demographics, insurance status, body mass index, bleeding pattern, obstetric history, prior medical therapy and duration, uterine characteristics, and tobacco use history. In all, 159 patients were identified and 142 charts were eligible for evaluation. A total of 45 patients (31.6%) had return of preablation vaginal bleeding. Menometrorrhagia was a significant predictor for failure (P = .027) and subsequent hysterectomy (P = .0025). Younger age (P = .044), tobacco use (P = .042), and Medicaid/Medicare insurance status (P = .039) were also associated with a higher risk of failure. Women who are younger, use tobacco products, and have menometrorrhagia are more likely to fail hydrothermal ablation.