{"id":20466,"date":"2024-10-01T08:33:09","date_gmt":"2024-10-01T12:33:09","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=20466"},"modified":"2024-10-01T16:01:10","modified_gmt":"2024-10-01T20:01:10","slug":"hysterectomy-rate-following-endometrial-ablation","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/hysterectomy-rate-following-endometrial-ablation\/","title":{"rendered":"Hysterectomy rate following endometrial ablation in Ontario: a cohort analysis of 76,446 patients"},"content":{"rendered":"<p><strong>Background <\/strong>\u2014\u00a0Endometrial Ablation (EA) is an alternative to hysterectomy for the management of abnormal uterine bleeding (AUB); however, it does not eliminate the need for future surgical re-intervention.<\/p>\n<p><strong>Objectives<\/strong>\u00a0\u2014\u00a0The primary objective of this study was to establish long-term clinical outcomes including the risk of hysterectomy in women who had undergone a primary EA.<\/p>\n<p><strong>Materials and methods<\/strong>\u00a0\u2014\u00a0This is a retrospective population-based cohort study utilising administrative data from the Canadian province of Ontario. This study assesses patients undergoing surgery in a publicly funded health care system.<\/p>\n<p><strong>Main outcome measures <\/strong>\u2014\u00a0We assessed women in Ontario undergoing a primary EA over a 15-year period. The primary outcome was hysterectomy within 5 years of primary EA. Secondary outcomes included myomectomy and repeat EA. All outcomes were also reported for 1, 3, 5, 10 and 15 years of follow-up. Logistic regression was used to establish predictors of hysterectomy within 5 years of primary EA.<\/p>\n<p><strong>Results<\/strong>\u00a0\u2014\u00a0A total of 76,446 primary EAs were evaluated from 2002-2017, with 16,480 (21.56%) undergoing a subsequent surgical intervention. The average age of primary EA was 43.8 (+\/- 6.3) years. Within 5 years, the evaluable cohort was 52,464, with 8,635 (16.46%) of women having proceeded to hysterectomy, 664 (1.27%) to myomectomy, and 2,468 (2.8%) to repeat ablation. By 15-years follow-up, the evaluable cohort was 1,788, with 28.75% had undergone a hysterectomy, 2.01% a myomectomy, and 5.20% a repeat EA. On logistic regression analysis, advancing age at time of EA was associated with significantly decreased odds of hysterectomy (OR=0.94, 95% CI 0.935-0.944, p&lt;.0001) as was increasing surgical experience (OR=0.997, 95% CI 0.994-1.000, p=.022). Conversely, complex diagnosis (OR=1.102, 95% CI 1.042-1.164, p&lt;.0001) and previous abdominal surgery (OR=1.288, 95% CI 1.222-1.357, p&lt;0.0001) were associated with increased risk of subsequent hysterectomy.<\/p>\n<p><strong>Conclusion<\/strong> \u2014\u00a0Primary EA is associated with a high risk of progression to subsequent hysterectomy or other surgical intervention, without evidence of plateau of risk with long term follow-up.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014\u00a0Endometrial Ablation (EA) is an alternative to hysterectomy for the management of abnormal uterine bleeding (AUB); however, it does not eliminate the need for future surgical re-intervention. Objectives\u00a0\u2014\u00a0The primary objective of this study was to establish long-term clinical outcomes including the risk of hysterectomy in women who had undergone a primary EA. Materials and [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[45,21],"migration-helper-qa-sample-set":[],"class_list":["post-20466","journal_article","type-journal_article","status-publish","hentry","topic-reproductive-medicine","topic-women-or-gender-based-research"],"acf":{"citation":"McGee J, McClure A, Ilnitsky S, Vilos A, Abu-Rafea A, Vilos G. <em>Facts Views Vis Obgyn.<\/em> 2024; 16(3):311-316. Epub 2024 Sep 30.","source_url":"https:\/\/fvvo.eu\/archive\/volume-16\/number-3\/original-articles\/hysterectomy-rate-following-endometrial-ablation-in-ontario-a-cohort-analysis-of-76446-patients\/","ices_scientist":[1310],"site":[6739],"research_program":[6741],"news_release":[20265],"journal_article":"","atlas":"","research_report":"","infographic":[20467],"video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Hysterectomy rate following endometrial ablation in Ontario: a cohort analysis of 76,446 patients<\/title>\n<meta name=\"description\" content=\"Background \u2014\u00a0Endometrial Ablation (EA) is an alternative to hysterectomy for the management of abnormal uterine bleeding (AUB); however, it does not\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/hysterectomy-rate-following-endometrial-ablation\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Hysterectomy rate following endometrial ablation in Ontario: a cohort analysis of 76,446 patients\" \/>\n<meta property=\"og:description\" content=\"Background \u2014\u00a0Endometrial Ablation (EA) is an alternative to hysterectomy for the management of abnormal uterine bleeding (AUB); 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