Efficacy and safety of endometrial ablation for treating abnormal uterine bleeding in pre- and postmenopausal women with liver cirrhosis.
AIM
Abnormal uterine bleeding (AUB) occurs in 10-30% of women of reproductive age and up to 61% of cirrhotic women. We evaluated the efficacy and safety of endometrial ablation (NovaSure therapy) for AUB in cirrhotic women.


METHODS
This prospective, two-arm, observational study enrolled patients for NovaSure treatment, and they were followed for 12 months. Primary measurements were the amenorrhea rate and changes of pictorial blood loss assessment chart (PBLAC) scores at 1-month post-therapy. Key secondary end-points included the longevity of amenorrhea at 12 months, safety profile, and progression of cirrhosis.


RESULTS
Among 88 women, 26 were cirrhotic and 62 were non-cirrhotic. At 1-month post-NovaSure treatment, a significant reduction of mean PBLAC scores was observed in cirrhotic patients compared to those at baseline (0.4 ± 1.3 vs 215.2 ± 410.9, P < 0.001), and the amenorrhea rate was 88.5%. The efficacy outcomes of the PBLAC scores and amenorrhea rate were maintained until the end of the 12-month follow-up. A significant improvement in quality of life scores was observed 1-month post-therapy compared to those at baseline (5.4 ± 3.1 vs 20.5 ± 5.5, P < 0.001). Patients' satisfaction rates were 100% and 92.31% at 6 and 12 months, respectively. The aforementioned outcomes were comparable with those in non-cirrhotic patients. No significant progression of cirrhosis or safety concern was reported.


CONCLUSION
Cirrhotic patients on NovaSure therapy had a high rate of amenorrhea 1-month post-treatment, which maintained longevity for 12 months. The safety profile was similar to that in non-cirrhotic patients.
['Liu|Qing|Q|', 'Li|Xiu-Lan|XL|', 'Liu|Ji-Juan|JJ|', 'Song|Xiao-Hong|XH|', 'Jiang|Xiao-Ying|XY|', 'Li|Wei|W|', 'Zhang|Hua|H|', 'Pan|Calvin Q|CQ|']
D000328:Adult D000568:Amenorrhea D055356:Endometrial Ablation Techniques D005260:Female D006801:Humans D008103:Liver Cirrhosis D008875:Middle Aged D017060:Patient Satisfaction D017698:Postmenopause D017697:Premenopause D011446:Prospective Studies D011788:Quality of Life D016896:Treatment Outcome D014592:Uterine Hemorrhage
endometrial ablation abnormal uterine bleeding NovaSure hepatic cirrhosis