Scolaris Content Display Scolaris Content Display

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
Figures and Tables -
Figure 1

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 1 Amenorrhoea rate.
Figures and Tables -
Analysis 1.1

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 1 Amenorrhoea rate.

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 2 Amenorrhoea/hypomenorrhoea rate.
Figures and Tables -
Analysis 1.2

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 2 Amenorrhoea/hypomenorrhoea rate.

Study

Laser ablation

TCRE + RB

Results

McClure 1992

N=12
Mean MBL (SD) at 6 months:
50.6 (41.6) mls

N=10
Mean MBL (SD) at 6 months:
27.0 (34.8) mls

Mann Whitney test.
Not statistically significant difference between groups

Figures and Tables -
Analysis 1.3

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 3 MBL at 6 months (descriptive data).

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 4 Participant satisfaction at 12 months (very/moderately).
Figures and Tables -
Analysis 1.4

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 4 Participant satisfaction at 12 months (very/moderately).

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 5 Duration of operation (mins).
Figures and Tables -
Analysis 1.5

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 5 Duration of operation (mins).

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 6 Operative difficulties (%).
Figures and Tables -
Analysis 1.6

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 6 Operative difficulties (%).

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 7 Good general health (proportion of women).
Figures and Tables -
Analysis 1.7

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 7 Good general health (proportion of women).

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 8 Improvement in symptoms (proportion of women).
Figures and Tables -
Analysis 1.8

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 8 Improvement in symptoms (proportion of women).

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 9 Improvement in dysmenorrhea.
Figures and Tables -
Analysis 1.9

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 9 Improvement in dysmenorrhea.

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 10 Complication rate (proportion of women).
Figures and Tables -
Analysis 1.10

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 10 Complication rate (proportion of women).

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 11 Requirement for further surgical treatment (within 12 mths).
Figures and Tables -
Analysis 1.11

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 11 Requirement for further surgical treatment (within 12 mths).

Comparison 2 VAPORISING ELECTRODE ABLATION (1st G) versus TCRE (1st G), Outcome 1 Amenorrhoea rate at 12 months follow up.
Figures and Tables -
Analysis 2.1

Comparison 2 VAPORISING ELECTRODE ABLATION (1st G) versus TCRE (1st G), Outcome 1 Amenorrhoea rate at 12 months follow up.

Comparison 2 VAPORISING ELECTRODE ABLATION (1st G) versus TCRE (1st G), Outcome 2 Amenorrhea/hypomenorrhoea rate at 12 months follow up.
Figures and Tables -
Analysis 2.2

Comparison 2 VAPORISING ELECTRODE ABLATION (1st G) versus TCRE (1st G), Outcome 2 Amenorrhea/hypomenorrhoea rate at 12 months follow up.

Study

Vaporising electrode

TCRE

Results

Vercellini 1999

N=47
Mean score (SD):
15 (24)

N=44
Mean score (SD):
20 (42)

Unpaired t test.
No significant difference between the 2 means.

Figures and Tables -
Analysis 2.3

Comparison 2 VAPORISING ELECTRODE ABLATION (1st G) versus TCRE (1st G), Outcome 3 PBAC score at 12 mths.

Comparison 2 VAPORISING ELECTRODE ABLATION (1st G) versus TCRE (1st G), Outcome 4 Satisfaction rate at 12 mths (very/moderately).
Figures and Tables -
Analysis 2.4

Comparison 2 VAPORISING ELECTRODE ABLATION (1st G) versus TCRE (1st G), Outcome 4 Satisfaction rate at 12 mths (very/moderately).

Comparison 2 VAPORISING ELECTRODE ABLATION (1st G) versus TCRE (1st G), Outcome 5 Duration of operation (mins).
Figures and Tables -
Analysis 2.5

Comparison 2 VAPORISING ELECTRODE ABLATION (1st G) versus TCRE (1st G), Outcome 5 Duration of operation (mins).

Comparison 2 VAPORISING ELECTRODE ABLATION (1st G) versus TCRE (1st G), Outcome 6 Operative difficulties.
Figures and Tables -
Analysis 2.6

Comparison 2 VAPORISING ELECTRODE ABLATION (1st G) versus TCRE (1st G), Outcome 6 Operative difficulties.

Comparison 2 VAPORISING ELECTRODE ABLATION (1st G) versus TCRE (1st G), Outcome 7 Degree of fluid deficit (ml).
Figures and Tables -
Analysis 2.7

Comparison 2 VAPORISING ELECTRODE ABLATION (1st G) versus TCRE (1st G), Outcome 7 Degree of fluid deficit (ml).

Comparison 3 ROLLERBALL (1st G) versus TCRE (1st G), Outcome 1 Duration of operation (mins).
Figures and Tables -
Analysis 3.1

Comparison 3 ROLLERBALL (1st G) versus TCRE (1st G), Outcome 1 Duration of operation (mins).

Study

Rollerball

TCRE

Comment

Boujida 2002

N=61
Median (range): 13 mins (6 to 105)

N=59
Median (range): 20 mins (4 to 45)

Mann Whitney test: P<0.05

Figures and Tables -
Analysis 3.2

Comparison 3 ROLLERBALL (1st G) versus TCRE (1st G), Outcome 2 Duration of operation (descriptive data).

Comparison 3 ROLLERBALL (1st G) versus TCRE (1st G), Outcome 3 Complication rate.
Figures and Tables -
Analysis 3.3

Comparison 3 ROLLERBALL (1st G) versus TCRE (1st G), Outcome 3 Complication rate.

Comparison 3 ROLLERBALL (1st G) versus TCRE (1st G), Outcome 4 Requirement for further surgery (hyst or ablation).
Figures and Tables -
Analysis 3.4

Comparison 3 ROLLERBALL (1st G) versus TCRE (1st G), Outcome 4 Requirement for further surgery (hyst or ablation).

Comparison 3 ROLLERBALL (1st G) versus TCRE (1st G), Outcome 5 Requirement for further surgery rate (hyst only).
Figures and Tables -
Analysis 3.5

Comparison 3 ROLLERBALL (1st G) versus TCRE (1st G), Outcome 5 Requirement for further surgery rate (hyst only).

Comparison 4 THERMAL LASER (2nd G) versus TCRE (1st G), Outcome 1 Amenorrhoea rate.
Figures and Tables -
Analysis 4.1

Comparison 4 THERMAL LASER (2nd G) versus TCRE (1st G), Outcome 1 Amenorrhoea rate.

Comparison 4 THERMAL LASER (2nd G) versus TCRE (1st G), Outcome 2 Satisfaction rate.
Figures and Tables -
Analysis 4.2

Comparison 4 THERMAL LASER (2nd G) versus TCRE (1st G), Outcome 2 Satisfaction rate.

Comparison 4 THERMAL LASER (2nd G) versus TCRE (1st G), Outcome 3 Duration of operation.
Figures and Tables -
Analysis 4.3

Comparison 4 THERMAL LASER (2nd G) versus TCRE (1st G), Outcome 3 Duration of operation.

Comparison 4 THERMAL LASER (2nd G) versus TCRE (1st G), Outcome 4 Pain score at 12 hrs after surgery (VAS: 1‐10).
Figures and Tables -
Analysis 4.4

Comparison 4 THERMAL LASER (2nd G) versus TCRE (1st G), Outcome 4 Pain score at 12 hrs after surgery (VAS: 1‐10).

Comparison 4 THERMAL LASER (2nd G) versus TCRE (1st G), Outcome 5 Intraoperative complication rate.
Figures and Tables -
Analysis 4.5

Comparison 4 THERMAL LASER (2nd G) versus TCRE (1st G), Outcome 5 Intraoperative complication rate.

Comparison 4 THERMAL LASER (2nd G) versus TCRE (1st G), Outcome 6 Requirement for further surgery rate (hyst only).
Figures and Tables -
Analysis 4.6

Comparison 4 THERMAL LASER (2nd G) versus TCRE (1st G), Outcome 6 Requirement for further surgery rate (hyst only).

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 1 Amenorrhoea rate.
Figures and Tables -
Analysis 5.1

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 1 Amenorrhoea rate.

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 2 PBAC </= 75.
Figures and Tables -
Analysis 5.2

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 2 PBAC </= 75.

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 3 Proportion with "normal" bleeding (PBAC </= 100).
Figures and Tables -
Analysis 5.3

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 3 Proportion with "normal" bleeding (PBAC </= 100).

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 4 Satisfaction rate.
Figures and Tables -
Analysis 5.4

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 4 Satisfaction rate.

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 5 Proportion having local anaesthesia (%).
Figures and Tables -
Analysis 5.5

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 5 Proportion having local anaesthesia (%).

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 6 Intraoperative complication rate.
Figures and Tables -
Analysis 5.6

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 6 Intraoperative complication rate.

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 7 Postoperative complication rate.
Figures and Tables -
Analysis 5.7

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 7 Postoperative complication rate.

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 8 Requirement for further surgery (any surgery).
Figures and Tables -
Analysis 5.8

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 8 Requirement for further surgery (any surgery).

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 9 Requirement for further surgery rate (hyst only).
Figures and Tables -
Analysis 5.9

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 9 Requirement for further surgery rate (hyst only).

Comparison 6 CRYOABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 1 Amenorrhoea rate.
Figures and Tables -
Analysis 6.1

Comparison 6 CRYOABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 1 Amenorrhoea rate.

Comparison 6 CRYOABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 2 Satisfaction rate.
Figures and Tables -
Analysis 6.2

Comparison 6 CRYOABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 2 Satisfaction rate.

Comparison 6 CRYOABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 3 Proportion having local anaesthesia (%).
Figures and Tables -
Analysis 6.3

Comparison 6 CRYOABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 3 Proportion having local anaesthesia (%).

Comparison 6 CRYOABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 4 Intraoperative complication rate.
Figures and Tables -
Analysis 6.4

Comparison 6 CRYOABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 4 Intraoperative complication rate.

Comparison 6 CRYOABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 5 Requirement for further surgery (any surgery).
Figures and Tables -
Analysis 6.5

Comparison 6 CRYOABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 5 Requirement for further surgery (any surgery).

Comparison 6 CRYOABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 6 Requirement for further surgery rate (hyst only).
Figures and Tables -
Analysis 6.6

Comparison 6 CRYOABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 6 Requirement for further surgery rate (hyst only).

Comparison 7 ELECTRODE ABLATION (2nd G) versus TCRE + ROLLERBALL (1st G), Outcome 1 Amenorrhea rate at 1 yr follow up.
Figures and Tables -
Analysis 7.1

Comparison 7 ELECTRODE ABLATION (2nd G) versus TCRE + ROLLERBALL (1st G), Outcome 1 Amenorrhea rate at 1 yr follow up.

Comparison 7 ELECTRODE ABLATION (2nd G) versus TCRE + ROLLERBALL (1st G), Outcome 2 Proportion with successful Rx (PBAC<75).
Figures and Tables -
Analysis 7.2

Comparison 7 ELECTRODE ABLATION (2nd G) versus TCRE + ROLLERBALL (1st G), Outcome 2 Proportion with successful Rx (PBAC<75).

Study

Electrode system

TCRE + RB

Stat test for diff

Balloon system

Corson 2000

N=122
Mean PBAC (SD): 18 (37)

N=112
Mean PBAC (SD): 28 (70)

Not significantly different

Mesh system

Cooper 2002

N=154
Mean PBAC (SD): 26.8

N=82
Mean PBAC (SD): 36.4 (66.3)

No reported difference

Figures and Tables -
Analysis 7.3

Comparison 7 ELECTRODE ABLATION (2nd G) versus TCRE + ROLLERBALL (1st G), Outcome 3 PBAC score 12 months after treatment.

Comparison 7 ELECTRODE ABLATION (2nd G) versus TCRE + ROLLERBALL (1st G), Outcome 4 Proportion satisfied with treatment at 1 year.
Figures and Tables -
Analysis 7.4

Comparison 7 ELECTRODE ABLATION (2nd G) versus TCRE + ROLLERBALL (1st G), Outcome 4 Proportion satisfied with treatment at 1 year.

