OBJECTIVE: To investigate the efficacy and safety of NovaSure system for dysmenorrhea and abnormal uterine bleeding of adenomyosis.
 METHODS: A retrospective analysis on 30 patients with adenomyosis, who treated by NovaSure, were carried out. We collected related clinical data before operation and collected postoperative information about dyemenorrhea, menstruation, anemia and uterine volume by visiting outpatient or telephone.
 RESULTS: All patients were followed up for 7 to 31 months after the operation. The relief rate of menstrual pain was 83.3%. All patients got obvious improvements in menstruation and anemia (P<0.05). After operation, uterine volume was significantly decreased (P<0.05). Only one case received intervention in 2 years (3.3%).
 CONCLUSION NovaSure can relieve symptoms of menorrhagia and alleviate dysmenorrhea symptoms. It is a new way for the treatment of uterine adenomyosis.
Adenomyosis ; surgery ; Dysmenorrhea ; surgery ; Endometrial Ablation Techniques ; methods ; Female ; Humans ; Menorrhagia ; surgery ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: Menorrhagia is defined as a complaint of heavy cyclical menstrual bleeding occurring over several consecutive cycles and approximately 30% of women suffer from it. Recently uterine balloon ablation therapy (UBT) system has been used widely as a safe and easy surgical option for this cumbersome symptom. The aims of this study were to determine the safety and the efficacy of UBT system in the management of menorrhagia, and to identify the possible factors for a successful outcome. METHODS: From August 2003 to May 2004, 77 patients with menorrhagia were enrolled. Demographic information, diary score for menorrhagia, and size of uterus were checked before treatment. All patients were treated with UBT system under IV anesthesia at day-surgery unit and followed up post-operatively. The change of diary score, and the change of hemoglobin/hematocrit were recorded. And the change of quality of life was assessed. RESULTS: Medical records of 73 patients who completed scheduled follow up were analyzed. Mean age was 43.7 years old, pre-operative mean diary score was 255.9+/-98.0 and pre-operative mean hemoglobin was 10.67+/-1.67. After the operation, the diary score significantly decreased to 53.3+/-27.5, and the hemoglobin significantly increased to 12.67+/-1.53. Multiple logistic regression analysis showed that success of treatment was influenced by the indication of UBT, patient age, uterine depth, and adequate intra-operative balloon pressure. An improvement in self-reported quality of life scores was also observed. CONCLUSION: The UBT system is a safe and effective method to treat menorrhagia and can be easily done under outpatient basis. Thus, it is a good alternative to hysterectomy or hysteroscopic endometrial ablation with a comparable success rate and minimal risk.
Anesthesia ; Endometrial Ablation Techniques ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Hysterectomy ; Logistic Models ; Medical Records ; Menorrhagia* ; Outpatients ; Quality of Life ; Uterus

OBJECTIVE: To determine the efficacy of second generation endometrial ablation (NovaSure) combined with levonorgestrel-releasing intrauterine system (Mirena) in the treatment of adenomyosis. METHODS: Clinical data of patients with adenomyosis admitted in Women's Hospital, Zhejiang University School of Medicine from January 2015 to December 2018 were retrospectively analyzed. Among 66 patients, 44 received Mirena placement only (control group) and 22 received Mirena placement and NovaSure treatment (study group). The menstruation blood loss, dysmenorrhea score, uterine size, expulsion rate of Mirena and the patients' satisfaction rate were assessed in two groups. RESULTS: There was a significant reduction in menstruation blood loss (<0.05) and significant improvement in dysmenorrhea (<0.05) after the treatment in both groups. The patients in study group had more marked improvement in menstruation blood loss than those in control group (<0.05). The patients' satisfaction was higher and the expulsion rate of Mirena was lower in study group than that in control group (all <0.05). The score of dysmenorrhea and the size of uterine had no significant difference between two groups (all >0.05). CONCLUSIONS NovaSure can improve the efficacy of Mirena in treatment of adenomyosis.
Adenomyosis ; therapy ; Dysmenorrhea ; Endometrial Ablation Techniques ; Female ; Humans ; Levonorgestrel ; administration & dosage ; Organ Size ; Retrospective Studies ; Uterus ; anatomy & histology

Dysfunctional uterine bleeding (DUB) is the major cause of heavy menstrual bleeding during reproductive years and impacts on women's health both medically and socially. The pathophysiology of DUB is largely unknown but occurs in both ovulatory and anovulatory menstrual cycles. Medical treatments include tranexamic acid, nonsteroidal antiinflammatory drugs, combined oral contraceptives, progesterone, danazol, and GnRH analogue. Surgical treatments include endometrial ablation and hysterectomy. Since none of the treatments for DUB is superior to one of the others, and since all treatments have their advantages and disadvantages, counselling and management of patients with DUB should incorporate medical approach, levonorgestrel releasing IUD, endometrial ablation and hysterectomy.
Contraceptives, Oral, Combined ; Danazol ; Endometrial Ablation Techniques ; Female ; Gonadotropin-Releasing Hormone ; Hemorrhage ; Humans ; Hysterectomy ; Levonorgestrel ; Menstrual Cycle ; Metrorrhagia* ; Progesterone ; Tranexamic Acid ; Women's Health

OBJECTIVE: To assess the effectiveness and safety of hysteroscopic endometrial ablation as a surgical management of abnormal uterine bleeding developed in renal transplant patients. METHODS: Data were collected retrospectively from 62 patients referred to Department of Obstetrics and Gynecology, Yonsei University Medical Center from January 1999 to December 2001 for abnormal uterine bleeding with prior history of renal transplantation who subsequently received hysteroscopic endometrial ablation. Hormonal status of these patients were evaluated before the operation by sampling estradiol (E2), lutenizing hormone (LH), follicle-stimulating hormone (FSH), thyroid stimulating hormone (TSH), and prolactin. Mean follow-up duration was 6 months. Levonorgestrel-releasing intrauterine system (LNG-IUS)s were inserted in those who experienced recurrent bleeding. RESULTS: Mean age of patients was 34.6+/-6.7 years and mean duration from renal transplant to onset of abnormal uterine bleeding was 4.5+/-2.5 years. All hormone levels (E2, LH, FSH, TSH, prolactin) were within normal range. 54 out of 62 patients (87.0%) who underwent hysteroscopic endometrial ablation reported decreased bleeding: amenorrhea in 25 (40.3%), spotting in 19 (30.6%), and eumenorrhea in 10 (16.1%). None reported complications related to the procedure. LNG-IUSs were inserted into 8 patients who experienced continuous bleeding, 5 out of whom showed symptomatic improvement: spotting in 3 (4.9%) and eumenorrhea in 2 (3.2%). 3 patients in whom LNG-IUS had no effect received total abdominal hysterectomy. CONCLUSION: Hysteroscopic endometrial ablation as a surgical management of abnormal uterine bleeding developed in renal transplant patients is an effective and safe procedure.
Academic Medical Centers ; Amenorrhea ; Endometrial Ablation Techniques* ; Estradiol ; Female ; Follicle Stimulating Hormone ; Follow-Up Studies ; Gynecology ; Hemorrhage ; Humans ; Hysterectomy ; Kidney Transplantation ; Metrorrhagia ; Obstetrics ; Prolactin ; Reference Values ; Retrospective Studies ; Thyrotropin ; Uterine Hemorrhage*