The purpose of this study is to evaluate the long-term clinical efficacy and secondary postoperative intervention of NovaSure endometrial ablation in the treatment of abnormal uterine bleeding(AUB).

From Jan. 2011 to Dec. 2018, AUB patients who underwent NovaSure endometrial ablation in Beijing Tiantan Hospital Affiliated to Capital Medical University were followed up. The postoperative amenorrhea rate, effective rate, dysmenorrhea remission rate, patient satisfaction, complications and reintervention were analyzed.

There were 285 AUB patients received NovaSure endometrial removal, after strict screening, 84 patients were excluded, 201 patients were finally selected for the clinical study. The follow-up time ranged from 12 to 106 months and the median follow-up time was 53 months. At the time points of 1 year, 2 years, 3 years, 4 years, 5-8 years after NovaSure operation, the amenorrhea rate was 67.66%, 70.27%, 76.32%, 75.83%, 78.82%; the effective rate was 96.02%, 95.68%, 95.36%, 95.00%, 92.94%; the remission rate of dysmenorrhea was 83.51%, 80.46%, 86.67%, 77.97%, 84.85%; the satisfaction rate was 90.55%, 88.65%, 90.79%, 87.50%, 88.24%; the incidence of complications was 2.49%、3.78%、5.26%、6.67%、8.24%. The re-intervention rate was 6.47%, 10.27%, 14.47%, 15.00%, 18.82%, respectively; the hysterectomy rate was 1.49%, 3.24%, 5.26%, 7.50%, 8.24% respectively. There were 33 cases of postoperative intervention. The re-intervention therapies include conservative operation with uterus preservation and hysterectomy. A total of 33 cases were re-intervened, including 20 cases of conservative surgery and 13 cases of total hysterectomy.

NovaSure Endometrial ablation has significant long-term effects in the treatment of AUB, especially for patients with severe internal or surgical diseases or acute severe massive hemorrhage. Recurring uterine bleeding and(or) pain after operation are the main reasons for treatment failure and re-intervention, which may be related to the residual or ectopic of endometrium after operation.