Comparison 7 ELECTRODE ABLATION (2nd G) versus TCRE + ROLLERBALL (1st G), Outcome 5 Duration of operation (mins).
Figures and Tables -
Analysis 7.5

Comparison 7 ELECTRODE ABLATION (2nd G) versus TCRE + ROLLERBALL (1st G), Outcome 5 Duration of operation (mins).

Comparison 7 ELECTRODE ABLATION (2nd G) versus TCRE + ROLLERBALL (1st G), Outcome 6 Proportion having local anaesthesia (%).
Figures and Tables -
Analysis 7.6

Comparison 7 ELECTRODE ABLATION (2nd G) versus TCRE + ROLLERBALL (1st G), Outcome 6 Proportion having local anaesthesia (%).

Comparison 7 ELECTRODE ABLATION (2nd G) versus TCRE + ROLLERBALL (1st G), Outcome 7 Intraoperative complication rate.
Figures and Tables -
Analysis 7.7

Comparison 7 ELECTRODE ABLATION (2nd G) versus TCRE + ROLLERBALL (1st G), Outcome 7 Intraoperative complication rate.

Comparison 7 ELECTRODE ABLATION (2nd G) versus TCRE + ROLLERBALL (1st G), Outcome 8 Postoperative complication rate.
Figures and Tables -
Analysis 7.8

Comparison 7 ELECTRODE ABLATION (2nd G) versus TCRE + ROLLERBALL (1st G), Outcome 8 Postoperative complication rate.

Comparison 7 ELECTRODE ABLATION (2nd G) versus TCRE + ROLLERBALL (1st G), Outcome 9 Requirement for further surgery at 2 years (hysterectomy).
Figures and Tables -
Analysis 7.9

Comparison 7 ELECTRODE ABLATION (2nd G) versus TCRE + ROLLERBALL (1st G), Outcome 9 Requirement for further surgery at 2 years (hysterectomy).

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 1 Amenorrhea rate.
Figures and Tables -
Analysis 8.1

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 1 Amenorrhea rate.

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 2 Success of treatment (PBAC<75).
Figures and Tables -
Analysis 8.2

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 2 Success of treatment (PBAC<75).

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 3 Satisfaction rate.
Figures and Tables -
Analysis 8.3

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 3 Satisfaction rate.

Study

Microwave

TCRE

Results

Cooper 1999

N=129
Mean duration of procedure (SD):
11.4 (10.5) mins

N=134
Mean duration of procedure (SD):
15.0 (7.2) mins

Mann Whitney U test
Mean difference:
3.6 (‐5.7, ‐1.4); P=0.001

Figures and Tables -
Analysis 8.4

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 4 Duration of operation (mins).

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 5 Operative difficulties.
Figures and Tables -
Analysis 8.5

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 5 Operative difficulties.

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 6 Proportion having local anaesthesia.
Figures and Tables -
Analysis 8.6

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 6 Proportion having local anaesthesia.

Study

Microwave

TCRE

Results

Cooper 1999

N=129
Mean duration of hospital stay (SD):
13.4 (17.6) hours

N=134
Mean duration of hospital stay (SD):
16.7 (21.2) hours

Mann Whitney U test
No differences between groups; P=0.17

Figures and Tables -
Analysis 8.7

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 7 Duration of hospital stay (hours).

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 8 Inability to work (proportion of women).
Figures and Tables -
Analysis 8.8

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 8 Inability to work (proportion of women).

Study

MEA

TCRE

Results

Physical functioning

Cooper 1999

AT 1 YEAR:
N=116
Mean change (SD):
0.7 (18.9)

AT 2 YEARS:
N=120
Mean change (SD):
2.3 (21.3)

AT 5 YEARS:
N=116
Mean change (SD): 0.2 (24)

AT 1 YEAR:
N=124
Mean change (SD):
2.4 (16.8)

AT 2 YEARS:
N=129
Mean change (SD):
0.9 (20.4)

AT 5 YEARS:
N=120
Mean change (SD): ‐1.2 (21)

AT 1 YEAR:
t test:
CI (‐6.4, 2.9); P=0.45
Ancova: P=0.58

AT 2 YEARS:
t test:
P=0.28 (95% CI ‐3.8, 6.6)

AT 5 YEARS:
t test:
NS (95% CI ‐4.5 to 7.3)

Social functioning

Cooper 1999

AT 1 YEAR:
N=116
Mean change (SD): 20.6 (26.5)

AT 2 YEARS:
N=120
Mean change (SD): 10.1 (27.5)

AT 5 YEARS:
N=116
Mean change (SD): 7.7 (30)

N=124
Mean change (SD): 16.2 (24.4)

AT 2 YEARS:
N=129
Mean change (SD): 6.2 (23.7)

AT 5 YEARS:
Mean change (SD):
9.7 (25)

AT 1 YEAR:
t test:
CI (‐2.1, 10.90): P=0.18
Ancova:
P=0.12

AT 2 YEARS:
t test:
P=0.33 (95% CI ‐2.5, 10.3)

AT 5 YEARS:
t test:
NS (95% CI ‐9.0 to 5.0)

Physical role

Cooper 1999

AT 1 YEAR:
N=116
Mean change (SD): 23.9 (49.4)

AT 2 YEARS:
N=120
Mean change (SD):
18.5 (53.7)

AT 5 YEARS:
N=116
Mean change (SD):
17 (54)

AT 1 YEAR:
N=124
Mean change (SD):
11.3 (41.7)

AT 2 YEARS:
N=129
Mean change (SD):
6.1 (43.8)

AT 5 YEARS:
N=120
Mean change (SD):
11 (43)

AT 1 YEAR:
t test:
CI (1.0 to 24.3);
P=0.03
Ancova:
P=0.03

AT 2 YEARS:
t test:
P=0.06 (95% CI ‐0.2, 24.6)

AT 5 YEARS:
t test:
NS, 95% CI ‐5.8 to 19

Emotional role

Cooper 1999

AT ONE YEAR:
N=116
Mean change (SD):
17.0 (48.5)

AT 2 YEARS:
N=120
Mean change (SD):
17.8 (47.5)

AT 5 YEARS:
N=116
Mean change (SD):
19 (48)

AT 1 YEAR:
N=124
Mean change (SD):
13.7 (47.9)

AT 2 YEARS:
N=129
Mean change (SD):
4.2 (40.1)

AT 5 YEARS:
Mean change (SD):
20 (41)

AT 1 YEAR:
t test:
CI (‐9.1 to 15.6);
P=0.59
Ancova:
P=0.38

AT 2 YEARS:
t test
P=0.17 (95% CI ‐3.6, 23.5)

AT 5 YEARS:
t test:
NS, 95% CI ‐13 to 10

Mental health

Cooper 1999

AT 1 YEAR:
N=116
Mean change (SD):
6.3 (19.5)

AT 2 YEARS:
N=120
Mean change (SD):
6.0 (21.6)

AT 5 YEARS:
N=116
Mean change (SD):
1.4 (21)

AT 1 YEAR:
N=124
Mean change (SD):
6.0 (22.2)

AT 2 YEARS:
N=129
Mean change (SD):
4.1 (19.8)

AT 5 YEARS
Mean change (SD):
1.2 (21)

AT 1 YEAR:
t test:
CI (‐4.9 to 5.7);
P=0.89
Ancova:
P=0.83

AT 2 YEARS:
t test:
P=0.44 (95% CI ‐3.3, 6.9)

AT 5 YEARS:
t test:
NS, 95% CI ‐5.2 to 5.6

Energy/fatigue

Cooper 1999

AT 1 YEAR:
N=116
Mean change (SD):
12.8 (21.7)

AT 2 YEARS:
N=120
Mean change (SD):
11.4 (25.1)

AT 5 YEARS:
Mean change (SD):
9.3 (25)

AT 1 YEAR:
N=124
Mean change (SD):
12.1 (23.0)

AT 2 YEARS:
N=129
Mean change (SD):
11.8 (22.6)

AT 5 YEARS:
Mean change (SD):
12 (26)

AT 1 YEAR:
t test:
CI (‐4.9 to 6.5);
p=0.80
Ancova:
p=0.58

AT 2 YEARS:
t test:
P=0.90 (95% CI ‐6.4, 5.5)

AT 5 YEARS:
t test:
NS, 95% CI ‐9.1 to 4.2

Pain

Cooper 1999

AT 1 YEAR:
N=116
Mean change (SD):
14.8 (31.0)

AT 2 YEARS:
N=120
Mean change (SD):
13.5 (31.7)

AT 5 YEARS:
Mean change (SD):
9.3 (35)

AT 1 YEAR:
N=124
Mean change (SD):
7.2 (31.1)

AT 2 YEARS:
N=129
Mean change (SD):
3.0 (29.8)

AT 5 YEARS:
Mean change (SD):
6.4 (31)

AT 1 YEAR:
t test:
CI (‐0.2 to 15.5);
P=0.06
Ancova:
P=0.54

AT 2 YEARS:
t test:
P=0.02 (95% CI 2.9, 18.2)

AT 5 YEARS:
t test:
NS, ‐5.7 to 12

General health

Cooper 1999

AT 1 YEAR:
N=116
Mean change (SD):
2.4 (20.3)

AT 2 YEARS:
N=120
Mean change (SD):
0.0 (24.4)

AT 5 YEARS:
Mean change (SD):
‐3.3 (26)

AT 1 YEAR:
N=124
Mean change (SD):
‐2.9 (20.0)

AT 2 YEARS:
N=129
Mean change (SD):
‐2.9 (19.0)

AT 5 YEARS:
Mean change (SD):
‐2.4 (19)

AT 1 YEAR:
t test:
CI (0.2 to 10.5);
P=0.04
Ancova:
P=0.06

AT 2 YEARS:
t test:
P=0.29 (95% CI ‐2.5, 8.4)

AT 5 YEARS:
t test:
NS, 95% CI ‐6.5 to 4.9

Figures and Tables -
Analysis 8.9

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 9 Change in SF36 score after treatment.

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 10 Improvement in symptoms.
Figures and Tables -
Analysis 8.10

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 10 Improvement in symptoms.

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 11 Improvement in dysmenorrhoea.
Figures and Tables -
Analysis 8.11

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 11 Improvement in dysmenorrhoea.

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 12 Postoperative analgesia rate.
Figures and Tables -
Analysis 8.12

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 12 Postoperative analgesia rate.

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 13 Intraoperative complication rate.
Figures and Tables -
Analysis 8.13

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 13 Intraoperative complication rate.

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 14 Postoperative complication rate (wihin 24 hours).
Figures and Tables -
Analysis 8.14

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 14 Postoperative complication rate (wihin 24 hours).

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 15 Requirement for further surgery (any surgery).
Figures and Tables -
Analysis 8.15

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 15 Requirement for further surgery (any surgery).

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 16 Requirement for further surgery rate (hyst only).
Figures and Tables -
Analysis 8.16

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 16 Requirement for further surgery rate (hyst only).

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 1 Amenorrhea rate.
Figures and Tables -
Analysis 9.1

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 1 Amenorrhea rate.

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 2 Amenorrhoea/eumenorrhoea rate.
Figures and Tables -
Analysis 9.2

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 2 Amenorrhoea/eumenorrhoea rate.

Study

Balloon

Rollerball

Results

At 1 year follow up

Meyer 1998

N=125
Mean PBAC (SD): 52.2 (85.2)

N=114
Mean PBAC (SD): 39.6 (86.4)

No statistical test performed of these outcomes

Soysal 2001

N=41
Mean PBAC (SD): 41.1 (29)

N=44
Mean PBAC (SD): 40.2 (45)

Significance not reported

van Zon‐Rabelink2003

N=74
Median PBAC (range): 70 (0, 2265)

N=55
Median PBAC (range): 73 (0, 535)

Wilcoxon test:
P=0.90

At 2 years follow up

van Zon‐Rabelink2003

N=66
Median PBAC (range): 33.5 (0, 905)

N=55
Median PBAC (range): 73 (0, 585)

Wilcoxon test: P=0.01

Figures and Tables -
Analysis 9.3

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 3 PBAC score after treatment.

