Title : Hysteroscopic endometrial resection with resectoscope versus Novasure ablation: A look at patient satisfaction with treatment of abnormal uterine bleeding and rates of progression to hysterectomy
Abstract:
We compared the treatment outcomes for hysteroscopic endometrial resection via monopolar or bipolar resectoscope, versus hysteroscopic endometrial ablation with Novasure, at a rural hospital in Victoria, Australia over a 10 year period between 2015 to 2025. The purpose of the study was to analyse whether hysteroscopic endometrial resection via resectoscope was equivalent in outcomes to Novasure ablation. This was a retrospective cohort study of 230 cases at West Gippsland Healthcare Group. Treatment outcomes were defined as ‘patient satisfaction with treatment of abnormal uterine bleeding’ and subsequent discharge from gynaecology clinic, as well whether the patients eventually progressed to hysterectomy for treatment of their abnormal uterine bleeding. Of the patients who underwent hysteroscopic endometrial resection with a resectoscope, 76.9% were done with monopolar resection, whilst 20.0% were done with bipolar resection, and a further 1.5% did not have a stated resection medium. Key findings were that 69.4% of patients who underwent endometrial resection via resectoscope were satisfied post treatment, versus 67.0% of the participants who had undergone Novasure ablation. 11.2% of patients who underwent endometrial resection via resectoscope later went on to have hysterectomies for ongoing abnormal uterine bleeding, versus 12.1% of patients who had had Novasure ablations. These results show that endometrial resection via resectoscope is equivalent to Novasure ablations in patient satisfaction with regards to treatment of their abnormal uterine bleeding. This finding has significance for smaller, more regional hospital sites that may have reduced access to Novasure ablation machines due to lower overall caseloads or challenging access to funding.
