High-risk factors of re-intervention after NovaSure endometrial ablation in patients with abnormal uterine bleeding

doi:10.3877/cma.j.issn.1674-6899.2020.04.008

Abstract

Abstract:

Objective

To analyze the characteristics and risk factors of patients undergoing re-intervention for failed NovaSure endometrial ablation.

Methods

This study is a retrospective cohort study. A total of 192 patients with abnormal uterine bleeding underwent NovaSure endometrial ablation at the department of gynaecology of Beijing Tiantan Hospital from Jan. 2011 to Jan. 2018. The clinical data of these patients were collected, including the basic information, the characteristics of the patient′s medical history and symptom, ultrasound results and the data of the surgical records. Univariate analysis and Logistic regression analysis were used to analyze the characteristics and risk factors of patients undergoing re-intervention for failed NovaSure endometrial ablation.

Results

A total of 192 people were eventually included in this study. 20(10.42%) patients need re-intervention after 2 year of the surgery, 13patients were vaginal bleeding, 3 patients were abdominal pain and 4 patients had both symptoms. Univariate analysis suggested that re-intervention after NovaSure was correlated with age, scores of PBLAC, Visual Analogue Score, adenomyosis and whether to use Mirena (P<0.05). The number of parity and gravity, BMI, the length of uterine cavity, uterine volume, the history of cesarean section, intramural fibroid, were not the risk factors (P>0.05). Multivariable binary logistic regression indicated that age, adenomyosis, Visual Analogue Score and whether to use Mirena were independent factors for re-intervention (P<0.05).

Conclusions

Age, adenomyosis, Visual Analogue Score and whether to use Mirena were independent predictor of patients undergoing re-intervention for failed NovaSure endometrial ablation, and vaginal bleeding was the main clinical manifestation of the patients for re-intervention.

Key words: Abnormal uterine bleeding, Endometrial ablation, Hysteroscopy, High-risk factors

Luping Zhang, Hongyu Shang, Wenjun Li, Hui Zhao, Lei Guo, Shengpeng Zhang, Limin Feng. High-risk factors of re-intervention after NovaSure endometrial ablation in patients with abnormal uterine bleeding[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2020, 13(04): 229-232.

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URL: https://zhqjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6899.2020.04.008

https://zhqjwkzz.cma-cmc.com.cn/EN/Y2020/V13/I04/229

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References 18

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因素	干预组(20例)	正常组(172例)	统计值	P值
年龄(岁， ±s)	42.50±4.35	46.62±4.52	t＝3.867	<0.001
BMI(kg/m²， ±s)	25.48±2.73	25.45±2.74	t＝0.050	0.960
孕(次， ±s)	2.80±1.70	2.85±1.43	t＝0.158	0.875
产(次， ±s)	1.35±0.75	1.46±0.74	t＝0.622	0.535
PBLAC评分(分)	485.00(258.25～598.75)	232.50(125.00～478.75)	Z＝-2.615	0.009
VAS评分(分)	6(3～8)	0(0～4)	Z＝-3.506	<0.001
宫腔深度(cm， ±s)	9.03±0.79	8.88±1.06	t＝0.611	0.542
子宫体积(cm， ±s)	17.86±2.19	17.14±2.64	t＝1.166	0.245
放置曼月乐[例(%)]	3(15.00)	70(40.70)	χ²＝3.990	0.046
剖宫产史[例(%)]	8(40.00)	61(35.47)	χ²＝0.160	0.689
子宫腺肌症[例(%)]	11(55.00)	39(22.67)	χ²＝9.721	0.002
子宫平滑肌瘤[例(%)]	7(35.00)	71(41.28)	χ²＝0.293	0.588

因素	干预组(20例)	正常组(172例)	统计值	P值
年龄(岁， ±s)	42.50±4.35	46.62±4.52	t＝3.867	<0.001
BMI(kg/m²， ±s)	25.48±2.73	25.45±2.74	t＝0.050	0.960
孕(次， ±s)	2.80±1.70	2.85±1.43	t＝0.158	0.875
产(次， ±s)	1.35±0.75	1.46±0.74	t＝0.622	0.535
PBLAC评分(分)	485.00(258.25～598.75)	232.50(125.00～478.75)	Z＝-2.615	0.009
VAS评分(分)	6(3～8)	0(0～4)	Z＝-3.506	<0.001
宫腔深度(cm， ±s)	9.03±0.79	8.88±1.06	t＝0.611	0.542
子宫体积(cm， ±s)	17.86±2.19	17.14±2.64	t＝1.166	0.245
放置曼月乐[例(%)]	3(15.00)	70(40.70)	χ²＝3.990	0.046
剖宫产史[例(%)]	8(40.00)	61(35.47)	χ²＝0.160	0.689
子宫腺肌症[例(%)]	11(55.00)	39(22.67)	χ²＝9.721	0.002
子宫平滑肌瘤[例(%)]	7(35.00)	71(41.28)	χ²＝0.293	0.588

因素	Beta	SE	Wald	OR值(95% CI)	P值
年龄	0.174	0.062	7.816	0.840(0.744～0.949)	0.005
子宫腺肌症	1.413	0.656	4.645	4.110(1.137～14.863)	0.031
VAS评分	0.206	0.090	5.306	1.229(1.031～1.465)	0.021
放置曼月乐	-2.609	0.819	10.141	0.074(0.015～0.367)	0.001

因素	Beta	SE	Wald	OR值(95% CI)	P值
年龄	0.174	0.062	7.816	0.840(0.744～0.949)	0.005
子宫腺肌症	1.413	0.656	4.645	4.110(1.137～14.863)	0.031
VAS评分	0.206	0.090	5.306	1.229(1.031～1.465)	0.021
放置曼月乐	-2.609	0.819	10.141	0.074(0.015～0.367)	0.001

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