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 4 Success of treatment (lighter periods and no further surgery).
Figures and Tables -
Analysis 9.4

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 4 Success of treatment (lighter periods and no further surgery).

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 5 Success of treatment (PBAC<75).
Figures and Tables -
Analysis 9.5

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 5 Success of treatment (PBAC<75).

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 6 Success of treatment (menstrual score <185).
Figures and Tables -
Analysis 9.6

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 6 Success of treatment (menstrual score <185).

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 7 Satisfaction rate.
Figures and Tables -
Analysis 9.7

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 7 Satisfaction rate.

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 8 Duration of operation (mins).
Figures and Tables -
Analysis 9.8

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 8 Duration of operation (mins).

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 9 Operative difficulties.
Figures and Tables -
Analysis 9.9

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 9 Operative difficulties.

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 10 Inability to work (proportion of women).
Figures and Tables -
Analysis 9.10

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 10 Inability to work (proportion of women).

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 11 Improvement in dysmenorrhea at 12 months.
Figures and Tables -
Analysis 9.11

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 11 Improvement in dysmenorrhea at 12 months.

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 12 Improvement in premenstrual symptoms (from moderate/severe).
Figures and Tables -
Analysis 9.12

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 12 Improvement in premenstrual symptoms (from moderate/severe).

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 13 Complication rate (proportion of women).
Figures and Tables -
Analysis 9.13

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 13 Complication rate (proportion of women).

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 14 Requirement for further surgery (any surgery).
Figures and Tables -
Analysis 9.14

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 14 Requirement for further surgery (any surgery).

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 15 Requirement for further surgery (hyst only).
Figures and Tables -
Analysis 9.15

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 15 Requirement for further surgery (hyst only).

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 1 Amenorrhoea rate.
Figures and Tables -
Analysis 10.1

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 1 Amenorrhoea rate.

Study

Balloon

Laser

Statistical test

At 6 months follow up

Hawe 2003

N=37
Mean PBAC (SD): 28.8 (59.6)

N=33
Mean PBAC (SD): 27.4 (57.6)

Significance not reported

Figures and Tables -
Analysis 10.2

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 2 PBAC score after treatment.

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 3 Satisfaction rate.
Figures and Tables -
Analysis 10.3

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 3 Satisfaction rate.

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 4 Operative difficulties.
Figures and Tables -
Analysis 10.4

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 4 Operative difficulties.

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 5 Euroquol 5D.
Figures and Tables -
Analysis 10.5

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 5 Euroquol 5D.

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 6 Euroquol 5D VAS.
Figures and Tables -
Analysis 10.6

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 6 Euroquol 5D VAS.

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 7 SF12 Physical Scale.
Figures and Tables -
Analysis 10.7

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 7 SF12 Physical Scale.

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 8 SF12 Mental Scale.
Figures and Tables -
Analysis 10.8

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 8 SF12 Mental Scale.

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 9 SAQ pleasure scale.
Figures and Tables -
Analysis 10.9

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 9 SAQ pleasure scale.

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 10 SAQ habit scale.
Figures and Tables -
Analysis 10.10

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 10 SAQ habit scale.

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 11 SAQ discomfort scale.
Figures and Tables -
Analysis 10.11

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 11 SAQ discomfort scale.

Study

Balloon

Laser

Statistical test

At 6 months follow up

Hawe 2003

N=37
Mean score (SD): 24.6 (33)

N=33
Mean score (SD): 34.8 (36)

Not reported

At 12 months follow up

Hawe 2003

N=34
Mean score (SD): 21.9 (26.9)

N=33
Mean score (SD): 30.5 (34.7)

Not reported

Figures and Tables -
Analysis 10.12

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 12 PMS (visual analogue).

Study

Balloon

Laser

Statistical test

At 6 months follow up

Hawe 2003

N=37
Mean score (SD): 24 (30.9)

N=33
Mean score (SD): 23 (33.9)

Not reported

At 12 months follow up

Hawe 2003

N=34
Mean score (SD): 25.2 (31.5)

N=33
Mean score (SD): 16.5 (22.3)

Not reported

Figures and Tables -
Analysis 10.13

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 13 Dysmenorrhoea (visual analogue).

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 14 Pain score.
Figures and Tables -
Analysis 10.14

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 14 Pain score.

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 15 Requirement for further surgery.
Figures and Tables -
Analysis 10.15

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 15 Requirement for further surgery.

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 1 Amenorrhoea rate.
Figures and Tables -
Analysis 11.1

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 1 Amenorrhoea rate.

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 2 Satisfaction rate.
Figures and Tables -
Analysis 11.2

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 2 Satisfaction rate.

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 3 Duration of operation (mins).
Figures and Tables -
Analysis 11.3

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 3 Duration of operation (mins).

Study

Cavaterm balloon

TCRE

Comments

Brun 2006

n=31

Median (range): 48 (24‐150)

n=20

Median (range): 45 (23‐105)

No statistical test reported ‐ unlikely to be a difference

Figures and Tables -
Analysis 11.4

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 4 Duration of operation (mins).

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 5 Operative difficulties.
Figures and Tables -
Analysis 11.5

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 5 Operative difficulties.

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 6 Hospital stay (days).
Figures and Tables -
Analysis 11.6

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 6 Hospital stay (days).

Study

Cavaterm balloon

TCRE

Comments

Brun 2006

n=31

Median (range): 21 (0‐36)

n=20

Median (range): 30 (6‐72)

Mann Whitney rank sum test

P=0.012

Figures and Tables -
Analysis 11.7

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 7 Duration of hospital stay (hours).

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 8 Return to normal activities (days).
Figures and Tables -
Analysis 11.8

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 8 Return to normal activities (days).

Study

Cavaterm balloon

TCRE

Comments

Brun 2006

n=31

Median (range): 4 (1‐20)

n=20

Median (range): 2 (1‐30)

Mann Whitney rank test ‐ not significantly different

Figures and Tables -
Analysis 11.9

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 9 Return to normal activities (days).

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 10 Intraoperative complications (continuous data).
Figures and Tables -
Analysis 11.10

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 10 Intraoperative complications (continuous data).

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 11 Intraoperative complications (dichotomous data).
Figures and Tables -
Analysis 11.11

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 11 Intraoperative complications (dichotomous data).

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 12 Postoperative pain (continuous data).
Figures and Tables -
Analysis 11.12

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 12 Postoperative pain (continuous data).

Study

Cavaterm balloon

TCRE

Comments

Brun 2006

n=31

Pain score (VAS scale 0‐100): median (range): 45 (1‐100)

n=20

Pain score (VAS scale 0‐100): median (range): 10 (0‐90)

Mann Whitney rank sum test:

P=0.012

Figures and Tables -
Analysis 11.13

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 13 Postoperative pain (descriptive data).

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 14 Postoperative complications.
Figures and Tables -
Analysis 11.14

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 14 Postoperative complications.

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 15 Requirement for further surgery.
Figures and Tables -
Analysis 11.15

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 15 Requirement for further surgery.

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 16 Requirement for further surgery (hyst only).
Figures and Tables -
Analysis 11.16

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 16 Requirement for further surgery (hyst only).

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 1 Amenorrhoea rate.
Figures and Tables -
Analysis 12.1

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 1 Amenorrhoea rate.

Study

Electrode

Balloon

Statistical test

At 12 months follow up

Abbott 2003

N=37
Median PBAC (range): 3 (0, 720)

N=18
Median PBAC (range): 21 (0, 157)

Mann Whitney
P=0.2

Figures and Tables -
Analysis 12.2

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 2 PBAC score after treatment.

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 3 Satisfaction rate.
Figures and Tables -
Analysis 12.3

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 3 Satisfaction rate.

Study

Electrode

Balloon

Statistical test

Abbott 2003

N=37
Mean time in mins (range): 4 (2, 8)

N=18
Mean time in mins (range): 23 (19, 29)

t test
P=0.0001

Bongers 2004

N=82
Mean time in mins (range): 9 (5, 32)

N=43
Mean time in mins (range): 14 (9, 40)

Not reported

Figures and Tables -
Analysis 12.4

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 4 Duration of operation.

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 5 Operative difficulties.
Figures and Tables -
Analysis 12.5

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 5 Operative difficulties.

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 6 SF12 physical score.
Figures and Tables -
Analysis 12.6

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 6 SF12 physical score.

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 7 SF12 mental score.
Figures and Tables -
Analysis 12.7

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 7 SF12 mental score.

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 8 SF‐36 Physical function score.
Figures and Tables -
Analysis 12.8

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 8 SF‐36 Physical function score.

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 9 SF‐36 Role physical.
Figures and Tables -
Analysis 12.9

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 9 SF‐36 Role physical.

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 10 SF‐36 Role emotional.
Figures and Tables -
Analysis 12.10

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 10 SF‐36 Role emotional.

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 11 SF‐36 Social functioning.
Figures and Tables -
Analysis 12.11

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 11 SF‐36 Social functioning.

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 12 SF‐36 Mental health.
Figures and Tables -
Analysis 12.12

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 12 SF‐36 Mental health.

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 13 SF‐36 Energy/vitality.
Figures and Tables -
Analysis 12.13

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 13 SF‐36 Energy/vitality.

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 14 SF‐36 Pain.
Figures and Tables -
Analysis 12.14

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 14 SF‐36 Pain.

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 15 SF‐36 General health.
Figures and Tables -
Analysis 12.15

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 15 SF‐36 General health.

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 16 RSCL Physical symptoms.
Figures and Tables -
Analysis 12.16

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 16 RSCL Physical symptoms.

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 17 RSCL Psychological distress.
Figures and Tables -
Analysis 12.17

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 17 RSCL Psychological distress.

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 18 RSCL Activity level.
Figures and Tables -
Analysis 12.18

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 18 RSCL Activity level.

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 19 RSCL Overall quality of life.
Figures and Tables -
Analysis 12.19

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 19 RSCL Overall quality of life.

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 20 SDS Depression.
Figures and Tables -
Analysis 12.20

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 20 SDS Depression.

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 21 Dysmenorrhoea rate.
Figures and Tables -
Analysis 12.21

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 21 Dysmenorrhoea rate.

Study

Electrode

Balloon

Statistical test

At 12 months follow up

Abbott 2003

N=37
Median score (range): 0 (0, 96)

N=18
Median score (range): 29 (0, 77)

Mann Whitney
P=0.008

Figures and Tables -
Analysis 12.22

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 22 Dysmenorrhoea rate (VAS score).

Study

Electrode

Balloon

Statistical test

At 12 months follow up

Abbott 2003

N=37
Median score (range): 0 (0, 100)

N=18
Median score (range): 32 (0, 100)

Mann Whitney
P=0.007

Figures and Tables -
Analysis 12.23

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 23 PMS rate (VAS score).

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 24 Requirement for further surgery (ablation or hyst).
Figures and Tables -
Analysis 12.24

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 24 Requirement for further surgery (ablation or hyst).

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 25 Requirement for further surgery (hyst only).
Figures and Tables -
Analysis 12.25

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 25 Requirement for further surgery (hyst only).

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 1 Amenorrhoea rate.
Figures and Tables -
Analysis 13.1

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 1 Amenorrhoea rate.

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 2 Satisfaction rate.
Figures and Tables -
Analysis 13.2

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 2 Satisfaction rate.

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 3 Operative difficulties.
Figures and Tables -
Analysis 13.3

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 3 Operative difficulties.

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 4 Duration of operation (mins).
Figures and Tables -
Analysis 13.4

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 4 Duration of operation (mins).

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 5 Proportion having local anaesthesia (%).
Figures and Tables -
Analysis 13.5

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 5 Proportion having local anaesthesia (%).

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 6 Inability to work.
Figures and Tables -
Analysis 13.6

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 6 Inability to work.

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 7 Operative or postoperative complication rate.
Figures and Tables -
Analysis 13.7

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 7 Operative or postoperative complication rate.

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 8 Requirement for any additional surgery.
Figures and Tables -
Analysis 13.8

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 8 Requirement for any additional surgery.

