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Radiofrequency endometrial ablation for menorrhagia using a mesh electrode1
Institute for Quality and Efficiency in Health Care (IQWiG).
Key statement
Research question:
The aim of the present investigation is
– to assess the benefit of treatment with radiofrequency endometrial ablation using a mesh electrode versus other treatment methods for endometrial resection or ablation commonly used in German health care (loop resection and/or rollerball ablation as well as balloon ablation)
in patients with menorrhagia and a medical indication for ablative therapy. The focus of the assessment was on patient-relevant outcomes.
Conclusion
Comparison of radiofrequency ablation versus loop resection / rollerball ablation:
Two studies were available comparing radiofrequency ablation and loop resection combined with rollerball ablation.
In each case, the data provide a hint of greater benefit with regard to dysmenorrhoea and for less harm with regard to adverse events (AEs) of radiofrequency ablation versus loop resection/rollerball ablation. Less harm in terms of AEs is primarily due to advantages with regard to intraoperative complications.
The data provide no hint of greater benefit or harm for the outcomes of bleeding severity, premenstrual syndrome, activities of daily living, and surgical re-interventions. For bleeding severity, the leading symptom, comparable benefit can be seen for both procedures.
No data were available for other morbidity outcomes, health-related quality of life, and mortality, so that the data provide no hint of greater benefit or harm for any of these outcomes.
Overall, across outcomes, the data provide a hint of greater benefit of radiofrequency ablation versus loop resection combined with rollerball ablation.
Comparison of radiofrequency ablation versus balloon ablation:
Four studies were available comparing radiofrequency ablation and balloon ablation.
For bleeding severity, the data provide proof and for premenstrual syndrome, the data provide a hint of greater benefit of radiofrequency ablation versus balloon ablation.
The data provide no hint of greater benefit or harm for the outcomes of dysmenorrhoea/pain, depressive symptoms, anxiety symptoms, state of health, postoperative pain, workdays missed after surgery, surgical re-interventions, AEs, health-related quality of life, and mortality.
No usable data were available for activities of daily living, so again the data provide no hint of greater benefit or harm.
Overall, across outcomes, the data provide an indication of greater benefit of radiofrequency ablation versus balloon ablation.
Keywords:
Radiofrequency Ablation, Menorrhagia, Benefit Assessment, Systematic ReviewContents
Publishing details
Publisher
Institute for Quality and Efficiency in Health Care
Topic
Radiofrequency endometrial ablation for menorrhagia using a mesh electrode
Commissioning agency
Federal Joint Committee
Commission awarded on
1 December 2020
Internal Commission No.
N20-06
Address of publisher
This report was prepared in collaboration with external experts.
The responsibility for the contents of the report lies solely with IQWiG.
According to §139b (3) No. 2 of Social Code Book (SGB) V, Statutory Health Insurance, external experts who are involved in the Institute’s research commissions must disclose “all connections to interest groups and contract organizations, particularly in the pharmaceutical and medical devices industries, including details on the type and amount of any remuneration received”. The Institute received the completed Form for disclosure of potential conflicts of interest from each external expert. The information provided was reviewed by a Committee of the Institute specifically established to assess conflicts of interests. The information on conflicts of interest provided by the external experts and external reviewers is presented in Chapter A of the full report. No conflicts of interest were detected that could endanger professional independence with regard to the work on the present commission.
External experts
- Hendrik Veldink, Klinikum Rheine, Rheine, Germany
IQWiG thanks the external expert for his collaboration in the project.
Involvement of patients or other persons affected
Patients or other persons affected were consulted as part of the production of the report and two people participated in the interview. IQWiG would like to thank them for commenting on their experience with the disease and its treatment as well as their treatment goals. They were not involved in the actual production of the report.
IQWiG employees
- Konstanze Angelescu
- Lina Rodenhäuser
- Wolfram Groß
- Tatjana Hermanns
- Julia Kreis
- Fabian Lotz
- Simone Ohlwein
- 1
Translation of Chapters 1 to 5 of the final report N20-06 Hochfrequenzablation des Endometriums mittels Netzelektrode bei Menorrhagie (Version 1.0; Status: 5 November 2021 [German original], 4 May 2022 [English translation]). Please note: This document is provided as a service by IQWiG to English-language readers. However, solely the German original text is absolutely authoritative and legally binding.
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