Is endometrial pretreatment necessary in NovaSure (TM) 3-D endometrial ablation?

Objective To assess and compare the efficacy of NovaSure, a novel 3-D bipol ar endometrial ablation system, for women with severe menorrhagia secondary to dysfunctional uterine bleeding (DUB), with and without endometrial prep aration. Study design A prospective, double-arm, controlled, observational pilot stu dy of 40 women undergoing endometrial ablation using the NovaSure system. Patients 40 premenopausal women, of average age 44 years, with menorrhagia secondary to DUB and unresponsive to medical therapy, who had completed chi ldbearing, with non-distorted uterine cavities, and cornu-to-cornu measurem ent of greater than 2.5 cm. Interventions Endometrial ablation using the 3-D bipolar NovaSure system. Methods 50% of the patients received gonadotrophin-releasing hormone (GnRH) agonist for endometrial thinning. The remaining patients received no treat ment for endometrial thinning. Pictorial blood assessment chart (PBLAC) dia ry sampling was used to select patients for the study, as well as to conduc t the post-treatment evaluation of menstrual blood loss and bleeding patter n (amenorrhoea, spotting, hypomenorrhea, eumenorrhoea or menorrhagia). All patients received the treatment under intravenous sedation with paracervica l block. Results No intraoperative complications were observed. Treatment time avera ged 72 seconds. Follow up of 12 months has been completed in 29 patients. N o significant difference was observed in the outcome (i.e. efficacy) of the procedure between the two groups of patients. Conclusions Preliminary results indicate that the NovaSure system can be su ccessfully used as an effective method of treatment for women with menorrha gia secondary to DUB. Endometrial pretreatment appears not to be necessary in global ablation performed using the NovaSure system.