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 9 Requirement for further surgery (hyst only).
Figures and Tables -
Analysis 13.9

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 9 Requirement for further surgery (hyst only).

Table 1. Risk of bias features of included studies

Study ID

Randomisation

Concealment

Blinding

Follow up

ITT

Power calculation

Prognostic balance

Abbott 2003

Adequate (2:1 ratio)

Adequate

Double

100% at 6 months and 83% at 12 months in the balloon group. 95% at 6 months and 97% at 12 months in the electrode group

Yes ‐ but did not include loss to follow up

Yes

Yes

Bhattacharya 1997

Adequate

Adequate

No

98% received treatment. 89% were followed up at 6 months and 86% were followed up at 12 months

Yes ‐ but did not include loss to follow up

Yes

Yes, but imbalances between groups recruited at different times

Bongers 2004

Adequate

Adequate

Double

99% of women received treatments. There was no loss to follow up

Yes

Yes

Mostly, except there were more women with a retroverted uterus in the bipolar group (16%) than in the balloon group (9%)

Boujida 2002

Alternation

Not clear

No

91% were followed up at 2 years and 94% were followed up at 5 years

No (except for re intervention rate)

Yes

Yes

Cooper 1999

Adequate

Adequate

No

91% were followed up at 1 year

Yes ‐ but did not include women lost to follow up

Yes

Yes

Cooper 2002

Adequate (2:1 ratio)

Not clear

No

89% were followed up at 1 year (for efficacy), 100% for safety

Yes ‐ only for safety

Yes

Yes

Cooper 2004

Adequate

Not clear

No

98% received treatment. 90% were considered "evaluable" but ITT analysis also performed

Yes

Yes

Yes

Corson 2000

Adequate

Adequate

No

97% received treatment. 85% followed up at 12 months

No

Yes

Yes

Corson 2001

Adequate (2:1 ratio)

Not clear

No

97% received treatment. 91% followed up at 12 months

Yes ‐ also per protocol analysis

Yes

Yes

Duleba 2003

Not clear

Not clear

No

82% were followed up at 12 months

No

Yes

No ‐ cryoablation group had higher PBAC scores at baseline

Hawe 2003

Adequate

Adequate

Double

1 woman excluded prior to surgery. 93% were followed up to 1 year

Yes ‐ but did not include lost to follow up

Yes

Yes ‐ except uterine cavity length significantly shorter in balloon group

McClure 1992

Not clear

Not clear

No

100% were followed up for MBL; 91% for duration of surgery

Yes

No

Yes

Meyer 1998

Adequate

Adequate

No

93% received treatment. 87% were followed up to 12 months

No

Yes

Yes

Pellicano 2002

Adequate

Not clear

No

100% received treatment. 83% followed up to 2 years.

No

Not reported

Yes

Perino 2004

Adequate

Adequate

No

96% of randomised group were analysed. Not clear how many were lost to follow up during the study

No

Yes

Yes

Romer 1998

Not clear

Not clear

No

100% analysed

Not reported

No

Yes

Soysal 2001

Adequate

Adequate

No

97% of sample were treated and analysed

No

Not reported

Yes

van Zon‐Rabelink 2003

Adequate

Not clear

No

99% of sample were treated and analysed.

Yes

Yes

Yes

Vercellini 1999

Adequate

Adequate

No

No women were lost to follow up

Yes

Yes

Yes

Figures and Tables -
Table 1. Risk of bias features of included studies
Table 2. Summary of findings table: 2nd generation versus 1st generation ablation

Outcome

No. of participants

Control group risk

Odds ratio

Change in events

Quality of evidence

Comments

Duration of surgery

1762 (9 trials)

nil

nil

‐14.9 mins (‐19.7 to ‐10.1)

Very strong evidence of heterogeneity (I square = 97%)

Use of local anaesthesia

1383 (5 trials)

19.2%

8.3 (3.9 to 17.5)

Strong evidence of heterogeneity (I square = 85.6%)

Equipment failure rate

333 (2 trials)

2%

4.2 (1.3 to 13.8)

Fluid overload (%)

681 (4 trials)

3%

0.13 (0.04 to 0.45)

Perforation (%)

1885 (8 trials)

1.3%

0.21 (0.07 to 0.65)

Cervical lacerations (%)

1676 (8 trials)

2.2%

0.12 (0.05 to 0.33)

Hematometra (%)

1133 (5 trials)

2.4%

0.25 (0.09 to 0.71)

Nausea/vomiting (%)

997 (4 trials)

7.7%

2.3 (1.5 to 3.4)

Cramping (%)

601 (2 trials)

33.2%

1.8 (1.1 to 2.9)

Likelihood of additional surgery

983 (6 trials)

6.6%

0.81 (0.5 to 1.4)

This outcome was measured after 1 year follow up. No significant difference was found between groups. Similar results were found after 2, 3 and 5 yrs follow up.

Figures and Tables -
Table 2. Summary of findings table: 2nd generation versus 1st generation ablation
Comparison 1. LASER ABLATION (1st G) versus TCRE (1st G)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Amenorrhoea rate Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 At 6 months

2

348

Odds Ratio (M‐H, Fixed, 95% CI)

0.97 [0.58, 1.61]

1.2 At 12 months

1

306

Odds Ratio (M‐H, Fixed, 95% CI)

1.07 [0.63, 1.83]

2 Amenorrhoea/hypomenorrhoea rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 At 6 months

1

326

Odds Ratio (M‐H, Fixed, 95% CI)

0.78 [0.41, 1.48]

2.2 At 12 months

1

306

Odds Ratio (M‐H, Fixed, 95% CI)

1.21 [0.74, 1.98]

3 MBL at 6 months (descriptive data) Show forest plot

Other data

No numeric data

4 Participant satisfaction at 12 months (very/moderately) Show forest plot

1

321

Odds Ratio (M‐H, Fixed, 95% CI)

0.88 [0.43, 1.82]

5 Duration of operation (mins) Show forest plot

2

386

Mean Difference (IV, Fixed, 95% CI)

9.15 [7.21, 11.09]

6 Operative difficulties (%) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

6.1 Procedure abandoned

1

366

Odds Ratio (M‐H, Fixed, 95% CI)

1.5 [0.60, 3.76]

6.2 Failed instrumentation

1

366

Odds Ratio (M‐H, Fixed, 95% CI)

0.19 [0.01, 4.06]

6.3 Equipment failure

1

366

Odds Ratio (M‐H, Fixed, 95% CI)

6.00 [1.73, 20.86]

6.4 Immediate hysterectomy

1

366

Odds Ratio (M‐H, Fixed, 95% CI)

0.32 [0.01, 8.01]

7 Good general health (proportion of women) Show forest plot

1

321

Odds Ratio (M‐H, Fixed, 95% CI)

1.30 [0.65, 2.58]

8 Improvement in symptoms (proportion of women) Show forest plot

1

321

Odds Ratio (M‐H, Fixed, 95% CI)

1.08 [0.68, 1.71]

9 Improvement in dysmenorrhea Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

9.1 At 6 months follow up

1

253

Odds Ratio (M‐H, Fixed, 95% CI)

1.72 [0.99, 2.97]

9.2 At 12 months follow up

1

218

Odds Ratio (M‐H, Fixed, 95% CI)

1.01 [0.53, 1.92]

10 Complication rate (proportion of women) Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

10.1 Perforation

1

366

Odds Ratio (M‐H, Fixed, 95% CI)

0.14 [0.01, 2.68]

10.2 Burns

1

366

Odds Ratio (M‐H, Fixed, 95% CI)

4.95 [0.24, 103.73]

10.3 Bowel obstruction

1

366

Odds Ratio (M‐H, Fixed, 95% CI)

2.95 [0.12, 72.92]

10.4 Urinary tract infection

1

366

Odds Ratio (M‐H, Fixed, 95% CI)

1.98 [0.36, 10.93]

10.5 Pelvic sepsis

1

366

Odds Ratio (M‐H, Fixed, 95% CI)

0.81 [0.24, 2.70]

10.6 Haematometra

1

366

Odds Ratio (M‐H, Fixed, 95% CI)

0.19 [0.01, 4.06]

10.7 Glycine toxicity

1

22

Odds Ratio (M‐H, Fixed, 95% CI)

5.0 [0.21, 117.21]

10.8 Fluid overload (>1.5L)

1

366

Odds Ratio (M‐H, Fixed, 95% CI)

5.24 [1.49, 18.41]

10.9 Uterine tamponade

1

366

Odds Ratio (M‐H, Fixed, 95% CI)

1.15 [0.38, 3.48]

11 Requirement for further surgical treatment (within 12 mths) Show forest plot

2

388

Odds Ratio (M‐H, Fixed, 95% CI)

0.81 [0.48, 1.36]

Figures and Tables -
Comparison 1. LASER ABLATION (1st G) versus TCRE (1st G)
Comparison 2. VAPORISING ELECTRODE ABLATION (1st G) versus TCRE (1st G)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Amenorrhoea rate at 12 months follow up Show forest plot

1

91

Odds Ratio (M‐H, Fixed, 95% CI)

0.62 [0.27, 1.44]

2 Amenorrhea/hypomenorrhoea rate at 12 months follow up Show forest plot

1

91

Odds Ratio (M‐H, Fixed, 95% CI)

0.95 [0.35, 2.62]

3 PBAC score at 12 mths Show forest plot

Other data

No numeric data

4 Satisfaction rate at 12 mths (very/moderately) Show forest plot

1

91

Odds Ratio (M‐H, Fixed, 95% CI)

1.65 [0.26, 10.35]

5 Duration of operation (mins) Show forest plot

1

91

Mean Difference (IV, Fixed, 95% CI)

‐1.50 [‐2.65, ‐0.35]

6 Operative difficulties Show forest plot

1

91

Odds Ratio (M‐H, Fixed, 95% CI)

0.22 [0.07, 0.75]

6.1 Difficulty with surgery (moderate or severe)

1

91

Odds Ratio (M‐H, Fixed, 95% CI)

0.22 [0.07, 0.75]

7 Degree of fluid deficit (ml) Show forest plot

1

91

Mean Difference (IV, Fixed, 95% CI)

‐258.0 [‐342.05, ‐173.95]

Figures and Tables -
Comparison 2. VAPORISING ELECTRODE ABLATION (1st G) versus TCRE (1st G)
Comparison 3. ROLLERBALL (1st G) versus TCRE (1st G)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Duration of operation (mins) Show forest plot

1

45

Mean Difference (IV, Fixed, 95% CI)

‐1.10 [‐2.92, 0.72]

2 Duration of operation (descriptive data) Show forest plot

Other data

No numeric data

3 Complication rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 Fluid deficit

1

120

Odds Ratio (M‐H, Fixed, 95% CI)

0.32 [0.01, 7.94]

3.2 Perforation

1

120

Odds Ratio (M‐H, Fixed, 95% CI)

0.32 [0.01, 7.94]

4 Requirement for further surgery (hyst or ablation) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 At 2 yrs follow up

1

120

Odds Ratio (M‐H, Fixed, 95% CI)

1.05 [0.45, 2.42]

4.2 2 to 5 yrs follow up

1

120

Odds Ratio (M‐H, Fixed, 95% CI)

1.31 [0.60, 2.87]

4.3 More than 5 years

1

120

Odds Ratio (M‐H, Fixed, 95% CI)

1.63 [0.75, 3.52]

5 Requirement for further surgery rate (hyst only) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

5.1 At 2 yrs follow up

1

120

Odds Ratio (M‐H, Fixed, 95% CI)

1.5 [0.40, 5.61]

5.2 2 to 5 yrs follow up

1

120

Odds Ratio (M‐H, Fixed, 95% CI)

1.25 [0.46, 3.42]

5.3 More than 5 years follow up

1

120

Odds Ratio (M‐H, Fixed, 95% CI)

1.42 [0.59, 3.42]

Figures and Tables -
Comparison 3. ROLLERBALL (1st G) versus TCRE (1st G)
Comparison 4. THERMAL LASER (2nd G) versus TCRE (1st G)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Amenorrhoea rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 At 1 year follow up

