Abstract:

Objective

To compare the long-term efficacy of endometrial radiofrequency ablation（Cardea^TM） and transcervical endometrial resection （TCRE） in the treatment of heavy menstrual bleeding（HMB）.

Methods

A prospective multicenter study enrolled 156 premenopausal women diagnosed with HMB and without desire for future fertility. Participants were randomly assigned to receive either endometrial radiofrequency ablation （Cardea^TM，experimental group， n = 80） or transcervical endometrial resection（TCRE，control group， n=76）. The primary outcome measure was the reintervention rate at 10 years posttreatment. Secondary outcome measures included efficacy rate，amenorrhea rate，and adverse event rate at 3，6，and 12 months post-treatment.

Results

The 10-year reintervention rates were 10.8% and 14.5% in the experimental and control groups，respectively （P = 0. 61）. No statistically significant difference in efficacy rates was observed between the two groups at 3，6，and 12 months post-treatment. However，the amenorrhea rate was significantly higher in the experimental group compared to the control group at 3，6，and 12 months （HR，0. 53； 95% CI，0. 31-0. 9； P = 0. 02）. Five patients were unable to complete the endometrial radiofrequency ablation procedure.

Conclusions

Endometrial radiofrequency ablation demonstrates a low long-term reintervention rate and achieves a high amenorrhea rate in the short term，making it a preferred treatment option for HMB in women without a desire for future fertility.

Key words: Endometrial radiofrequency ablation, Transcervical endometrial resection, Heavy menstrual bleeding, Amenorrhea, Bipolar non-resectoscopic endometrial ablation