Comprehensive analysis of NovaSure® endometrial ablation in patients with heavy menstrual bleeding: Identifying success rate and predictive factors for post-NovaSure® hysterectomy

Objective: To analyze success rate and predictive factors for post-NovaSure hysterectomy in patients with heavy menstrual bleeding. Study design: 469 patients undergoing NovaSure endometrial ablation (NEA) were included in this retrospective single center cohort study at Martini Hospital Groningen, the Netherlands. The outcomes of these procedures and predictive factors for undergoing additional post-Novasure hysterectomy were analyzed. Results: Of 446 patients undergoing successful NEA ablation 82.9 % were satisfied with the results after 3 months. At this time point 37.3 % of patients reported an amenorrhea. 51 patients (11.4 %) underwent a hysterectomy during the follow-up period with a mean number of 18.5 months after NEA. A shorter duration of the ablation procedure was significantly associated with undergoing a hysterectomy (p = 0.034). Patients with a higher BMI also underwent a hysterectomy more often (p = 0.017) as well as patients with a large uterine cavity (p = 0.041). Pathology results revealed that in 27 (52.9 %) of removed uteruses adenomyosis was present. Complications occurred in 2.9 % of procedures. Conclusion: This study highlights the effectiveness of NEA in the setting of a large general teaching hospital and multiple characteristics associated with failure of treatment. The results of our study reaffirm the place of NEA as a safe and effective treatment for patients with menorrhagia.