1

111

Odds Ratio (M‐H, Fixed, 95% CI)

4.88 [2.17, 11.00]

1.2 2 to 5 years follow up

1

111

Odds Ratio (M‐H, Fixed, 95% CI)

4.64 [2.04, 10.51]

2 Satisfaction rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 At one year follow up

1

111

Odds Ratio (M‐H, Fixed, 95% CI)

1.77 [0.40, 7.78]

2.2 2 to 5 years follow up

1

111

Odds Ratio (M‐H, Fixed, 95% CI)

1.3 [0.33, 5.12]

3 Duration of operation Show forest plot

1

111

Mean Difference (IV, Fixed, 95% CI)

‐9.30 [‐11.36, ‐7.24]

4 Pain score at 12 hrs after surgery (VAS: 1‐10) Show forest plot

1

111

Mean Difference (IV, Fixed, 95% CI)

0.70 [0.02, 1.38]

5 Intraoperative complication rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

5.1 Perforation

1

111

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.2 UTI

1

111

Odds Ratio (M‐H, Fixed, 95% CI)

0.48 [0.04, 5.47]

6 Requirement for further surgery rate (hyst only) Show forest plot

1

111

Odds Ratio (M‐H, Fixed, 95% CI)

0.57 [0.13, 2.49]

6.1 2 to 5 years follow up

1

111

Odds Ratio (M‐H, Fixed, 95% CI)

0.57 [0.13, 2.49]

Figures and Tables -
Comparison 4. THERMAL LASER (2nd G) versus TCRE (1st G)
Comparison 5. HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Amenorrhoea rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 At 1 year follow up

1

250

Odds Ratio (M‐H, Fixed, 95% CI)

0.65 [0.38, 1.11]

1.2 At 2 years follow up

1

225

Odds Ratio (M‐H, Fixed, 95% CI)

1.02 [0.58, 1.78]

1.3 2 to 5 years follow up

1

203

Odds Ratio (M‐H, Fixed, 95% CI)

1.36 [0.76, 2.45]

2 PBAC </= 75 Show forest plot

1

250

Odds Ratio (M‐H, Fixed, 95% CI)

0.72 [0.37, 1.41]

2.1 At 1 year follow up

1

250

Odds Ratio (M‐H, Fixed, 95% CI)

0.72 [0.37, 1.41]

2.2 2 to 5 years follow up

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Proportion with "normal" bleeding (PBAC </= 100) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 At 1 year follow up

1

250

Odds Ratio (M‐H, Fixed, 95% CI)

0.77 [0.37, 1.60]

3.2 At 2 years follow up

1

225

Odds Ratio (M‐H, Fixed, 95% CI)

1.02 [0.37, 2.84]

3.3 2 to 5 years follow up

1

203

Odds Ratio (M‐H, Fixed, 95% CI)

1.54 [0.51, 4.62]

4 Satisfaction rate Show forest plot

1

203

Odds Ratio (M‐H, Fixed, 95% CI)

1.33 [0.22, 8.18]

4.1 2 to 5 years follow up

1

203

Odds Ratio (M‐H, Fixed, 95% CI)

1.33 [0.22, 8.18]

5 Proportion having local anaesthesia (%) Show forest plot

1

269

Odds Ratio (M‐H, Fixed, 95% CI)

2.85 [1.59, 5.13]

6 Intraoperative complication rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

6.1 Cervical lacerations

1

269

Odds Ratio (M‐H, Fixed, 95% CI)

0.09 [0.00, 1.91]

6.2 Endometritis

1

269

Odds Ratio (M‐H, Fixed, 95% CI)

0.92 [0.08, 10.32]

6.3 Urinary tract infection

1

269

Odds Ratio (M‐H, Fixed, 95% CI)

1.16 [0.22, 6.10]

6.4 Hematometra

1

269

Odds Ratio (M‐H, Fixed, 95% CI)

0.18 [0.03, 0.93]

6.5 First degree burn

1

269

Odds Ratio (M‐H, Fixed, 95% CI)

2.34 [0.11, 49.32]

7 Postoperative complication rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

7.1 Abdominal pain (at 2 weeks)

1

269

Odds Ratio (M‐H, Fixed, 95% CI)

1.85 [1.09, 3.12]

7.2 Uterine cramping

1

269

Odds Ratio (M‐H, Fixed, 95% CI)

1.17 [0.65, 2.11]

7.3 Nausea or vomiting

1

269

Odds Ratio (M‐H, Fixed, 95% CI)

3.66 [1.49, 9.00]

8 Requirement for further surgery (any surgery) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

8.1 At 1 year follow up

1

269

Odds Ratio (M‐H, Fixed, 95% CI)

2.34 [0.11, 49.32]

8.2 2 to 5 years follow up

1

262

Odds Ratio (M‐H, Fixed, 95% CI)

1.30 [0.55, 3.06]

9 Requirement for further surgery rate (hyst only) Show forest plot

1

262

Odds Ratio (M‐H, Fixed, 95% CI)

1.59 [0.56, 4.50]

9.1 At 1 year follow up

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

9.2 2 to 5 years follow up

1

262

Odds Ratio (M‐H, Fixed, 95% CI)

1.59 [0.56, 4.50]

Figures and Tables -
Comparison 5. HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G)
Comparison 6. CRYOABLATION (2nd G) versus ROLLERBALL (1st G)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Amenorrhoea rate Show forest plot

1

228

Odds Ratio (M‐H, Fixed, 95% CI)

0.30 [0.17, 0.55]

1.1 At 1 year follow up

1

228

Odds Ratio (M‐H, Fixed, 95% CI)

0.30 [0.17, 0.55]

2 Satisfaction rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 At 1 year follow up

1

279

Odds Ratio (M‐H, Fixed, 95% CI)

1.68 [0.76, 3.69]

2.2 At 2 years follow up

1

137

Odds Ratio (M‐H, Fixed, 95% CI)

1.41 [0.43, 4.61]

3 Proportion having local anaesthesia (%) Show forest plot

1

279

Odds Ratio (M‐H, Fixed, 95% CI)

13.19 [5.79, 30.04]

4 Intraoperative complication rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 Perforation

1

279

Odds Ratio (M‐H, Fixed, 95% CI)

0.15 [0.01, 3.65]

4.2 Vaginal bleeding

1

279

Odds Ratio (M‐H, Fixed, 95% CI)

1.35 [0.05, 33.43]

4.3 Abdominal cramping

1

279

Odds Ratio (M‐H, Fixed, 95% CI)

2.26 [0.11, 47.54]

4.4 UTI

1

279

Odds Ratio (M‐H, Fixed, 95% CI)

0.15 [0.01, 3.65]

4.5 Severe pelvic pain

1

279

Odds Ratio (M‐H, Fixed, 95% CI)

0.15 [0.01, 3.65]

5 Requirement for further surgery (any surgery) Show forest plot

1

279

Odds Ratio (M‐H, Fixed, 95% CI)

1.00 [0.42, 2.40]

5.1 At 2 years follow up

1

279

Odds Ratio (M‐H, Fixed, 95% CI)

1.00 [0.42, 2.40]

6 Requirement for further surgery rate (hyst only) Show forest plot

1

279

Odds Ratio (M‐H, Fixed, 95% CI)

0.82 [0.31, 2.12]

6.1 At 2 years follow up

1

279

Odds Ratio (M‐H, Fixed, 95% CI)

0.82 [0.31, 2.12]

Figures and Tables -
Comparison 6. CRYOABLATION (2nd G) versus ROLLERBALL (1st G)
Comparison 7. ELECTRODE ABLATION (2nd G) versus TCRE + ROLLERBALL (1st G)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Amenorrhea rate at 1 yr follow up Show forest plot

2

470

Odds Ratio (M‐H, Fixed, 95% CI)

1.03 [0.70, 1.52]

1.1 Balloon system

1

234

Odds Ratio (M‐H, Fixed, 95% CI)

0.85 [0.49, 1.46]

1.2 Mesh system

1

236

Odds Ratio (M‐H, Fixed, 95% CI)

1.27 [0.73, 2.20]

2 Proportion with successful Rx (PBAC<75) Show forest plot

2

470

Odds Ratio (M‐H, Fixed, 95% CI)

1.50 [0.90, 2.53]

2.1 Balloon system

1

234

Odds Ratio (M‐H, Fixed, 95% CI)

1.35 [0.66, 2.78]

2.2 Mesh system

1

236

Odds Ratio (M‐H, Fixed, 95% CI)

1.69 [0.80, 3.56]

3 PBAC score 12 months after treatment Show forest plot

Other data

No numeric data

3.1 Balloon system

Other data

No numeric data

3.2 Mesh system

Other data

No numeric data

4 Proportion satisfied with treatment at 1 year Show forest plot

1

236

Odds Ratio (M‐H, Fixed, 95% CI)

0.84 [0.28, 2.52]

4.1 Balloon system

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.2 Mesh system

1

236

Odds Ratio (M‐H, Fixed, 95% CI)

0.84 [0.28, 2.52]

5 Duration of operation (mins) Show forest plot

2

520

Mean Difference (IV, Fixed, 95% CI)

‐18.70 [‐20.66, ‐16.75]

5.1 Balloon system

1

255

Mean Difference (IV, Fixed, 95% CI)

‐16.20 [‐19.55, ‐12.85]

5.2 Mesh system

1

265

Mean Difference (IV, Fixed, 95% CI)

‐20.0 [‐22.41, ‐17.59]

6 Proportion having local anaesthesia (%) Show forest plot

2

520

Odds Ratio (M‐H, Fixed, 95% CI)

15.92 [10.12, 25.06]

6.1 Balloon system

1

255

Odds Ratio (M‐H, Fixed, 95% CI)

20.53 [10.73, 39.26]

6.2 Mesh system

1

265

Odds Ratio (M‐H, Fixed, 95% CI)

12.60 [6.67, 23.78]

7 Intraoperative complication rate Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

7.1 Perforation

2

532

Odds Ratio (M‐H, Fixed, 95% CI)

0.13 [0.02, 1.06]

7.2 Bradycardia

1

265

Odds Ratio (M‐H, Fixed, 95% CI)

1.56 [0.06, 38.58]

7.3 Cervical tear/stenosis

2

532

Odds Ratio (M‐H, Fixed, 95% CI)

0.11 [0.01, 0.89]

7.4 Fluid overload

1

267

Odds Ratio (M‐H, Fixed, 95% CI)

0.28 [0.01, 7.00]

7.5 Procedure abandoned

1

267

Odds Ratio (M‐H, Fixed, 95% CI)

2.58 [0.10, 63.95]

8 Postoperative complication rate Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

8.1 Fever

1

267

Odds Ratio (M‐H, Fixed, 95% CI)

0.85 [0.05, 13.78]

8.2 Nausea/vomiting or severe pelvic pain

2

532

Odds Ratio (M‐H, Fixed, 95% CI)

1.10 [0.35, 3.46]

8.3 UTI

2

532

Odds Ratio (M‐H, Fixed, 95% CI)

1.05 [0.37, 3.02]

8.4 Hematometra

2

532

Odds Ratio (M‐H, Fixed, 95% CI)

0.42 [0.08, 2.22]

8.5 Myometritis

1

267

Odds Ratio (M‐H, Fixed, 95% CI)

0.28 [0.01, 7.00]

8.6 Urinary incontinence

1

267

Odds Ratio (M‐H, Fixed, 95% CI)

0.28 [0.01, 7.00]

8.7 PID

1

265

Odds Ratio (M‐H, Fixed, 95% CI)

1.03 [0.09, 11.50]

8.8 Haemorrhage

1

265

Odds Ratio (M‐H, Fixed, 95% CI)

0.51 [0.03, 8.27]

8.9 Pelvic abscess

1

265

Odds Ratio (M‐H, Fixed, 95% CI)

0.17 [0.01, 4.22]

8.10 Endometritis

1

265

Odds Ratio (M‐H, Fixed, 95% CI)

0.34 [0.05, 2.04]

9 Requirement for further surgery at 2 years (hysterectomy) Show forest plot

1

255

Odds Ratio (M‐H, Fixed, 95% CI)

0.50 [0.16, 1.53]

9.1 Balloon system

1

255

Odds Ratio (M‐H, Fixed, 95% CI)

0.50 [0.16, 1.53]

9.2 Mesh system

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 7. ELECTRODE ABLATION (2nd G) versus TCRE + ROLLERBALL (1st G)
Comparison 8. MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Amenorrhea rate Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 At 1 year follow up

2

562

Odds Ratio (M‐H, Fixed, 95% CI)

1.24 [0.88, 1.75]

1.2 At 2 years follow up

1

249

Odds Ratio (M‐H, Fixed, 95% CI)

1.30 [0.79, 2.14]

1.3 At 2 to 5 years follow up

1

236

Odds Ratio (M‐H, Fixed, 95% CI)

0.82 [0.47, 1.40]

2 Success of treatment (PBAC<75) Show forest plot

1

322

Odds Ratio (M‐H, Fixed, 95% CI)

1.35 [0.71, 2.57]

2.1 At 1 year follow up

1

322

Odds Ratio (M‐H, Fixed, 95% CI)

1.35 [0.71, 2.57]

3 Satisfaction rate Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 At 1 year follow up

2

533

Odds Ratio (M‐H, Fixed, 95% CI)

1.06 [0.60, 1.88]

3.2 At 2 years follow up

1

249

Odds Ratio (M‐H, Fixed, 95% CI)

1.90 [1.07, 3.37]

3.3 At 2 to 5 years follow up

1

236

Odds Ratio (M‐H, Fixed, 95% CI)

2.37 [1.22, 4.60]

4 Duration of operation (mins) Show forest plot

Other data

No numeric data

5 Operative difficulties Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

5.1 Equipment failure

1

263

Odds Ratio (M‐H, Fixed, 95% CI)

4.07 [1.11, 14.95]

5.2 Procedure abandoned

1

263

Odds Ratio (M‐H, Fixed, 95% CI)

1.04 [0.29, 3.68]

6 Proportion having local anaesthesia Show forest plot

1

315

Odds Ratio (M‐H, Fixed, 95% CI)

4.41 [2.58, 7.55]

7 Duration of hospital stay (hours) Show forest plot

Other data

No numeric data

8 Inability to work (proportion of women) Show forest plot

1

240

Odds Ratio (M‐H, Fixed, 95% CI)

0.52 [0.15, 1.77]

9 Change in SF36 score after treatment Show forest plot

Other data

No numeric data

9.1 Physical functioning

Other data

No numeric data

9.2 Social functioning

Other data

No numeric data

9.3 Physical role

Other data

No numeric data

9.4 Emotional role

Other data

No numeric data

9.5 Mental health

Other data

No numeric data

9.6 Energy/fatigue

Other data

No numeric data

9.7 Pain

Other data

No numeric data

9.8 General health

Other data

No numeric data

10 Improvement in symptoms Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

10.1 At 1 year follow up

1

240

Odds Ratio (M‐H, Fixed, 95% CI)

1.16 [0.64, 2.13]

10.2 At 2 to 5 years follow up

1

236

Odds Ratio (M‐H, Fixed, 95% CI)

1.65 [0.88, 3.06]

11 Improvement in dysmenorrhoea Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

11.1 At 1 year follow up

2

533

Odds Ratio (M‐H, Fixed, 95% CI)

0.94 [0.63, 1.40]

11.2 At 2 years follow up

1

249

Odds Ratio (M‐H, Fixed, 95% CI)

1.29 [0.69, 2.40]

12 Postoperative analgesia rate Show forest plot

1

263

Odds Ratio (M‐H, Fixed, 95% CI)

0.82 [0.48, 1.40]

13 Intraoperative complication rate Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

13.1 Perforation

2

585

Odds Ratio (M‐H, Fixed, 95% CI)

1.64 [0.23, 11.89]

13.2 Haemorrhage

1

263

Odds Ratio (M‐H, Fixed, 95% CI)

0.09 [0.00, 1.66]

13.3 Cervical laceration

1

322

Odds Ratio (M‐H, Fixed, 95% CI)

0.49 [0.07, 3.55]

13.4 Cervical stenosis

1

322

Odds Ratio (M‐H, Fixed, 95% CI)

1.50 [0.06, 37.22]

14 Postoperative complication rate (wihin 24 hours) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

14.1 Chills

1

322

Odds Ratio (M‐H, Fixed, 95% CI)

1.38 [0.56, 3.40]

14.2 Bloating

1

322

Odds Ratio (M‐H, Fixed, 95% CI)

0.82 [0.35, 1.93]

14.3 Dysuria

1

322

Odds Ratio (M‐H, Fixed, 95% CI)

0.75 [0.34, 1.66]

14.4 Fever

1

322

Odds Ratio (M‐H, Fixed, 95% CI)

2.52 [0.12, 52.90]

14.5 Headache

1

322

Odds Ratio (M‐H, Fixed, 95% CI)

0.74 [0.20, 2.68]

14.6 Nausea

1

322

Odds Ratio (M‐H, Fixed, 95% CI)

1.46 [0.80, 2.66]

14.7 Vomiting

1

322

Odds Ratio (M‐H, Fixed, 95% CI)

4.01 [1.37, 11.74]

14.8 UTI

1

322

Odds Ratio (M‐H, Fixed, 95% CI)

0.50 [0.03, 8.00]

14.9 Vaginal infection

1

322

Odds Ratio (M‐H, Fixed, 95% CI)

1.50 [0.06, 37.22]

14.10 Uterine cramping

1

322

Odds Ratio (M‐H, Fixed, 95% CI)

1.74 [1.07, 2.83]

14.11 Abdominal tenderness

1

322

Odds Ratio (M‐H, Fixed, 95% CI)

0.59 [0.24, 1.46]

14.12 Endometritis

1

322

Odds Ratio (M‐H, Fixed, 95% CI)

6.67 [0.37, 119.53]

15 Requirement for further surgery (any surgery) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

15.1 At 1 year follow up

1

240

Odds Ratio (M‐H, Fixed, 95% CI)

0.81 [0.34, 1.92]

15.2 At 2 years follow up

1

249

Odds Ratio (M‐H, Fixed, 95% CI)

0.97 [0.49, 1.90]

15.3 At 2 to 5 years follow up

1

263

Odds Ratio (M‐H, Fixed, 95% CI)

0.80 [0.46, 1.39]

16 Requirement for further surgery rate (hyst only) Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

16.1 At 1 year follow up

2

562

Odds Ratio (M‐H, Fixed, 95% CI)

0.75 [0.32, 1.78]

16.2 At 2 years follow up

1

249

Odds Ratio (M‐H, Fixed, 95% CI)

0.94 [0.45, 1.98]

16.3 At 2 to 5 years follow up

1

263

Odds Ratio (M‐H, Fixed, 95% CI)

0.56 [0.30, 1.04]

Figures and Tables -
Comparison 8. MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G)
Comparison 9. BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Amenorrhea rate Show forest plot

3

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 At 1 year follow up

3

352

Odds Ratio (M‐H, Fixed, 95% CI)

0.56 [0.33, 0.96]

1.2 At 2 years follow up

1

227

Odds Ratio (M‐H, Fixed, 95% CI)

0.54 [0.27, 1.08]

1.3 At 2 to 5 years follow up

1

122

Odds Ratio (M‐H, Fixed, 95% CI)

0.61 [0.27, 1.36]

2 Amenorrhoea/eumenorrhoea rate Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 At 1 year follow up

2

259

Odds Ratio (M‐H, Fixed, 95% CI)

0.75 [0.38, 1.46]

2.2 At 2 years follow up

1

227

Odds Ratio (M‐H, Fixed, 95% CI)

0.88 [0.37, 2.10]

2.3 At 2 to 5 years follow up

1

122

Odds Ratio (M‐H, Fixed, 95% CI)

0.66 [0.11, 4.07]

3 PBAC score after treatment Show forest plot

Other data

No numeric data

3.1 At 1 year follow up

Other data

No numeric data

3.2 At 2 years follow up

Other data

No numeric data

4 Success of treatment (lighter periods and no further surgery) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 At 2 to 5 years follow up

1

170

Odds Ratio (M‐H, Fixed, 95% CI)

0.95 [0.49, 1.81]

5 Success of treatment (PBAC<75) Show forest plot

1

93

Odds Ratio (M‐H, Fixed, 95% CI)

0.81 [0.31, 2.15]

5.1 At 1 year follow up

1

93

Odds Ratio (M‐H, Fixed, 95% CI)

0.81 [0.31, 2.15]

6 Success of treatment (menstrual score <185) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

6.1 At 1 year follow up

1

129

Odds Ratio (M‐H, Fixed, 95% CI)

1.01 [0.43, 2.36]

6.2 At 2 years follow up

1

121

Odds Ratio (M‐H, Fixed, 95% CI)

1.05 [0.45, 2.46]

7 Satisfaction rate Show forest plot

4

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

7.1 At 1 year follow up

3

352

Odds Ratio (M‐H, Fixed, 95% CI)

0.94 [0.44, 1.99]

7.2 At 2 years follow up

2

348

Odds Ratio (M‐H, Fixed, 95% CI)

1.12 [0.64, 1.98]

7.3 At 2 to 5 years follow up

1

122

Odds Ratio (M‐H, Fixed, 95% CI)

0.10 [0.01, 1.97]

8 Duration of operation (mins) Show forest plot

3

471

Mean Difference (IV, Fixed, 95% CI)

‐20.87 [‐22.47, ‐19.28]

9 Operative difficulties Show forest plot

1

139

Odds Ratio (M‐H, Fixed, 95% CI)

1.06 [0.43, 2.60]

9.1 Technical complication rate

1

139

Odds Ratio (M‐H, Fixed, 95% CI)

1.06 [0.43, 2.60]

10 Inability to work (proportion of women) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

10.1 At 1 year follow up

1

239

Odds Ratio (M‐H, Fixed, 95% CI)

1.54 [0.36, 6.60]

10.2 At 2 years follow up

1

227

Odds Ratio (M‐H, Fixed, 95% CI)

0.28 [0.03, 2.74]

10.3 At 2 to 5 years follow up

1

210

Odds Ratio (M‐H, Fixed, 95% CI)

0.87 [0.24, 3.10]

11 Improvement in dysmenorrhea at 12 months Show forest plot

1

239

Odds Ratio (M‐H, Fixed, 95% CI)

0.77 [0.44, 1.37]

12 Improvement in premenstrual symptoms (from moderate/severe) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

12.1 At 1 year follow up

1

185

Odds Ratio (M‐H, Fixed, 95% CI)

0.85 [0.47, 1.53]

12.2 At 2 years follow up

1

177

Odds Ratio (M‐H, Fixed, 95% CI)

1.08 [0.59, 1.99]

12.3 At 2 to 5 years follow up

1

166

Odds Ratio (M‐H, Fixed, 95% CI)

0.97 [0.52, 1.79]

13 Complication rate (proportion of women) Show forest plot

3

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

13.1 Fluid overload

2

332

Odds Ratio (M‐H, Fixed, 95% CI)

0.19 [0.02, 1.66]

13.2 Perforation

2

378

Odds Ratio (M‐H, Fixed, 95% CI)

0.17 [0.02, 1.42]

13.3 Cervical lacerations

3

471

Odds Ratio (M‐H, Fixed, 95% CI)

0.20 [0.03, 1.20]

13.4 Endometritis

2

332

Odds Ratio (M‐H, Fixed, 95% CI)

2.50 [0.47, 13.13]

13.5 UTI

1

239

Odds Ratio (M‐H, Fixed, 95% CI)

2.76 [0.11, 68.41]

13.6 Hematometra

2

332

Odds Ratio (M‐H, Fixed, 95% CI)

0.42 [0.06, 2.91]

13.7 Hydrosalpinx

1

239

Odds Ratio (M‐H, Fixed, 95% CI)

0.30 [0.01, 7.47]

13.8 Bleeding

1

93

Odds Ratio (M‐H, Fixed, 95% CI)

0.20 [0.01, 4.38]

13.9 Pain

1

139

Odds Ratio (M‐H, Fixed, 95% CI)

5.87 [0.30, 115.87]

13.10 Nausea

1

139

Odds Ratio (M‐H, Fixed, 95% CI)

0.26 [0.01, 6.61]

13.11 Infection

1

139

Odds Ratio (M‐H, Fixed, 95% CI)

0.26 [0.01, 6.61]

14 Requirement for further surgery (any surgery) Show forest plot

3

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

14.1 At 1 year follow up

2

332

Odds Ratio (M‐H, Fixed, 95% CI)

0.85 [0.28, 2.62]

14.2 At 2 years follow up

2

392

Odds Ratio (M‐H, Fixed, 95% CI)

0.64 [0.31, 1.31]

14.3 At 2 to 5 years follow up

1

122

Odds Ratio (M‐H, Fixed, 95% CI)

1.0 [0.48, 2.07]

15 Requirement for further surgery (hyst only) Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

15.1 At 1 year follow up

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

15.2 At 2 years follow up

1

137

Odds Ratio (M‐H, Fixed, 95% CI)

1.04 [0.34, 3.19]

15.3 At 2 to 5 years follow up

1

122

Odds Ratio (M‐H, Fixed, 95% CI)

1.0 [0.47, 2.11]

Figures and Tables -
Comparison 9. BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G)
Comparison 10. BALLOON (2nd G) versus LASER (1st G)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Amenorrhoea rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 At 6 months follow up

1

70

Odds Ratio (M‐H, Fixed, 95% CI)

1.19 [0.45, 3.14]

1.2 At 12 months follow up

1

67

Odds Ratio (M‐H, Fixed, 95% CI)

0.64 [0.23, 1.77]

2 PBAC score after treatment Show forest plot

Other data

No numeric data

2.1 At 6 months follow up

Other data

No numeric data

3 Satisfaction rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 At 6 months follow up

1

69

Odds Ratio (M‐H, Fixed, 95% CI)

1.81 [0.28, 11.58]

3.2 At 12 months follow up

1

57

Odds Ratio (M‐H, Fixed, 95% CI)

0.54 [0.05, 6.30]

4 Operative difficulties Show forest plot

1

70

Odds Ratio (M‐H, Fixed, 95% CI)

4.72 [0.22, 101.93]

4.1 Failure of equipment

1

70

Odds Ratio (M‐H, Fixed, 95% CI)

4.72 [0.22, 101.93]

5 Euroquol 5D Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

5.1 At 6 months follow up

1

70

Mean Difference (IV, Fixed, 95% CI)

0.01 [‐0.11, 0.13]

5.2 At 12 months follow up

1

67

Mean Difference (IV, Fixed, 95% CI)

‐0.01 [‐0.13, 0.11]

6 Euroquol 5D VAS Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

6.1 At 6 months follow up

1

70

Mean Difference (IV, Fixed, 95% CI)

1.20 [‐5.95, 8.35]

6.2 At 12 months follow up

1

67

Mean Difference (IV, Fixed, 95% CI)

10.10 [2.43, 17.77]

7 SF12 Physical Scale Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

7.1 At 6 months follow up

1

70

Mean Difference (IV, Fixed, 95% CI)

1.70 [‐2.18, 5.58]

7.2 At 12 months follow up

1

67

Mean Difference (IV, Fixed, 95% CI)

‐0.20 [‐3.89, 3.49]

8 SF12 Mental Scale Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

8.1 At 6 months follow up

1

70

Mean Difference (IV, Fixed, 95% CI)

3.40 [‐0.42, 7.22]

8.2 At 12 months follow up

1

67

Mean Difference (IV, Fixed, 95% CI)

2.10 [‐2.04, 6.24]

9 SAQ pleasure scale Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

9.1 At 6 months follow up

1

70

Mean Difference (IV, Fixed, 95% CI)

0.5 [‐1.30, 2.30]

9.2 At 12 months follow up

1

67

Mean Difference (IV, Fixed, 95% CI)

‐0.60 [‐2.68, 1.48]

10 SAQ habit scale Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

10.1 At 6 months follow up

1

70

Mean Difference (IV, Fixed, 95% CI)

‐0.16 [‐0.42, 0.10]

10.2 At 12 months follow up

1

67

Mean Difference (IV, Fixed, 95% CI)

‐0.09 [‐0.27, 0.09]

11 SAQ discomfort scale Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

11.1 At 6 months follow up

1

70

Mean Difference (IV, Fixed, 95% CI)

‐0.14 [‐0.98, 0.70]

11.2 At 12 months follow up

1

67

Mean Difference (IV, Fixed, 95% CI)

0.10 [‐0.67, 0.87]

12 PMS (visual analogue) Show forest plot

Other data

No numeric data

12.1 At 6 months follow up

Other data

No numeric data

12.2 At 12 months follow up

Other data

No numeric data

13 Dysmenorrhoea (visual analogue) Show forest plot

Other data

No numeric data

13.1 At 6 months follow up

Other data

No numeric data

13.2 At 12 months follow up

Other data

No numeric data

14 Pain score Show forest plot

1

70

Mean Difference (IV, Fixed, 95% CI)

32.7 [23.72, 41.68]

15 Requirement for further surgery Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

15.1 At 6 months follow up

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

15.2 At 12 months follow up

1

67

Odds Ratio (M‐H, Fixed, 95% CI)

0.75 [0.18, 3.06]

Figures and Tables -
Comparison 10. BALLOON (2nd G) versus LASER (1st G)
Comparison 11. BALLOON (2nd G) versus TCRE (1st G)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Amenorrhoea rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 At 6 months follow up

1

49

Odds Ratio (M‐H, Fixed, 95% CI)

0.94 [0.23, 3.88]

1.2 At 12 months follow up

1

45

Odds Ratio (M‐H, Fixed, 95% CI)

1.33 [0.36, 4.88]

2 Satisfaction rate Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 At 6 months follow up

1

50

Odds Ratio (M‐H, Fixed, 95% CI)

4.69 [0.18, 121.10]

2.2 At 12 months follow up

2

122

Odds Ratio (M‐H, Fixed, 95% CI)

2.38 [0.57, 9.99]

2.3 At 2 years follow up

1

68

Odds Ratio (M‐H, Fixed, 95% CI)

7.17 [1.44, 35.85]

3 Duration of operation (mins) Show forest plot

1

82

Mean Difference (IV, Fixed, 95% CI)

‐13.0 [‐15.20, ‐10.80]

4 Duration of operation (mins) Show forest plot

Other data

No numeric data

5 Operative difficulties Show forest plot

1

51

Odds Ratio (M‐H, Fixed, 95% CI)

8.51 [0.44, 162.89]

5.1 Equipment failure

1

51

Odds Ratio (M‐H, Fixed, 95% CI)

8.51 [0.44, 162.89]

6 Hospital stay (days) Show forest plot

1

82

Mean Difference (IV, Fixed, 95% CI)

‐0.30 [‐0.52, ‐0.08]

7 Duration of hospital stay (hours) Show forest plot

Other data

No numeric data

8 Return to normal activities (days) Show forest plot

1

82

Mean Difference (IV, Fixed, 95% CI)

‐2.10 [‐3.38, ‐0.82]

9 Return to normal activities (days) Show forest plot

Other data

No numeric data

10 Intraoperative complications (continuous data) Show forest plot

1

82

Mean Difference (IV, Fixed, 95% CI)

‐81.8 [‐93.33, ‐70.27]

10.1 Blood loss

1

82

Mean Difference (IV, Fixed, 95% CI)

‐81.8 [‐93.33, ‐70.27]

11 Intraoperative complications (dichotomous data) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

11.1 Fluid overload

1

82

Odds Ratio (M‐H, Fixed, 95% CI)

0.08 [0.00, 1.57]

11.2 Cervical tear

1

82

Odds Ratio (M‐H, Fixed, 95% CI)

0.34 [0.01, 8.63]

11.3 Conversion to hysterectomy

1

88

Odds Ratio (M‐H, Fixed, 95% CI)

0.23 [0.01, 4.92]

12 Postoperative pain (continuous data) Show forest plot

1

82

Mean Difference (IV, Fixed, 95% CI)

‐0.60 [‐0.88, ‐0.32]

13 Postoperative pain (descriptive data) Show forest plot

Other data

No numeric data

14 Postoperative complications Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

14.1 Fever

1

82

Odds Ratio (M‐H, Fixed, 95% CI)

0.51 [0.04, 5.89]

14.2 Urinary infection or retention

1

82

Odds Ratio (M‐H, Fixed, 95% CI)

0.34 [0.01, 8.63]

14.3 Hemorrhage

1

82

Odds Ratio (M‐H, Fixed, 95% CI)

1.36 [0.34, 5.46]

14.4 Blood transfusion

1

82

Odds Ratio (M‐H, Fixed, 95% CI)

5.52 [0.26, 118.61]

15 Requirement for further surgery Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

15.1 At 12 months follow up

1

75

Odds Ratio (M‐H, Fixed, 95% CI)

0.49 [0.08, 2.83]

15.2 At 2 years follow up

1

68

Odds Ratio (M‐H, Fixed, 95% CI)

0.34 [0.06, 1.89]

16 Requirement for further surgery (hyst only) Show forest plot

1

45

Odds Ratio (M‐H, Fixed, 95% CI)

0.11 [0.00, 2.41]

16.1 At 12 months follow up

1

45

Odds Ratio (M‐H, Fixed, 95% CI)

0.11 [0.00, 2.41]

Figures and Tables -
Comparison 11. BALLOON (2nd G) versus TCRE (1st G)
Comparison 12. BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Amenorrhoea rate Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 At 6 months follow up

2

179

Odds Ratio (M‐H, Fixed, 95% CI)

6.97 [2.79, 17.47]

1.2 At 12 months follow up

2

180

Odds Ratio (M‐H, Fixed, 95% CI)

7.84 [2.92, 21.00]

1.3 At 2 to 5 years follow up

1

120

Odds Ratio (M‐H, Fixed, 95% CI)

2.09 [0.93, 4.69]

2 PBAC score after treatment Show forest plot

Other data

No numeric data

2.1 At 12 months follow up

Other data

No numeric data

3 Satisfaction rate Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 At 6 months follow up

2

181

Odds Ratio (M‐H, Fixed, 95% CI)

1.65 [0.72, 3.78]

3.2 At 12 months follow up

2

181

Odds Ratio (M‐H, Fixed, 95% CI)

2.18 [0.88, 5.36]

4 Duration of operation Show forest plot

Other data

No numeric data

5 Operative difficulties Show forest plot

1

55

Odds Ratio (M‐H, Fixed, 95% CI)

0.71 [0.11, 4.65]

5.1 Technical complication rate

1

55

Odds Ratio (M‐H, Fixed, 95% CI)

0.71 [0.11, 4.65]

6 SF12 physical score Show forest plot

1

55

Mean Difference (IV, Fixed, 95% CI)

1.60 [‐4.27, 7.47]

6.1 At 12 months follow up

1

55

Mean Difference (IV, Fixed, 95% CI)

1.60 [‐4.27, 7.47]

7 SF12 mental score Show forest plot

1

55

Mean Difference (IV, Fixed, 95% CI)

7.5 [‐0.52, 15.52]

7.1 At 12 months follow up

1

55

Mean Difference (IV, Fixed, 95% CI)

7.5 [‐0.52, 15.52]

8 SF‐36 Physical function score Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

8.1 At 6 months follow up

1

90

Mean Difference (IV, Fixed, 95% CI)

2.0 [‐6.55, 10.55]

8.2 At 12 months follow up

1

78

Mean Difference (IV, Fixed, 95% CI)

3.0 [‐6.44, 12.44]

8.3 At 2 to 5 years follow up

1

98

Mean Difference (IV, Fixed, 95% CI)

2.0 [‐8.26, 12.26]

9 SF‐36 Role physical Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

9.1 At 6 months follow up

1

90

Mean Difference (IV, Fixed, 95% CI)

5.0 [‐7.67, 17.67]

9.2 At 12 months follow up

1

78

Mean Difference (IV, Fixed, 95% CI)

5.0 [‐6.96, 16.96]

9.3 At 2 to 5 years follow up

1

98

Mean Difference (IV, Fixed, 95% CI)

8.0 [‐2.66, 18.66]

10 SF‐36 Role emotional Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

10.1 At 6 months follow up

1

90

Mean Difference (IV, Fixed, 95% CI)

‐6.0 [‐18.64, 6.64]

10.2 At 12 months follow up

1

78

Mean Difference (IV, Fixed, 95% CI)

4.0 [‐1.92, 9.92]

10.3 At 2 to 5 years follow up

1

98

Mean Difference (IV, Fixed, 95% CI)

‐9.0 [‐14.45, ‐3.55]

11 SF‐36 Social functioning Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

11.1 At 6 months follow up

1

90

Mean Difference (IV, Fixed, 95% CI)

‐1.0 [‐9.98, 7.98]

11.2 At 12 months follow up

1

78

Mean Difference (IV, Fixed, 95% CI)

3.0 [‐6.17, 12.17]

11.3 At 2 to 5 years follow up

1

98

Mean Difference (IV, Fixed, 95% CI)

4.0 [‐5.60, 13.60]

12 SF‐36 Mental health Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

12.1 At 6 months follow up

1

90

Mean Difference (IV, Fixed, 95% CI)

‐3.0 [‐10.84, 4.84]

12.2 At 12 months follow up

1

78

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐8.03, 8.03]

12.3 At 2 to 5 years follow up

1

98

Mean Difference (IV, Fixed, 95% CI)

‐5.0 [‐11.39, 1.39]

13 SF‐36 Energy/vitality Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

13.1 At 6 months follow up

1

90

Mean Difference (IV, Fixed, 95% CI)

‐6.0 [‐13.54, 1.54]

13.2 At 12 months follow up

1

78

Mean Difference (IV, Fixed, 95% CI)

9.0 [‐0.44, 18.44]

13.3 At 2 to 5 years follow up

1

98

Mean Difference (IV, Fixed, 95% CI)

‐3.0 [‐10.39, 4.39]

14 SF‐36 Pain Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

14.1 At 6 months follow up

1

90

Mean Difference (IV, Fixed, 95% CI)

2.0 [‐6.00, 12.00]

14.2 At 12 months follow up

1

78

Mean Difference (IV, Fixed, 95% CI)

‐1.0 [‐12.61, 10.61]

14.3 At 2 to 5 years follow up

1

98

Mean Difference (IV, Fixed, 95% CI)

‐5.0 [‐14.79, 4.79]

15 SF‐36 General health Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

15.1 At 6 months follow up

1

90

Mean Difference (IV, Fixed, 95% CI)

‐5.0 [‐13.30, 3.30]

15.2 At 12 months follow up

1

78

Mean Difference (IV, Fixed, 95% CI)

6.0 [‐4.10, 16.10]

15.3 At 2 to 5 years follow up

1

98

Mean Difference (IV, Fixed, 95% CI)

6.0 [‐5.72, 17.72]

16 RSCL Physical symptoms Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

16.1 At 6 months follow up

1

90

Mean Difference (IV, Fixed, 95% CI)

1.0 [‐3.94, 5.94]

16.2 At 12 months follow up

1

78

Mean Difference (IV, Fixed, 95% CI)

‐4.0 [‐8.56, 0.56]

17 RSCL Psychological distress Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

17.1 At 6 months follow up

1

90

Mean Difference (IV, Fixed, 95% CI)

‐1.0 [‐10.14, 8.14]

17.2 At 12 months follow up

1

78

Mean Difference (IV, Fixed, 95% CI)

‐1.0 [‐7.92, 5.92]

18 RSCL Activity level Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

18.1 At 6 months follow up

1

90

Mean Difference (IV, Fixed, 95% CI)

‐1.0 [‐3.35, 1.35]

18.2 At 12 months follow up

1

78

Mean Difference (IV, Fixed, 95% CI)

‐2.0 [‐4.32, 0.32]

19 RSCL Overall quality of life Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

19.1 At 6 months follow up

1

90

Mean Difference (IV, Fixed, 95% CI)

‐2.0 [‐12.29, 8.29]

19.2 At 12 months follow up

1

78

Mean Difference (IV, Fixed, 95% CI)

‐9.0 [‐18.77, 0.77]

20 SDS Depression Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

20.1 At 6 months follow up

1

90

Mean Difference (IV, Fixed, 95% CI)

2.0 [‐1.55, 5.55]

20.2 At 12 months follow up

1

78

Mean Difference (IV, Fixed, 95% CI)

‐1.0 [‐5.24, 3.24]

21 Dysmenorrhoea rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

21.1 At 6 months follow up

1

126

Odds Ratio (M‐H, Fixed, 95% CI)

0.66 [0.21, 2.03]

21.2 At 12 months follow up

1

126

Odds Ratio (M‐H, Fixed, 95% CI)

0.48 [0.15, 1.59]

21.3 At 2 to 5 years follow up

1

97

Odds Ratio (M‐H, Fixed, 95% CI)

0.54 [0.18, 1.60]

22 Dysmenorrhoea rate (VAS score) Show forest plot

Other data

No numeric data

22.1 At 12 months follow up

Other data

No numeric data

23 PMS rate (VAS score) Show forest plot

Other data

No numeric data

23.1 At 12 months follow up

Other data

No numeric data

24 Requirement for further surgery (ablation or hyst) Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

24.1 At 6 months follow up

1

53

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

24.2 At 12 months follow up

1

54

Odds Ratio (M‐H, Fixed, 95% CI)

7.22 [0.38, 135.96]

24.3 At 2 to 5 years follow up

1

120

Odds Ratio (M‐H, Fixed, 95% CI)

0.69 [0.23, 2.09]

25 Requirement for further surgery (hyst only) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

25.1 At 12 months follow up

1

126

Odds Ratio (M‐H, Fixed, 95% CI)

0.49 [0.12, 2.08]

25.2 At 2 to 5 years follow up

1

120

Odds Ratio (M‐H, Fixed, 95% CI)

0.75 [0.23, 2.45]

Figures and Tables -
Comparison 12. BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G)
Comparison 13. Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Amenorrhoea rate Show forest plot

12

Odds Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 At 6 months follow up

1

49

Odds Ratio (M‐H, Random, 95% CI)

3.00 [0.72, 12.53]

1.2 At 1 year follow up

12

2085

Odds Ratio (M‐H, Random, 95% CI)

0.92 [0.62, 1.37]

1.3 At 2 years follow up

3

701

Odds Ratio (M‐H, Random, 95% CI)

0.94 [0.58, 1.51]

1.4 At 2 to 5 years follow up

4

672

Odds Ratio (M‐H, Random, 95% CI)

1.30 [0.61, 2.79]

2 Satisfaction rate Show forest plot

13

Odds Ratio (M‐H, Random, 95% CI)

Subtotals only

2.1 At 6 months follow up

1

50

Odds Ratio (M‐H, Random, 95% CI)

4.69 [0.18, 121.10]

2.2 At 1 year follow up

11

1690

Odds Ratio (M‐H, Random, 95% CI)

1.20 [0.85, 1.70]

2.3 At 2 years follow up

5

802

Odds Ratio (M‐H, Random, 95% CI)

1.60 [1.00, 2.56]

2.4 At 2 to 5 years follow up

4

672

Odds Ratio (M‐H, Random, 95% CI)

1.43 [0.59, 3.46]

3 Operative difficulties Show forest plot

5

Odds Ratio (M‐H, Random, 95% CI)

Subtotals only

3.1 Equipment failure

3

384

Odds Ratio (M‐H, Random, 95% CI)

4.61 [1.52, 13.97]

3.2 Procedure abandoned

3

629

Odds Ratio (M‐H, Random, 95% CI)

1.19 [0.37, 3.85]

4 Duration of operation (mins) Show forest plot

9

1762

Mean Difference (IV, Random, 95% CI)

‐14.86 [‐19.68, ‐10.05]

5 Proportion having local anaesthesia (%) Show forest plot

6

1434

Odds Ratio (M‐H, Random, 95% CI)

6.40 [2.99, 13.68]

6 Inability to work Show forest plot

2

479

Odds Ratio (M‐H, Random, 95% CI)

0.83 [0.29, 2.40]

7 Operative or postoperative complication rate Show forest plot

11

Odds Ratio (M‐H, Random, 95% CI)

Subtotals only

7.1 Fluid overload

4

681

Odds Ratio (M‐H, Random, 95% CI)

0.17 [0.04, 0.77]

7.2 Perforation

8

1885

Odds Ratio (M‐H, Random, 95% CI)

0.32 [0.10, 1.00]

7.3 Cervical lacerations

8

1676

Odds Ratio (M‐H, Random, 95% CI)

0.22 [0.08, 0.60]

7.4 Endometritis

5

1188

Odds Ratio (M‐H, Random, 95% CI)

1.26 [0.44, 3.60]

7.5 UTI

8

1834

Odds Ratio (M‐H, Random, 95% CI)

0.88 [0.43, 1.83]

7.6 Hematometra

5

1133

Odds Ratio (M‐H, Random, 95% CI)

0.31 [0.11, 0.85]

7.7 Hydrosalpinx

1

239

Odds Ratio (M‐H, Random, 95% CI)

0.30 [0.01, 7.47]

7.8 Haemorrhage

5

982

Odds Ratio (M‐H, Random, 95% CI)

0.69 [0.25, 1.92]

7.9 Muscle fasciculation

1

267

Odds Ratio (M‐H, Random, 95% CI)

2.58 [0.10, 63.95]

7.10 Fever

3

671

Odds Ratio (M‐H, Random, 95% CI)

0.92 [0.19, 4.44]

7.11 Nausea/vomiting

4

997

Odds Ratio (M‐H, Random, 95% CI)

2.44 [1.55, 3.85]

7.12 Myometritis

1

267

Odds Ratio (M‐H, Random, 95% CI)

0.28 [0.01, 7.00]

7.13 Pelvic inflammatory disease

1

265

Odds Ratio (M‐H, Random, 95% CI)

1.03 [0.09, 11.50]

7.14 Pelvic abscess

1

265

Odds Ratio (M‐H, Random, 95% CI)

0.17 [0.01, 4.22]

7.15 Cervical stenosis

1

322

Odds Ratio (M‐H, Random, 95% CI)

1.50 [0.06, 37.22]

7.16 Uterine cramping

2

601

Odds Ratio (M‐H, Random, 95% CI)

1.75 [1.08, 2.83]

7.17 Severe pelvic pain

3

683

Odds Ratio (M‐H, Random, 95% CI)

0.86 [0.18, 4.14]

7.18 External burns

1

269

Odds Ratio (M‐H, Random, 95% CI)

2.34 [0.11, 49.32]

7.19 Blood transfusion

1

82

Odds Ratio (M‐H, Random, 95% CI)

5.52 [0.26, 118.61]

8 Requirement for any additional surgery Show forest plot

9

Odds Ratio (M‐H, Random, 95% CI)

Subtotals only

8.1 In 1 year follow up

7

1028

Odds Ratio (M‐H, Random, 95% CI)

0.74 [0.42, 1.31]

8.2 In 2 years follow up

5

988

Odds Ratio (M‐H, Random, 95% CI)

0.80 [0.48, 1.34]

8.3 In 2 to 5 years follow up

3

647

Odds Ratio (M‐H, Random, 95% CI)

0.94 [0.64, 1.39]

9 Requirement for further surgery (hyst only) Show forest plot

9

Odds Ratio (M‐H, Random, 95% CI)

Subtotals only

9.1 At 1 year follow up

4

772

Odds Ratio (M‐H, Random, 95% CI)

0.70 [0.35, 1.42]

9.2 At 2 years follow up

4

920

Odds Ratio (M‐H, Random, 95% CI)

0.85 [0.49, 1.46]

9.3 At 2 to 5 years follow up

4

758

Odds Ratio (M‐H, Random, 95% CI)

0.81 [0.51, 1.28]

Figures and Tables -
Comparison 13. Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION