Scolaris Content Display Scolaris Content Display

Endometrial resection / ablation techniques for heavy menstrual bleeding

Esta versión no es la más reciente

ver la versión actual 22 enero 2019
Contraer todo Desplegar todo

Referencias

References to studies included in this review

Ir a:

Abbott 2003 {published data only}

Abbott J, Hawe J, Hunter D, Garry R. A double‐blind randomized trial comparing the Cavaterm and the Novasure endometrial ablation systems for the treatment of dysfunctional uterine bleeding. Fertility and Sterility 2003;80(1):203‐8.

Bhattacharya 1997 {published data only}

Bhattacharya S, Cameron IM, Parkin DE, Abramovich DR, Mollison J, Pinion SB, et al. A pragmatic randomised comparison of transcervical resection of the endometrium with endometrial laser ablation for the treatment of menorrhagia. British Journal of Obstetrics & Gynaecology 1997;104:601‐7.

Bongers 2004 {published data only}

Bongers MY, Bourdrez P, Heintz PM, Brolmann HAM, Mol BWJ. Bipolar radio frequency endometrial ablation compared with balloon endometrial ablation in dysfunctional uterine bleeding: Impact on patients' health‐related quality of life. Fertility and Sterility 2005;83(3):724‐34.
Bongers MY, Bourdrez P, Mol BWJ, Heintz APM, Brolmann HAM. Randomised controlled trial of bipolar radio‐frequency endometrial ablation and balloon endometrial ablation. BJOG: British Journal of Obstetrics and Gynaecology 2004;111:1095‐102.
Kleijn JH, Engels R, Bourdrez P, Mol BWJ, Bongers MY. Five‐year follow up of a randomised controlled trial comparing NovaSure and ThermaChoice endometrial ablation. British Journal of Obstetrics and Gynaecology 2008;115:193‐198.

Boujida 2002 {published data only}

Boujida VH, Philipsen T, Pelle J, Joergensen JC. Five‐year follow‐up of endometrial ablation: endometrial coagulation versus endometrial resection. Obstetrics and Gynecology 2002;99:988‐92.
Furst SN, Philipsen T, Joergensen JC. Ten‐year follow‐up of endometrial ablation. Acta Obstetricia et Gynecologica 2007;86:334‐338.

Brun 2006 {published data only}

Brun J‐L, Raynal J, Burlet G, Galand B, Quereux C, Bernard P. Cavaterm thermal balloon endometrial ablation versus hysteroscopic endometrial resection to treat menorrhagia: The French, multicenter, randomized study. Journal of Minimally Invasive Gynecology 2006;13:424‐430.

Cooper 1999 {published data only}

Bain C, Cooper KG, Parkin DE. Microwave endometrial ablation versus endometrial resection: a randomized controlled trial. Obstetrics and Gynecology 2002;99:983‐7.
Cooper KG, Bain C, Lawrie L, Parkin DE. A randomised comparison of microwave endometrial ablation with transcervical resection of the endometrium; follow up at a minimum of five years. British Journal of Obstetrics and Gynaecology 2005;112:470‐5.
Cooper KG, Bain C, Parkin DE. Comparison of microwave endometrial ablation and transcervical resection of the endometrium for treatment of heavy menstrual loss: a randomised trial. Lancet 1999;354:1859‐63.

Cooper 2002 {published data only}

Cooper J, Gimpelson R, Laberge P, Galen D, Garza‐Leal JG, Scott J, et al. A randomized, multicenter trial of safety and efficacy of the NovaSure system in the treatment of menorrhagia. Journal of the American Association of Gynecologic Laparoscopists 2002;9(4):418‐28.

Cooper 2004 {published data only}

Cooper JM, Anderson TL, Fortin CA, Jack SA, Plentl MB. Microwave endometrial ablation vs rollerball electroablation for menorrhagia: a multicenter randomized trial. Journal of the American Association of Gynecologic Laparoscopists 2004;11(3):394‐403.

Corson 2000 {published data only}

Corson SL, Brill AI, Brooks PG, Cooper JM, Indman PD, Liu JH, et al. Interim results of the American Vesta trial of endometrial ablation. Journal of the American Association of Gynecologic Laparoscopists 1999;6(1):45‐9.
Corson SL, Brill AI, Brooks PG, Cooper JM, Indman PD, Liu JH, et al. One‐year results of the Vesta system for endometrial ablation. Journal of the American Association of Gynecologic Laparoscopists 2000;7(4):489‐97.

Corson 2001 {published data only}

Corson SL. A multicenter evaluation of endometrial ablation by hydrothermablator and rollerball for treatment of menorrhagia. Journal of the American Association of Gynecologic Laparoscopists 2001;8(3):359‐67.
Goldrath MH. Evaluation of hydrothermablator and rollerball endometrial ablation for menorrhagia 3 years after treatment. Journal of the American Association of Gynecologic Laparoscopists 2003;10(4):505‐11.
Loffer F. A clinical comparison of hydrothermablation (HTA) and rollerball for endometrial ablation to treat menorrhagia: a randomized multicenter clinical trial. XVI FIGO World Congress of Obstetrics & Gynecology. 2000; Vol. Abstract Book 2:95.

Duleba 2003 {published data only}

Duleba AJ, Heppard MC, Soderstrom RM, Townsend DE. A randomized study comparing endometrial cryoablation and rollerball electroablation for treatment of dysfunctional uterine bleeding. Journal of the American Association of Gynecologic Laparoscopists 2003;10(1):17‐26.
Townsend DE, Duleba AJ, Wilkes MM, et al. Durability of treatment effects after cryoablation versus rollerball electroablation for abnormal uterine bleeding: two‐year results of a multicenter randomized trial. American Journal of Obstetrics & Gynecology 2003;188:699‐701.

Hawe 2003 {published data only}

Hawe J, Abbott J, Hunter D, Phillips G, Garry R. A randomised controlled trial comparing the Cavaterm endometrial ablation system with the Nd:YAG laser for the treatment of dysfunctional uterine bleeding. BJOG: British Journal of Obstetrics & Gynecology 2003;110:350‐7.

McClure 1992 {published data only}

McClure N, Marners M, Healy DL, Hill DJ, Lawrence AS, Wingfield M, et al. A quantitative assessment of endometrial electorcautery in the management of menorrhagia and a comparative report of argon laser endometrial ablation. Gynaecological Endoscopy 1992;1:199‐202.

Meyer 1998 {published data only}

Grainger DA, Tjaden DO, Rowland C, Meyer WR. Thermal balloon and rollerball ablation to treat menorrhagia: two‐year results of a multicenter, prospective, randomized clinical trial. Journal of the American Association of Gynecologic Laparoscopists 2000;7(2):175‐9.
Loffer FD. Five year post‐procedure follow‐up of patients participating in a randomised trial of uterine balloon therapy vs rollerball ablation for the treatment of menorrhagia. Journal of the American Association of Gynecologic Laparoscopy. 2001; Vol. 8, issue 1:48‐54.
Loffer FD. Three‐year comparison of thermal balloon and rollerball ablation in treatment of menorrhagia. Journal of the American Association of Gynecologic Laparoscopists 2001;8(1):48‐54.
Meyer WR, Walsh BW, Grainger DA, Peacock LM, Loffer FD, Steege JF. Thermal balloon and rollerball ablation to treat menorrhagia: a multicenter comparison. Obstetrics & Gynecology 1998;92:98‐103.

Onoglu 2007 {published data only}

Onoglu A, Taskin O, Inal M, Sadik S, Simsek M, Akar M, Kursun S, Menilcioglu I, Postaci H, Ispahi C. Comparison of the long‐term histopathologic and morphologic changes after endometrial rollerball ablation and resection: a prospective randomized trial. Journal of Minimally Invasive Gynecology 2007;14:39‐42.

Pellicano 2002 {published data only}

Pellicano M, Guida M, Acunzo G, Cirillo D, Bifulco G, Nappi C. Hysteroscopic transcervical endometrial resection versus thermal destruction for menorrhagia: a prospective randomized trial on satisfaction rate. American Journal of Obstetrics and Gynecology 2002;187:545‐50.

Perino 2004 {published data only}

Perino A, Castelli A, Cucinella G, Biondo A, Pane A, Venezia R. A randomized comparison of endometrial laser intrauterine thermotherapy and hysteroscopic endometrial resection. Fertility and Sterility 2004;82:731‐4.

Romer 1998 {published data only}

Romer T. The treatment of recurrent menorrhagias ‐ Cavaterm‐balloon‐coagulation versus Rollerball‐endometrial ablation ‐ a prospective randomized comparative study [Die therapie rezidivierender Menorrhagien ‐ Cavaterm‐Ballon‐Koagulatioon versus Roller‐Ball‐Endometriumkoagulation ‐ eine prospektive randomisierte Vergleichsstudie]. Zentralblatt fur Gynakologie 1998;120(10):511‐4.

Soysal 2001 {published data only}

Soysal ME, Soysal SK, Vicdan K. Thermal balloon ablation in myoma‐induced menorrhagia under local anesthesia. Gynecologic and Obstetric Investigation 2001;51:128‐33.

van Zon‐Rabelink2003 {published data only}

van Zon‐Rabelink IAA, Vleugels MPH. Treating menorrhagia with endometrial ablation: rollerball electrocoagulation versus thermal ablation with the uterine balloon. Gynaecological Endoscopy Abstract from the 6th Annual Congress of the European Society for Gynaecological Endoscopy 1997;6(Suppl 2):41.
van Zon‐Rabelink IAA, Vleugels MPH, Merkus HMWM, de Graaf R. Efficacy and satisfaction rate comparing endometrial ablation by rollerball electrocoagulation to uterine balloon thermal ablation in a randomised controlled trial. European Journal of Obstetrics, Gynecology and Reproductive Biology 2004;114(1):97‐103.
van Zon‐Rabelink IAA, Vleugels MPH, Merkus HMWM, de Graaf R. Endometrial ablation by rollerball electrocoagulation compared to uterine balloon thermal ablation. Technical and safety aspects. European Journal of Obstetrics, Gynecology and Reproductive Biology 2003;110:220‐3.

Vercellini 1999 {published data only}

Vercellini P, Oldani S, Yaylayan L, Zaina B, De Giorgi O, Crosignani PG. Randomised comparison of vaporising electrode and cutting loop for endometrial ablation. Obstetrics & Gynecology 1999;94:521‐7.

References to studies excluded from this review

Ir a:

Vihko 2003 {published data only}

Vihko KK, Raitala R, Taina E. Endometrial thermoablation for treatment of menorrhagia: comparison of two methods in outpatient setting. Acta Obstetricia et Gynecologica Scandinavian 2003;82:269‐74.

References to studies awaiting assessment

Ir a:

Chang 2009 {published data only}

Chang P, Vilos G, Abu‐Rafea B, Hollett‐Caines J, Abyaneh Z, Edris F. Comparison of Clinical Outcomes with Low‐Voltage (Cut) Versus High‐Voltage (Coag) Waveforms during Hystereroscopic Endometraila Ablation with the Rollerball: A Pilot Study. The Journal of Minimally Invasive Gynecology 2009;1:350‐4.

Feng 2006 {published data only}

Feng LM, Gao WL. Clinical analysis of abnormal uterine bleeding treatment with Thermablate EAS. Beijing da Xue Xue Bao 2006;38(4):432‐5.

Hamza 2005 {published data only}

Hamza A, Ismail MT, Abu Shady Y, Hawas NG. Resection versus coagulation techniques of ablation in the management of dysfunctional uterine bleeding. Royal College of Obstetricians and Gynaecologists 6th International Scientific Meeting, Cairo Egypt. 27‐30 September 2005.

Kleijn 2007 {published data only}

Kleijn JH, Engles R, Bourdrez P, Mol BWJ. Five‐year follow up of a randomised controlled trail comparing NovaSure and ThermaChoice endometrial ablation. General gynaecology 2007;2:193‐9.

Sambrook 2009 {published data only}

Sambrook AM, Bain C, Parkin DE, Cooper KG. A randomised comparison of microwave endometrial ablation with transcervical resection of the endometrium: follow up at a minimum of ten years. Gynaecological surgery 2009;1:1038‐46.

Sambrook 2009b {published data only}

Sambrook AM, Cooper KG, Campbell MK, Cook JA. Clinical outcomes from a randomised comparison of Microwave Endometrail Ablation with Thermal Balloon endometrial ablation for the treatment of heavy menstrual bleeding. Gynaecological surgery 2009;1:1039‐45.

Abbott 2002

Abbott JA, Garry R. The surgical management of menorrhagia. Human Reproduction Update 2002;8(1):68‐78.

Baggish 1995

Baggish MS, Paraiso M, Brexnock EM, Griffey S. A computer‐controlled, continuously circulating hot irrigating system for endometrial ablation. American Journal of Obstetrics & Gynecology 1995;173:1842‐8.

Bradlow 1992

Bradlow J, Coulter A, Brooks P. Patterns of referral. Oxford: Health Services Research Unit, 1992.

Bridgman 1994

Bridgman SA. Increasing operative rates for dysfunctional uterine bleeding after endometrial ablation (letter). Lancet 1994;344:893.

Chimbira 1980

Chimbira TH, Anderson BM, Turnbull AC. Relationship between measured menstrual blood loss and patient's subjective assessment of loss, duration of bleeding, number of sanitary towels used, uterine weight and endometrial surface area. British Journal of Obstetrics & Gynaecology 1980;87:603‐9.

Cole 1971

Cole S, Billewicz W, Thomson A. Sources of variation in menstrual blood loss. Journal of Obstetrics & Gynaecology of the British Commonwealth 1971;78:933‐9.

Cooper 2000

Cooper JM, Erickson ML. Global endometrial technologies. Obstetrics & Gynecology Clinics of North America 2000;27(2):385‐96.

Coulter 1994

Coulter A. Trends in gynaecological surgery (letter). Lancet 1994;344:1367.

Coulter 1995

Coulter A, Kelland J, Peto V, Rees MC. Treating menorrhagia in primary care. An overview of drug trials and a survey of prescribing practice. International Journal of Technology Assessment in Health Care 1995;11:456‐71.

Crosignani 1997

Crosignani PG, Vercellini P, Mosconi P, Oldani S, Cortesi I, De Giorgi O. Levonorgestrel‐releasing intrauterine device versus hysteroscopic endometrial resection in treatment of dysfunctional uterine bleeding. Obstetrics & Gynecology 1997;90:257‐63.

DeCherney 1983

DeCherney AH, Polan ML. Hysteroscopic management of intrauterine lesions and intractable uterine bleeding. Obstetrics & Gynecology 1983;61:392‐7.

DeCherney 1987

DeCherney AH, Diamond MP, Lavey G, Polan ML. Endometrial ablation for intractable uterine bleeding: hysteroscopic resection. Obstetrics & Gynecology 1987;70:668‐70.

Donnez 1996

Donnez J, Polet R, Mathieu PE, Konwitz E, Nisolle M, Casanas‐Roux F. Endometrial laser interstitial hyperthermy: a potential modality for endometrial ablation. Obstetrics & Gynecology 1996;87:459‐64.

EHC 1995

University of Leeds, Nuffield Institute for Health, University of York, NHS Centre for Reviews and Dissemination. The management of menorrhagia: What are effective ways of treating excessive regular menstrual blood loss in primary and secondary care?. Effective Health Care1995; Vol. 9:1‐14.

Fehr 1995

Fehr MK, Madsen SJ, Svaasand LO, Tromberg BJ, Eusebio J, Berns MW, et al. Intrauterine light delivery for photodynamic therapy of the human endometrium. Human Reproduction 1995;10:3067‐72.

Fraser 1984

Fraser IS, McCarron G, Markham R. A preliminary study of factors influencing perception of menstrual blood loss volume. American Journal of Obstetrics & Gynecology 1984;149:788‐93.

Gath 1987

Gath D, Osborn M, Bungay G, Iles S, Day A, Bond A, et al. Psychiatric disorder and gynaecological symptoms in middle aged women: a community survey. BMJ 1987;294:213‐8.

Goldrath 1981

Goldrath MH, Fuller TA, Segal S. Laser photovaporization of endometrium for the treatment of menorrhagia. American Journal of Obstetrics & Gynecology 1981;140:14‐9.

Hallberg 1964

Hallberg L, Nilsson L. Determination of menstrual blood loss. Scandinavian Journal of Clinical & Laboratory Investigation 1964;16:244‐8.

Hallberg 1966

Hallberg L, Hogdahl AM, Nilsson L, Rybo G. Menstrual blood loss ‐ a population study. Acta Obstetricia et Gynecologica Scandinavian 1966;45:320‐51.

Higgins 2008

Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.0. The Cochrane Collaboration, updated February 2008.

Higham 1990

Higham JM, O'Brien PMS, Shaw RW. Assessment of menstrual blood loss using a pictorial chart. British Journal of Obstetrics & Gynaecology 1990;97:734‐9.

HMB Guidelines 1998

National Health Committee (NZ). Guidelines for the management of heavy menstrual bleeding. Guidelines for management of heavy menstrual bleedingJune 1998.

Hospital Stats 1995

Anonymous. Finished consultant episodes by diagnosis, operation and speciality; Hospital Episode Statistics Volume 1. London: HMSO, 1995.

Irvine 1998

Irvine GA, Campbell‐Brown MB, Lumsden MA, Heikkila A, Walker JJ, Cameron IT. Randomised comparative trial of the levonorgestrel intrauterine system and norethisterone for the treatment of idiopathic menorrhagia. British Journal of Obstetrics & Gynaecology 1998;105:592‐8.

Istre 2001

Istre O, Trolle B. Treatment of menorrhagia with the levonorgestrel intrauterine system versus endometrial resection. Fertility and Sterility 2001;76(2):304‐9.

Lethaby 1999

Lethaby A, Shepperd S, Cooke I. Endometrial resection and ablation versus hysterectomy for heavy menstrual bleeding (Cochrane Review). Cochrane Database of Systematic Reviews 1999, Issue 2. [DOI: 10.1002/14651858]

Lin 1988

Lin BL, Miyamoto N, Tomomatu M. The development of a new hysteroscopic resectoscope and its clinical applications on transcervical resection and endometrial ablation. Japanese Journal of Gynecological & Obstetrical Endoscopy 1988;4:56‐9.

Magos 1989

Magos AL, Bauman R, Turnbull AC. Transcervical resection of endometrium in women with menorrhagia. BMJ: British Medical Journal 1989;298:1209‐12.

Marjoribanks 2003

Marjoribanks J, Lethaby A, Farquhar C. Surgery versus medical therapy for heavy menstrual bleeding (Cochrane Review). Cochrane Database of Systematic Reviews 2003, Issue 2. [Art. No.: CD003855. DOI: 10.1002/14651858. CD003855]

McGurgan 2007

McGurgan P, O'Donovan P. Second‐generation endometrial ablation ‐ an overview. Best Practice and Research Clinical Obstetrics and Gynaecology 2007;21(6):931‐945.

Munroe 2006

Munroe MG. Endometrial ablation: where have we been? Where are we going?. Clinical Obstetrics and Gynecology 2006;49(4):736‐766.

Nagele 1998

Nagele F, Rubinger T, Magos A. Why do women choose endometrial ablation rather than hysterectomy?. Fertility and Sterility 1998;69(6):1063‐6.

Newton 1977

Newton J, Barnard G, Collins W. A rapid method for measuring menstrual blood loss using automatic extraction. Contraception 1977;16:269‐82.

Overton 1997

Overton C, Hargreaves J, Maresh M. A national survey of the complications of endometrial destruction for menstrual disorders: the MISTLETOE study. British Journal of Obstetrics & Gynaecology 1997;104(12):1351‐9.

Papadopoulos 2007

Papadopoulos NP, Magos A. First‐generation endometrial ablation: rollerball vs loop vs laser. Best Practice and Research Clinical Obstetrics and Gynaecology 2007;21(6):915‐929.

Pitroff 1993

Pitroff R, Majia S, Murray A. Initial experience with transcervical cryoablation using saline as a uterine distension medium. Minimally Invasive Therapy 1993;2:69‐73.

RCOG 1995

RCOG Medical Audit Unit. Mistletoe Report for the Fifth Bulletin. Manchester: RCOG, 1995.

Reid 2000

Reid PC, Coker A, Coltart R. Assessment of menstrual blood loss using a pictorial chart: a validation study. British Journal of Obstetrics & Gynaecology 2000;107(3):320‐3.

Rybo 1966

Rybo G. Clinical and experimental studies on menstrual blood loss. Acta Obstetrica et Gynaecologica Scandinavian 1966;45(Suppl 7):1‐23.

Sharp 1995

Sharp NC, Cronin N, Feldberg I, Evans M, Hodgson D, Ellis S. Microwaves for menorrhagia: a new fast technique for endometrial ablation. Lancet 1995;346(8981):1003‐4.

SIGN 2008

SIGN. Filters. http://www.sign.ac.uk/methodology/filters.html#random.

Singer 1994

Singer A, Almanza R, Gutierrez A, Haber G, Bolduc L, Neuwirth R. Preliminary clinical experience with thermal balloon endometrial ablation method to treat menorrhagia. Obstetrics & Gynecology 1994;83:732‐7.

Vaincaillie 1989

Vaincaillie TG. Electrocoagulation of the endometrium with the ball‐ended resectoscope. Obstetrics & Gynecology 1989;74:425‐7.

Vessey 1992

Vessey M, Villard‐Mackintosh L, McPherson K, Coulter A, Yeates D. The epidemiology of hysterectomy: findings in a large cohort study. British Journal of Obstetrics & Gynaecology 1992;99:402‐7.

Waimedca 1994

McAvoy B, Davis P, Raymont A, Gribben B. The Waikato Medical Care (WaiMedCa) Survey 1991‐2. New Zealand Medical Journal 1994;107:388‐433.

Warner 2001

Warner P, Critchley HO, Lumsden MA, Campbell‐Brown M, Douglas A, Murray G. Referral for menstrual problems: cross sectional survey of symptoms, reasons for referral and management. BMJ: British Medical Journal 2001;323:2‐8.

Characteristics of studies

Characteristics of included studies [ordered by study ID]

Ir a:

Abbott 2003

Methods

Randomisation: computer‐generated sequences in balanced blocks of 5, imbalanced randomization 2:1 & opaque envelope.
Study was a randomised controlled trial, with use of double blinding (women & assessor) and the authors did not report the number of centres involved in the study.
Number of women randomised: 57.
Number of women analysed: 55 evaluated at 6 months follow up.
Power calculation performed and the authors reported the use of intention to treat analysis.
Source of funding: Novacept.

Participants

57 women with unstated ages (mean Novasure 40.5(6.0), mean Cavaterm 40.5(8.1) recruited from James Cook University Hospital in the UK.
Inclusion criteria: abnormal uterine bleeding ‐ pictorial blood loss assessment chart score > 150; no intrauterine pathology demonstrated by in‐ or outpatient hysterectomy; normal endometrial biopsy; a uterine length < 12 cm; premenstrual gonatrophin levels; normal pap smear; had completed their family
Exclusion criteria: none reported.

Interventions

(1) Novasure (TM) endometrial ablation
(2) Cavaterm (TM) endometrial ablation
Duration: 6 month follow up & 12 month follow up.

Outcomes

Primary: amenorrhoea; menstrual change, QOL, sexual activity, patient satisfaction, procedure acceptability.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Adequate sequence generation?

Low risk

Computer generated sequences in balanced blocks of five

Allocation concealment?

Low risk

Opaque envelopes

Blinding?
All outcomes

Low risk

Participants, nursing staff, GP and assessors of outcomes at later follow up all blinded

Incomplete outcome data addressed?
All outcomes

Low risk

One participant in each group withdrew after randomisation and prior to surgery

Free of selective reporting?

Unclear risk

No prior published protocol identified

Free of other bias?

Unclear risk

Groups appeared balanced at baseline but medical equipment company provided funding
Bhattacharya 1997

Methods

Randomisation: Random number sequence computer generated + numbered concealed opaque envelopes.
Single centre, parallel groups with no blinding.
Number of women randomised: 372.
Number of women analysed: 366 had treatments, 332 were evaluated at 6 months follow up, 321 evaluated at 12 months follow up.
Power calculation performed for sample size and authors reported intention to treat analysis (although because of dropouts, this was impossible).
Source of funding: Chief Scientist Office of the Scottish Dept of Health.

Participants

372 women with mean age 41 years, recruited from gynaecology clinics at Aberdeen Royal Infirmary, Scotland.
Inclusion criteria: </= 50 years of age; <100 kg in weight; clinical diagnosis of dysfunctional uterine bleeding (uterus < size of a pregnancy of 10 weeks and normal endometrial histology).
Exclusion criteria: not reported

Interventions

All women had clinical assessment and endometrial biopsy prior to treatment, and also endometrial preparation with a single injection of goserelin 3.6 mg subcutaneously 5 weeks prior to surgery.
(1) Laser ablation
(2) TCRE with rollerball
Duration: 12 months

Outcomes

Operative complications; post‐operative recovery; relief of menstrual and other symptoms; need for further surgical treatment; satisfaction with treatment; differential resource use.

Notes

Recruitment of participants took place over 2 different time periods. 105 women were randomised to ELA or TCRE for an earlier study. After a gap of 8 months, an additional 267 women were recruited.

Risk of bias

Bias

Authors' judgement

Support for judgement

Adequate sequence generation?

Low risk

Computer generated

Allocation concealment?

Low risk

Numbered sealed opaque envelopes stratified per consultant

Blinding?
All outcomes

High risk

Open study

Incomplete outcome data addressed?
All outcomes

High risk

Different numbers of participants provided data for different outcomes; 366/372 for operative details, 321/372 for satisfaction; 306/372 for menstrual loss.

Free of selective reporting?

Unclear risk

No prior published protocol identified

Free of other bias?

Unclear risk

Recruitment of participants over 2 different time period and the 2 groups differed in baseline characteristics. 15% of one group crossed over to the other treatment but analyses were undertaken according to randomised group.

Bongers 2004

Methods

Randomisation: computer generated at a 2:1 ratio with opaque sealed envelopes.
Single centre, parallel group design and double blind (participants and investigators).
No of women randomised: 126
Number of women analysed: 126 (1 woman in bipolar group did not receive any treatment but was included in the analyses) (at 5 year follow up, 6 participants were lost to follow up and not included in the analyses)
Power calculation for sample size performed and authors claimed analysis by intention to treat.
Source of funding: Novasure devices provided by Novacept; Thermachoice devices discounted.

Participants

126 women with mean age 43 years, recruited from a large teaching hospital (500 beds) in the Netherlands.
Inclusion:
Menorrhagia (PBAC>/= 150); normal uterus with benign histology and uterine length 6‐11 cm; normal PAP smear; negative Chlamydia test, FSH<40 iu/L.
Exclusion:
Coagulopathies; treatment with anticoagulation; desire to preserve fertility; prior uterine surgery (except low segment caesarean section)

Interventions

(1) Novasure endometrial ablation
(2) Thermachoice endometrial ablation
Follow up at 3, 6 and 12 months

Outcomes

Primary:
Amenorrhoea at 3, 6, 12 months and later follow up at 5 years
Secondary:
Duration of surgery; satisfaction; re‐intervention rates (hysterectomy); dysmenorrhoea rates; proportion with blood clots; health related quality of life

Notes

A technical failure with the Novasure generator part way during the trial. As a result, 2 analyses were performed:
A: analysis of all women
B: analysis of only those women included after the technical failure

Risk of bias

Bias

Authors' judgement

Support for judgement

Adequate sequence generation?

Low risk

Computer generated

Allocation concealment?

Low risk

Opaque sealed envelopes

Blinding?
All outcomes

Low risk

Participants and coordinator of follow up

Incomplete outcome data addressed?
All outcomes

Low risk

Minimal loss to follow up over 5 years (6/126)

Free of selective reporting?

Unclear risk

No prior published protocol identified

Free of other bias?

Unclear risk

Support to trial by medical equipment company. At baseline, more women (16%) in the bipolar group had a retroverted uterus when compared with women (9%) in the balloon group.

Boujida 2002

Methods

Randomisation: Geigy random numbers in sealed envelopes (even=coagulation, uneven=resection).
The study was a randomized controlled trial, the use of blinding is unclear and the authors did not report the number of centres involved.
Number of women randomized: 120
Number of women analysed: 109 evaluated at 2 years for bleeding outcomes, 113 at 5 and 10 years for bleeding outcomes (reasons given).
A power calculation was performed; the authors did not report Intention ‐to‐treat analysis but no dropouts reported for primary outcomes.
Source of funding: Research Foundation of the County of West Zealand.

Participants

120 women aged >35 years (mean coagulation 42.6, mean resection 44.8) recruited from an unreported location.
Inclusion criteria: bleeding abnormalities so severe that hysterectomy would have been performed if ablation not possible.
Exclusion criteria: uterus more than twice normal size as evaluated by exploration; uterine cavity depth of >12 cm; pelvic pain a major problem; if in doubt about future pregnancy.

Interventions

(1) Transcervical hysteroscopic endometrial coagulation (n=61)
(2) Endometrial resection (n=59)
Duration: clinical exam 2 years post questionnaire & 5 year follow up

Outcomes

Primary: rate of hysterectomy 5 and 10 years later; days with bleeding; would they recommend treatment.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Adequate sequence generation?

Low risk

Documenta Geigy random numbers; even numbers rollerball, odd numbers TCRE

Allocation concealment?

Low risk

Numbered sealed envelopes opened just prior to surgery

Blinding?
All outcomes

High risk

Unlikely

Incomplete outcome data addressed?
All outcomes

Low risk

True intention to treat analysis. No dropouts for assessment of primary outcomes

Free of selective reporting?

Unclear risk

No prior published protocol identified

Free of other bias?

Low risk

Groups balanced at baseline.
Brun 2006

Methods

Randomisation: computer generated telephone number sequence in a 1:1 allocation ratio.

Parallel group randomised trial in 6 centres in France, blinding unlikely.

Number of women randomised: 62

Number of women analysed: 45 at 12 months (1 in Cavaterm group and 8 in TCRE group were excluded prior to treatment mostly because of non eligibility; 1 in each group decided to withdraw before treatment; of the remaining 51 treated women, 2 in TCRE group withdrawn because of menopause and pulmonary embolism and 2 in Cavaterm group because of loss to follow up)

Power calculation for sample size (26 participants in each arm for 80% power to detect 42% difference in amenorrhoea rate between groups). Analysis not by intention to treat and randomisation unbalanced after withdrawals.

Source of funding: Wallsten (a medical equipment company in Switzerland) acknowledged for technical assistance ‐ unknown whether funding provided.

Participants

62 women with a median age of 45 years (Cavaterm) and 46 years (TCRE) recruited between Feb 2000 and Dec 2001 from departments of Obstetrics and Gynaecology in university hospitals in France (6 centres)

Inclusion: women with menorrhagia unresponsive to medical treatment requesting conservative surgical management; no longer wishing to become pregnant; Higham blood loss score >100; internal uterine cavity length 4‐12cm; normal endometrial biopsy; normal cervical cytology; completed family; using a reliable method of contraception

Exclusion: endometrial malignancy; active pelvic infection; submucous fibroids; polyps; uterine malformation; history of endometrial ablation; hormone treatment (GnRHa or danazol) in previous 6 months

Interventions

(1) Cavaterm thermal balloon ablation

(2) Transcervical resection of the endometrium (TCRE)

Duration: 6 and 12 month follow up

Outcomes

Primary: amenorrhoea rates; PBAC scores

Secondary: satisfaction; safety (technical complication rate, duration of surgery; clinical complications (intra and postoperative); pain scores; hospital stay' resumption of normal or work activities; additional surgery

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Adequate sequence generation?

Low risk

Computer generated telephone number sequence in 1:1 allocation ratio

Allocation concealment?

Low risk

Centralised system

Blinding?
All outcomes

High risk

Unlikely

Incomplete outcome data addressed?
All outcomes

High risk

Withdrawals unbalanced between groups ‐ created unbalanced randomisation

Free of selective reporting?

Unclear risk

No prior protocol identified; not clear whether all adverse effects reported

Free of other bias?

High risk

Menstrual blood loss higher in the Cavaterm group at baseline. Medical equipment company acknowledged ‐ not sure if they provided funding.

Cooper 1999

Methods

Randomisation:
Allocation obtained by phone after consent given. Sequence by computer generated random number tables in balanced blocks of 20. Sealed opaque envelopes opened by an independent person. 1:1 ratio.
Single centre, parallel group design with no blinding.
Number of women randomised = 263.
Number of dropouts/lost to follow up = 23.
Power calculation for sample size (230 women required to have a power of 80% to detect a minimum 15% difference in satisfaction, significant at 0.5 level).
Analysis by intention to treat but loss to follow up of 23 women not included.
Support received from Microsulis (microwave equipment and salary support)

Participants

263 women with mean age 41 years, recruited from gynaecology outpatient department of Aberdeen Royal Infirmary (referred for surgery) between Sept 1996 and February 1998.
Inclusion criteria: premenopausal, completed their families, dysfunctional uterine bleeding (uterine size equivalent to 10 weeks pregnancy or less), informed consent.
Exclusion criteria: histopathological abnormalities of the endometrium.

Interventions

Endometrial thinning with goserelin 3.6 mg 5 weeks prior to surgery for all women
(1) TCRE with rollerball
(2) Microwave endometrial ablation after USS for measurement of endometrial thickness
(2) Microwave endometrial ablation
Duration: 12 months initially; extended to 5 years.

Outcomes

Primary:
Participant satisfaction with and acceptability of treatment.
Secondary: Menstrual status, quality of life, morbidity, duration of surgery, intraoperative complications, postoperative pain relief, postoperative stay, absence from work.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Adequate sequence generation?

Low risk

Computer generated random number tables in balanced blocks of 20

Allocation concealment?

Low risk

Sealed opaque envelopes opened by an independent person

Blinding?
All outcomes

High risk

Unlikely

Incomplete outcome data addressed?
All outcomes

Low risk

Total dropouts 23/263 for menstrual and satisfaction outcomes ‐ balanced between groups and unlikely to affect estimates

Free of selective reporting?

Unclear risk

No prior published protocol identified

Free of other bias?

Unclear risk

Funding by medical equipment company
Cooper 2002

Methods

Randomisation: list of random numbers for each site (separate for <40 and >40).
Multicentre (9), randomised multicentre double‐arm study with no blinding.
Number of women randomised: 265 (using ratio of 2:1 Novasure:Rollerball)
Number of women analysed: 259 received treatment, 235 left after others discontinued trial.
No power calculation performed and the authors did not report Intention to treat analysis (except for safety results).
Source of funding: in part by unrestricted grant from Novacept Inc (Dr Cooper is a stockholder and Dr Laberge a consultant).

Participants

265 women aged 25 ‐ 50 recruited from centres in the USA.
Inclusion criteria: menorrhagia verified by validated PBLAC = 150 for 3 consecutive months; history of failed medical therapy
Exclusion criteria: bacteraemia sepsis or other active systemic infection; active or recurrent chronic pelvis inflammatory disease; symptomatic endometriosis; history of uterine surgery that would have interrupted integrity of uterine wall; previous endometrial ablation; abnormal pap smear and/or endometrial biopsy; taking anticoagulants, hormone contraceptives or drugs that could thin myometrial muscle like long term steroids; desire future childbearing/ preservation of fertility; abnormal or obstructed uterine cavity.

Interventions

(1) Novasure Impedance ‐ controlled endometrial oblation
(2) Hysteroscopic wire loop resection & rollerball ablation
Duration: follow up at 3, 6, & 12 months.

Outcomes

Pictorial blood loss assessment chart; procedure time; sedation; intraoperative adverse events / postop adverse effects

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Adequate sequence generation?

Low risk

List of random numbers

Allocation concealment?

Unclear risk

Not reported

Blinding?
All outcomes

Unclear risk

Unlikely

Incomplete outcome data addressed?
All outcomes

Unclear risk

All participants contributed data for safety outcomes but for other outcomes there was a 13% lost to follow up with no details reported

Free of selective reporting?

Unclear risk

No prior published protocol identified

Free of other bias?

Unclear risk

Groups appeared balanced at baseline but funding by medical equipment company
Cooper 2004

Methods

Randomisation: computer generated random numbers in a 2:1 ratio.
8 centres, parallel group design and blinding not reported (unlikely).
Number of women randomised: 322
Number of women analysed: 322 for primary outcomes
Power calculation for sample size and intention to treat analysis (evaluable patient analysis also performed)
Source of funding: all authors are associated with the company that produces the microwave device.

Participants

322 women with mean age 41 years recruited from 5 centres in the USA, 2 centres in Canada and 1 centre in the UK (academic medical centres and private medical practices).
Inclusion:
Non pregnant women >30 years; no desire for future pregnancy; failed, refused or not tolerated medical treatment; PBAC>/=185 (previous 1 or 3 months); FSH </= 30 iu/L; uterine cavity 6‐14 cm.
Exclusion:
Myometrial wall thickness <8 mm; active endometriosis; endometrial hyperplasia; endometrial cancer; active PID; previous endometrial ablation; previous caesarean section (classical scar); history of gynaecological malignancy in past 5 years; untreated or unevaluable cervical dysplasia; known clotting defects or bleeding disorders; IUD

Interventions

(1) Microwave ablation
(2) Rollerball

All women had prior investigations with ultrasound, endometrial biopsy and pap smear

All women had pre treatment with GnRHa for 1 month

Duration: 12 months

Outcomes

Primary:
PBAC<75
Secondary:
amenorrhoea; duration of surgery; anaesthesia; complications; adverse events; dysmenorrhoea; quality of life (SF36); satisfaction; acceptability

Notes

Women were stratified into 2 groups: <40 years and >/=40 years

Risk of bias

Bias

Authors' judgement

Support for judgement

Adequate sequence generation?

Low risk

Computer generated random numbers

Allocation concealment?

Unclear risk

Not reported

Blinding?
All outcomes

Unclear risk

Not reported

Incomplete outcome data addressed?
All outcomes

Low risk

True intention to treat analysis for primary outcomes; dropouts regarded as failures

Free of selective reporting?

Unclear risk

No prior published protocol identified

Free of other bias?

Unclear risk

Authors were either employees, consultants/speakers for or owned stock in a medical equipment company that produced one of the interventions

Corson 2000

Methods

Randomisation: Allocation computerised using sealed individual envelopes.
Multicentre study (n=8), parallel group design with no blinding.
Number of women randomised = 276.
Number of dropouts/lost to follow up = 21/276 lost before surgery; 42/276 lost at 12 months follow up.
No power calculation for sample size reported.
Analysis was not by intention to treat.
Supported by Vesta Medical, Colorado.

Participants

276 women aged from 30 to 49 years recruited from 8 centres (7 in the USA, 1 in Australia).
Inclusion criteria: Score of 150 or more on the PBAC (pictorial blood loss assessment chart); no plan for more children; either using contraception or one of either partner sterilised; failed progestin therapy or refused medical therapy or shown intolerance to these agents.
Exclusion criteria: FSH (follicle‐stimulating hormone) levels >40mIU/ml (suggestive of impending menopause); distorted uterine cavities; myomas or polyps; cavity in excess of 9.75 cm; significant systemic medical diseases; pregnancy; pelvic inflammatory disease; carcinoma; clotting defects; previous unsuccessful endometrial ablation; myomectomy; uterine reconstruction; long acting hormone therapy within 3 months of enrolment; hyperplasia of the endometrium.

Interventions

All participants were initially treated with 2 weeks of oral contraceptive pills and their randomised treatment followed immediately after withdrawal bleeding.
Rx 1: TCRE + rollerball
Rx 2: Vesta device (inflatable balloon with electrodes)
Duration: 12 months (follow up at 2 weeks, 3, 6 and 12 months)

Outcomes

PBAC scores post Rx
Proportion with amenorrhoea
Proportion with successful Rx (defined as PBAC<76)
Adverse events

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Adequate sequence generation?

Low risk

Computerised random number sequence

Allocation concealment?

Low risk

Sealed individual envelopes

Blinding?
All outcomes

High risk

Unlikely

Incomplete outcome data addressed?
All outcomes

Unclear risk

42/276 (15%) participants lost at assessment of outcomes at 12 months follow up ‐ no reasons given. For assessment of operative outcomes 21/276 participants lost.

Free of selective reporting?

Unclear risk

No prior protocol identified

Free of other bias?

Unclear risk

Funding by medical equipment company that produces one of the interventions and some of the authors received stocks in the company

Corson 2001

Methods

Randomisation: In blocks of 12 stratified by site with a 2:1 ratio,
and stratified into 2 groups by age. Allocation concealment unclear.
Multicentre study (n=9), parallel group design with no blinding.
Number of women randomised: 276
Number of exclusions prior to treatment: 3 (HTA), 4 (balloon).
Number of dropouts/lost to follow up after treatment by 1 year: 17 (HTA) ‐ 7 of these for equipment failure; 2 (balloon).
Power calculation for sample size (276 required, assuming success in rollerball arm 80% and rates not differing by more than 20%, a=0.05, b=.10, dropout rate=12%.
Analyses both intention to treat and per protocol.
Support received from BEI Medical Systems

Participants

276 women aged 30 ‐ 50 years recruited from 9 private practice and university centres in the USA.
Inclusion criteria: 30 ‐ 50 years; family planning complete; documentation of excessive bleeding; uterine cavity measuring </=10.5 cm; history of ineffective, not tolerated or refused medical therapy.
Exclusion criteria: active or symptomatic pelvic inflammatory disease; intramural myomas >4 cm; submucous myomas or polyps.

Interventions

All participants had endometrial biopsy and cervical cytology to exclude pathology and endometrial preparation (single injection of depot leuprolide acetate 7.5 mg on day 21 of cycle) and a pregnancy test.
(1) HTA (Hydro Thermablator
(2) Rollerball ablation
Duration: 1 year

Outcomes

Reduction in menstrual diary blood loss scores; success of treatment (PBAC score <75); amenorrhoea rates; quality of life scores; adverse events; need for further surgery; operative complications; need for analgesia.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Adequate sequence generation?

Low risk

Block randomisation stratified by site

Allocation concealment?

Unclear risk

Not reported

Blinding?
All outcomes

High risk

Unlikely

Incomplete outcome data addressed?
All outcomes

Unclear risk

26/276 (9%) lost at 12 months ‐ unbalanced between groups and no reasons given. Authors claimed intention to treat analyses but not for all randomised participants. Dropouts regarded as failures.

Free of selective reporting?

Unclear risk

No prior published protocol identified

Free of other bias?

Unclear risk

Groups appeared balanced at baseline but funding provided by medical equipment company that produced one of the interventions

Duleba 2003

Methods

Randomisation: sealed envelopes stratified for age at a ratio of 2:1.
Multicentre (10), parallel prospective randomized design with the use of blinding unclear.
Number of women randomized: 279
Number of women analysed: 228 were evaluated at 12 mos follow up.
Power calculation performed and authors did not state Intention to Treat analysis.
Source of funding: Cryogen Inc (Duleba, Soderstrom & Townsend all consultants)

Participants

279 women aged 30 ‐ 50 years (mean EC 41.2(5.1) & RBE 41.1(4.8)) recruited from university and private medical centres in the USA.
Inclusion criteria: menorrhagia due to benign causes, good general health, documented history of excessive uterine bleeding for at least 3 months, failed traditional therapy, did not desire future fertility, PBAC>150
Exclusion criteria: uterine volume greater than 300 ml, uterine cavity sounding more than 10 cm, clotting deficit or bleeding disorders, active pelvic inflammatory disease, abnormal cervical cytology within 1 year; history of gynaecologic malignancy within 5 years, intramural myomas>2 cm, submucous myomas or endometrial polyps; septate uterus; previous endometrial ablation or other surgery in which thinning of uterine wall may occur; malignant pathology or hyperplasia; pregnancy

Interventions

(1) Endometrial Cryoablation (n=193)
(2) Rollerball Electroablation (n=86)

Outcomes

Menstrual diaries 1 cycle before and 12 months after; PBAC, bleeding, pain, mood, PMS; QOL ‐ Dartmouth COOP assessment questionnaire, anaesthesia, adverse outcomes, satisfaction; those randomised to cryoablation had significantly worse menorrhagia.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Adequate sequence generation?

Unclear risk

Method not reported

Allocation concealment?

Unclear risk

Sealed envelopes but no other details of how allocation concealed

Blinding?
All outcomes

High risk

Unlikely

Incomplete outcome data addressed?
All outcomes

Unclear risk

51/279 (18%) dropouts for outcomes measured at 12 months ‐ no reasons given or details on distribution per group

Free of selective reporting?

Unclear risk

No prior published protocol identified

Free of other bias?

Unclear risk

Participants receiving cryoablation had higher PBAC scores at baseline. Authors consultants for the medical equipment company that provided funding for cryoablation

Hawe 2003

Methods

Randomisation: random permutated blocks predetermined by computer generated random number tables (blocks of four sequentially numbered envelopes).
Single centre study, randomised controlled trial with double blinding.
Number of women randomised: 72
Number of women analysed: 71 underwent surgery, 70 were evaluated at 6 mos and 67 were evaluated at 12 months.
Power calculation performed and the authors didn't report Intention to Treat analysis.
Source of funding: not reported but Wallsten Medical supplied the Cavaterm equipment

Participants

72 women aged 29 ‐ 51 years (mean cav 41.4, mean laser 41.1) recruited from a minimal access gynae surgery unit in a district general hospital.
Inclusion criteria: normal endometrial biopsy, no intrauterine pathology; normal uterine cavity (uterine length <12 cm); high on blood loss score (>100); normal cervical cytology; completed family & using contraception
Exclusion criteria: endometrial hyperplasia & malignancy; active pelvic infection & intrauterine pathology

Interventions

(1) Cavatern thermal balloon endometrial ablation (n=37)
(2) Nd :YAG laser (n=35)
Duration: pre op 6 & 12 months for questionnaire; pictorial blood loss assessment 6 months

Outcomes

Primary:amenorrhoea rate then effect on menstrual status; questionnaire assessing menstrual symptoms, QOL, sexual activity; procedure satisfaction & acceptability‐ included questionnaire EQ‐51, SF‐12, SAQ; VAS; pain VAS; operative details & morbidity

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Adequate sequence generation?

Low risk

Random permutated blocks predetermined by computer generated random number tables (blocks of four sequentially numbered envelopes)

Allocation concealment?

Low risk

Sequentially numbered envelopes

Blinding?
All outcomes

Low risk

Participants, nursing staff, GP and assessor of outcomes

Incomplete outcome data addressed?
All outcomes

Low risk

1 participant excluded after randomisation because she didn't meet the inclusion criteria; 4 other participants lost by 12 months ‐ unlikely to affect assessment of outcomes

Free of selective reporting?

Unclear risk

No prior published protocol identified

Free of other bias?

Unclear risk

Groups appeared balanced at baseline except for cavity length but difference unlikely to be clinically significant. A medical equipment company provided one of the interventions.

McClure 1992

Methods

Randomisation: method not stated and allocation concealment not reported.
Single centre study, parallel group design with unclear blinding.
Number of women randomised: 22.
No dropouts reported.
No power calculation for sample size.
Analysis by intention to treat except for duration of surgery (malfunction of laser in 2 cases).
Source of funding not stated.

Participants

38 women initially recruited for trial, mean age 42 years, from tertiary referral centre at University Department, Monash University.
12 excluded prior to randomisation because prior MBL measurements <70ml and 4 dropped out because of dissatisfaction with operative delay.
Inclusion criteria: Subjective diagnosis of menorrhagia unresponsive to medical therapy; normal cervical cytology; MBL>/=70ml (alkaline hematin method).
Exclusion criteria: fibroid enlargement; other intrauterine pathology

Interventions

All participants had pelvic examination and transvaginal ultrasonography. Those randomised also had preoperative treatment with 10 mg MPA 3 times/day for 3 months to thin the endometrium.
(1) Laser (argon) ablation
(2) TCRE + rollerball
Duration: 6 months

Outcomes

Reduction in MBL; duration of surgery; post operative complications and requirement for analgesia; need for further surgery; amenorrhoea rate.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Adequate sequence generation?

Unclear risk

Method not stated

Allocation concealment?

Unclear risk

Not reported

Blinding?
All outcomes

High risk

Unlikely

Incomplete outcome data addressed?
All outcomes

Low risk

No dropouts reported but very small study

Free of selective reporting?

Unclear risk

No prior published protocol identified

Free of other bias?

Low risk

No evidence of other biases. Source of funding not reported and groups appeared balanced at baseline

Meyer 1998

Methods

Randomisation: random numbers table in a 1:1 allocation ratio.
Multicentre (n=14), parallel group, blinding not reported.
Number of women randomised = 275.
Number of women treated =255. Withdrawals/exclusions prior to treatment, n = 20 (15 withdrew before treatment, 4 had exclusion criteria and 1 had a uterine perforation). 239/275 had data at 12 months follow up
Power calculation for sample size performed (108 participants required per group (assuming response rate of 85% for those treated with rollerball) to detect if balloon therapy more than 20% less effective at a 5% level of significance with 90% power).
Analysis not by intention to treat.
Source of funding: Gynecare Ltd, USA.

Participants

275 women aged 29 to 50 years recruited from 12 investigative centres in USA and 2 in Canada.
Inclusion criteria: 30 years or more and premenopausal; normal Pap smears; normal endometrial biopsies within last 6 months; history of 3 months of excessive uterine bleeding (PBAC score >/= 150); ineffective medical therapy; uterine cavity normal (by either hysterosalpingography, hysteroscopy or TSS) and with a range between 4 and 10 cm; no desire for future fertility; willing to continue current contraception.
Exclusion criteria: submucous fibroids; suspected genital tract infection or malignancy; previous endometrial ablation.

Interventions

Rx 1: Rollerball ablation
Rx 2: Balloon ablation (Thermachoice)
Duration: 12 months follow up

Outcomes

Satisfaction rate
Improvement in dysmenorrhoea symptoms
Proportion with PMS after treatment
Inability to work
PBAC score
Complication rate
Duration of surgery
Requirement for additional surgery.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Adequate sequence generation?

Low risk

Random numbers table

Allocation concealment?

Unclear risk

Not reported

Blinding?
All outcomes

Unclear risk

Unlikely

Incomplete outcome data addressed?
All outcomes

Low risk

20/275 (7%) withdrew prior to surgery. 239/275 (87%) provided data at 12 months follow up. Authors compared characteristics of original randomised group with the group that provided 6 and 12 month data and found no differences. Reasons not provided for loss to follow up.

Free of selective reporting?

Unclear risk

No prior published protocol identified

Free of other bias?

Unclear risk

Funding provided by medical equipment company
Onoglu 2007

Methods

Randomisation: order in which seen in the clinic

Single centre study, parallel group, with unclear blinding (except for histopathologist who assessed outcomes not extracted for this review)

Number of women randomised: n=48

Number of women analysed: n=45 (reasons not given for dropouts)

No power calculation for sample size and intention to treat analysis not reported

Source of funding: Akdeniz University

Participants

48 women with average age 48yrs and 47 yrs recruited from hospital clinic in Turkey

Inclusion criteria: women with heavy menstrual bleeding in the absence of physical abnormality

Exclusion criteria: intrauterine disease diagnosed at hysteroscopy (polyps, myomata, adenomyosis)

Interventions

Rx 1: Rollerball

Rx 2: TCRE

Duration: not reported

Outcomes

Duration of surgery

Menstrual blood loss

Notes

Quasi‐randomised trial

Risk of bias

Bias

Authors' judgement

Support for judgement

Adequate sequence generation?

High risk

Participants randomised in order at which seen in the clinic ‐ this has the potential for significant bias

Allocation concealment?

High risk

Not reported but very likely allocation known to investigators

Blinding?
All outcomes

High risk

Unlikely

Incomplete outcome data addressed?
All outcomes

Low risk

3 dropouts ‐ unlikely to affect calculation of estimates

Free of selective reporting?

Unclear risk

No prior published protocol identified

Free of other bias?

Low risk

No evidence of other significant bias ‐ groups appeared balanced at baseline and funding not reported

Pellicano 2002

Methods

Randomisation: Computer generated randomisation sequence.
Single centre, parallel group, blinding not reported.
Number of women randomised: 82
Number of women analysed: 82 for some outcomes such as satisfaction and additional surgery rates (75 at 1yr, 68 at 2 yrs)
Power calculation not reported.
Analysis was not intention to treat.
Source of funding: surgical equipment provided by medical equipment company.

Participants

82 women with mean age 43 yrs recruited from University of Naples Obs and Gyn Department (Italy).
Inclusion criteria:
Aged <50 yrs; weighed <100 kg; not desiring pregnancy; history of >/= 3 months failed medical Rx; evidence of normal endometrial histology/Pap smear within previous 12 months.
Exclusion criteria:
Uterine size >12 weeks pregnancy; submucosal fibroids, adnexal masses or endometriosis; uterovaginal prolapse and severe urinary symptoms; severe intercurrent illness.

Interventions

(1) Cavaterm balloon ablation
(2) Transcervical endometrial resection (after pre Rx with 2 months of GnRHa)
Duration: 3 months, 1 year and 2 years follow‐up

Outcomes

Primary: satisfaction rate at 3 months, 1 yr and 2 yrs.
Secondary:
Duration of surgery; intraoperative blood loss; requirement for further surgery; postoperative pain; hospital stay; complications; resumption of normal activity

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Adequate sequence generation?

Low risk

Computer generated

Allocation concealment?

Unclear risk

Not reported

Blinding?
All outcomes

High risk

Unlikely

Incomplete outcome data addressed?
All outcomes

Unclear risk

Assessment of some outcomes such as requirement for further surgery and satisfaction included all randomised participants. 8.5% had dropped out for assessment of year 1 outcomes; 17% had dropped out for assessment of year 2 outcomes. No reasons given.

Free of selective reporting?

Unclear risk

No prior published protocol identified

Free of other bias?

Unclear risk

Groups appeared balanced at baseline; funding by medical equipment company
Perino 2004

Methods

Randomisation: Computer generated list.
Single centre, parallel group design, blinding not reported but unlikely.
No randomised: 116
No analysed: 111
Power calculation for sample size.
No intention to treat analysis performed.
Source of funding not mentioned.

Participants

116 women with age range 36 to 48 years (mean, 41‐42) recruited from university clinic in Italy.
Inclusion criteria:
dysfunctional uterine bleeding not associated with organic pathology and not responding to medical treatment.
Exclusion criteria: not reported.

Interventions

(1) ELITT (endometrial laser intrauterine thermal therapy)
(2) TCRE
All women had investigations prior to treatment: ultrasound, hysteroscopy with endometrial biopsy, blood tests for clotting defects, FSH/E2 serum sampling. All had pre‐treatment with 1 dose of GnRHa.

Outcomes

Primary:
Amenorrhoea and other menstrual status; satisfaction rates.
Secondary:
Intraoperative complication rate, operation time, pain; further treatment with hysterectomy

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Adequate sequence generation?

Low risk

Computer generated

Allocation concealment?

Unclear risk

Not reported

Blinding?
All outcomes

High risk

Unlikely

Incomplete outcome data addressed?
All outcomes

Low risk

5/116 (4%) dropped out and no reasons given, but proportion was balanced between randomised groups

Free of selective reporting?

Unclear risk

No prior published protocol identified

Free of other bias?

Low risk

Groups appeared balanced at baseline but characteristics only reported for 96% of those randomised (minimal dropout). No source of funding reported. No evidence of significant other bias.

Romer 1998

Methods

Randomisation: Method not stated.
Single centre, parallel group, blinding not reported.
Number of women randomised = 20
Number of dropouts/lost to follow up: none reported.
No power calculation for sample size reported.
Analysis by intention to treat (no dropouts).
Source of funding not reported.

Participants

20 women aged 35 to 52 recruited.
Inclusion criteria: recurrent menorrhagia not responsive to medical therapy; no desire for future fertility.
Exclusion criteria: intrauterine abnormality; fibroids; hyperplasia.

Interventions

All women were pre‐treated with 2 injections (4 weeks apart) of leuprorelin acetate depot. Treatment followed 2 weeks after the last injection.
Rx 1: Rollerball ablation
Rx 2: Cavaterm balloon ablation.
Duration: Follow up of 9 ‐ 15 months.

Outcomes

Satisfaction rate
Amenorrhoea or hypomenorrhoea rate

Notes

Paper in German language. Author contacted for clarification but no reply received.

Risk of bias

Bias

Authors' judgement

Support for judgement

Adequate sequence generation?

Unclear risk

Not reported

Allocation concealment?

Unclear risk

Not reported

Blinding?
All outcomes

High risk

Unlikely

Incomplete outcome data addressed?
All outcomes

Low risk

No dropouts reported but very small study

Free of selective reporting?

Unclear risk

No prior published protocol identified

Free of other bias?

Low risk

Groups appear balanced at baseline. No source of funding reported. No evidence of other significant bias

Soysal 2001

Methods

Randomisation: computer generated, numbered opaque sealed envelopes.
Single centre, prospective randomised design, unclear if blinding used.
Number of women randomised: 96
Number of women analysed: 93 had treatments, 3 lost to follow up (no reason given).
No power calculation was mentioned and authors did not report intention to treat analysis.
Source of funding: not reported.

Participants

96 women aged 40 ‐ 49 years (mean TBA 43.6, mean RBA 44.3) recruited from the Teaching Dept of University Medical Centre.
Inclusion criteria: myoma‐induced menorrhagia; completion of childbearing; =40 years; menorrhagia documented by PBAC>150; myomatous uterus ding by high resolution ultrasound, a volume of =12‐week; pregnancy at clinical evaluation and/or =380 ml at ultrasonography or a myoma <5 cm diameter
Exclusion criteria: active pelvic inflammatory disease; submucous myoma = 3 cm diameter or with <50% intramural extension

Interventions

(1) Rollerball Ablation (n=48)
(2) Thermal Balloon Ablation (n=45, 3 lost post randomisation)
Duration: PBAC pre op 3, 6, 12 months, hemoglobin pre op & 12 months

Outcomes

Operating time; intraoperative complications; post op pain; eumenorrhea & PBAC = 75 / satisfaction / hysterectomy

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Adequate sequence generation?

Low risk

Computer generated

Allocation concealment?

Low risk

Numbered opaque sealed envelopes

Blinding?
All outcomes

High risk

Unlikely

Incomplete outcome data addressed?
All outcomes

Low risk

3/96 (3%) lost prior to surgery but no further loss to follow up ‐ unlikely to affect the assessment of estimates

Free of selective reporting?

Unclear risk

No prior published protocol identified

Free of other bias?

Unclear risk

No source of funding identified. Groups appeared balanced at baseline but denominators for some outcomes in the publication did not correspond to the numbers of participants allocated to treatment

van Zon‐Rabelink2003

Methods

Randomisation: allocated to treatment at random by blind envelope.
Single centre, randomized controlled trial, use of blinding is unclear.
Number of women randomized: 139
Number of women analysed: 139 (none lost to follow up).
Power Calculation was performed and authors did not state Intention to Treat analysis.
Source of funding: not reported.

Participants

139 women with unreported ages recruited from a teaching hospital, in the Netherlands.
Inclusion criteria: menorrhagia without sufficient relief from medical therapy by GP; menstrual blood loss score = 185 pt in 2 periods due to dysfunctional uterine bleeding according to ultrasound & diagnostic hysteroscopy
Exclusion criteria: not reported

Interventions

(1) RBE Hysteroscopic Rollerball Electrocoagulation (n=62)
(2) UBT Non‐hysteroscopic Uterine Balloon Thermal Ablation ThermachoiceTM (n=77)

Outcomes

Technical safety aspects; reduction in menstrual bleeding; not much outcome data ‐ menstrual bleeding data not reported in this paper

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Adequate sequence generation?

Unclear risk

Method not reported

Allocation concealment?

Unclear risk

Not reported

Blinding?
All outcomes

High risk

Unlikely

Incomplete outcome data addressed?
All outcomes

Low risk

No dropouts reported

Free of selective reporting?

Unclear risk

No prior published protocol identified

Free of other bias?

Unclear risk

Groups appeared balanced at baseline but only for age and cavity length; other characteristics not reported. No source of funding identified. Numbers in the randomised groups differed substantially.

Vercellini 1999

Methods

R: Computer generated randomisation sequence using serially numbered opaque sealed envelopes kept by an independent source.
Single centre, parallel group, no blinding.
Number of women randomised = 91
Number of dropouts/lost to follow up = 1
Power calculation for sample size performed (40 women per treatment arm required to find a difference of 200 mL in fluid absorption with 80% power and 5% significance level).
Intention to treat analysis for satisfaction rate and menstrual pattern.
Source of funding = Circum Acmi (supply of vaporising electrodes).

Participants

91 women with mean age 46 years recruited from outpatient clinic in Milan, Italy.
Inclusion criteria: >35 years; referred for hysterectomy; uterine volume < 12 week pregnancy; normal uterine cavity at hysteroscopy; no evidence of atypical hyperplasia; no adnexal tumours on clinical and ultrasonographic examination.
Exclusion criteria: women uncertain about future children; recent use of hormonal agents or drugs that might affect menstrual blood loss; intramural or subserous fibroids of >/= 3 cm; "unstable" general conditions.

Interventions

All participants had complete clinical examination, transvaginal ultrasonography, diagnostic hysteroscopy and endometrial biopsy prior to treatment. They also had preoperative treatment with depot GnRH agonist triptorelin for 2 months.
Rx 1: Vaporising electrode
Rx 2: TCRE
Duration: 12 months

Outcomes

Amount of absorption of distension fluid
Duration of surgery
Difficulty of surgery
Satisfaction rate
Proportion with amenorrhoea
Proportion with amenorrhoea and hypomenorrhoea
PBAC score

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Adequate sequence generation?

Low risk

Computer generated

Allocation concealment?

Low risk

Serially numbered opaque sealed envelopes kept secure in another location

Blinding?
All outcomes

High risk

Open study

Incomplete outcome data addressed?
All outcomes

Low risk

Immediate postoperative outcomes included all randomised participants; for outcomes assessed at 1 year, one woman was lost to follow up and did not contribute data to the PBAC

Free of selective reporting?

Unclear risk

No prior published protocol identified

Free of other bias?

Unclear risk

Groups were balanced at baseline but a medical equipment company provided funding

Characteristics of excluded studies [ordered by study ID]

Ir a:

Study

Reason for exclusion

Vihko 2003

Was excluded as it compared two types of balloon ablation, Menotreat and Cavaterm.

Characteristics of studies awaiting assessment [ordered by study ID]

Ir a:

Chang 2009

Methods

RCT

Participants

Interventions

Outcomes

Notes
Feng 2006

Methods

Not clear whether randomised

Participants

No details provided

Interventions

1) Thermablate EAS uterine balloon therapy, 2) transcervical resection of the endometrium (TCRE)

Outcomes

Complications, menstrual blood loss, pain scores, dysmenorrhoea

Notes
Hamza 2005

Methods

Not clear whether randomised

Participants

Participants had dysfunctional uterine bleeding

Interventions

1) rollerball ablation, 2) TCRE

Outcomes

Complications, menstrual blood loss

Notes
Kleijn 2007

Methods

RCT

Participants

Interventions

Outcomes

Notes
Sambrook 2009

Methods

RCT

Participants

Interventions

Outcomes

Notes
Sambrook 2009b

Methods

RCT

Participants

Interventions

Outcomes

Notes

Data and analyses

Open in table viewer
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
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 1 Amenorrhoea rate.

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

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

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
Analysis 1.3

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

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 3 MBL at 6 months (descriptive 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]
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 4 Participant satisfaction at 12 months (very/moderately).

5 Duration of operation (mins) Show forest plot

2

386

Mean Difference (IV, Fixed, 95% CI)

9.15 [7.21, 11.09]
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 5 Duration of operation (mins).

6 Operative difficulties (%) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only
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 6 Operative difficulties (%).

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]
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 7 Good general health (proportion of women).

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]
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 8 Improvement in symptoms (proportion of women).

9 Improvement in dysmenorrhea Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only
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 9 Improvement in dysmenorrhea.

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
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 10 Complication rate (proportion of women).

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

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

Open in table viewer
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]
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 1 Amenorrhoea rate at 12 months follow up.

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]
Analysis 2.2
Comparison 2 VAPORISING ELECTRODE ABLATION (1st G) versus TCRE (1st G), Outcome 2 Amenorrhea/hypomenorrhoea 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.

3 PBAC score at 12 mths Show forest plot

Other data

No numeric data
Analysis 2.3

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.

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

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]
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 4 Satisfaction rate at 12 mths (very/moderately).

5 Duration of operation (mins) Show forest plot

1

91

Mean Difference (IV, Fixed, 95% CI)

‐1.50 [‐2.65, ‐0.35]
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 5 Duration of operation (mins).

6 Operative difficulties Show forest plot

1

91

Odds Ratio (M‐H, Fixed, 95% CI)

0.22 [0.07, 0.75]
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 6 Operative difficulties.

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

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

Open in table viewer
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]
Analysis 3.1
Comparison 3 ROLLERBALL (1st G) versus TCRE (1st G), Outcome 1 Duration of operation (mins).

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

2 Duration of operation (descriptive data) Show forest plot

Other data

No numeric data
Analysis 3.2

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

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

3 Complication rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only
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 3 Complication rate.

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
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 4 Requirement for further surgery (hyst or ablation).

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

Comparison 3 ROLLERBALL (1st G) versus TCRE (1st G), Outcome 5 Requirement for further surgery rate (hyst 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]
Open in table viewer
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
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 1 Amenorrhoea rate.

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
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 2 Satisfaction rate.

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]
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 3 Duration of operation.

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]
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 4 Pain score at 12 hrs after surgery (VAS: 1‐10).

5 Intraoperative complication rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only
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 5 Intraoperative complication rate.

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

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

6.1 2 to 5 years follow up

1

111

Odds Ratio (M‐H, Fixed, 95% CI)

0.57 [0.13, 2.49]
Open in table viewer
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
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 1 Amenorrhoea rate.

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]
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 2 PBAC </= 75.

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
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 3 Proportion with "normal" bleeding (PBAC </= 100).

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]
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 4 Satisfaction rate.

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]
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 5 Proportion having local anaesthesia (%).

6 Intraoperative complication rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only
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 6 Intraoperative complication rate.

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
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 7 Postoperative complication rate.

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
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 8 Requirement for further surgery (any surgery).

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

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

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]
Open in table viewer
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]
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 1 Amenorrhoea rate.

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
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 2 Satisfaction rate.

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]
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 3 Proportion having local anaesthesia (%).

4 Intraoperative complication rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only
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 4 Intraoperative complication rate.

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]
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 5 Requirement for further surgery (any surgery).

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

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

6.1 At 2 years follow up

1

279

Odds Ratio (M‐H, Fixed, 95% CI)

0.82 [0.31, 2.12]
Open in table viewer
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]
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 1 Amenorrhea rate at 1 yr follow up.

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

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

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
Analysis 7.3

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

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

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]
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 4 Proportion satisfied with treatment at 1 year.

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]
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 5 Duration of operation (mins).

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]
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 6 Proportion having local anaesthesia (%).

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
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 7 Intraoperative complication rate.

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
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 8 Postoperative complication rate.

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

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]
Open in table viewer
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
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 1 Amenorrhea rate.

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]
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 2 Success of treatment (PBAC<75).

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

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

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
Analysis 8.4

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

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

5 Operative difficulties Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only
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 5 Operative difficulties.

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

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

7 Duration of hospital stay (hours) Show forest plot

Other data

No numeric data
Analysis 8.7

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

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

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

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

9 Change in SF36 score after treatment Show forest plot

Other data

No numeric data
Analysis 8.9

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

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

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
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 10 Improvement in symptoms.

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
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 11 Improvement in dysmenorrhoea.

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]
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 12 Postoperative analgesia rate.

13 Intraoperative complication rate Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only
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 13 Intraoperative complication rate.

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
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 14 Postoperative complication rate (wihin 24 hours).

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
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 15 Requirement for further surgery (any surgery).

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

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 16 Requirement for further surgery rate (hyst 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]
Open in table viewer
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
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 1 Amenorrhea rate.

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

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

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
Analysis 9.3

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

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

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
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 4 Success of treatment (lighter periods and no further surgery).

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]
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 5 Success of treatment (PBAC<75).

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
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 6 Success of treatment (menstrual score <185).

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
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 7 Satisfaction rate.

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]
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 8 Duration of operation (mins).

9 Operative difficulties Show forest plot

1

139

Odds Ratio (M‐H, Fixed, 95% CI)

1.06 [0.43, 2.60]
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 9 Operative difficulties.

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
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 10 Inability to work (proportion of women).

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]
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 11 Improvement in dysmenorrhea at 12 months.

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

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only
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 12 Improvement in premenstrual symptoms (from moderate/severe).

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
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 13 Complication rate (proportion of women).

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
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 14 Requirement for further surgery (any surgery).

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
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 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 15 Requirement for further surgery (hyst 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]
Open in table viewer
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
Analysis 10.1
Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 1 Amenorrhoea rate.

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

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
Analysis 10.2

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

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

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
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 3 Satisfaction rate.

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]
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 4 Operative difficulties.

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
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 5 Euroquol 5D.

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
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 6 Euroquol 5D VAS.

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
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 7 SF12 Physical Scale.

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
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 8 SF12 Mental Scale.

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
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 9 SAQ pleasure scale.

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
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 10 SAQ habit scale.

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

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

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
Analysis 10.12

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

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

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
Analysis 10.13

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

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

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]
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 14 Pain score.

15 Requirement for further surgery Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only
Analysis 10.15
Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 15 Requirement for further surgery.

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

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]
Open in table viewer
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
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 1 Amenorrhoea rate.

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
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 2 Satisfaction rate.

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

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

4 Duration of operation (mins) Show forest plot

Other data

No numeric data
Analysis 11.4

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

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

5 Operative difficulties Show forest plot

1

51

Odds Ratio (M‐H, Fixed, 95% CI)

8.51 [0.44, 162.89]
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 5 Operative difficulties.

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

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

7 Duration of hospital stay (hours) Show forest plot

Other data

No numeric data
Analysis 11.7

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

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

8 Return to normal activities (days) Show forest plot

1

82

Mean Difference (IV, Fixed, 95% CI)

‐2.10 [‐3.38, ‐0.82]
Analysis 11.8
Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 8 Return to normal activities (days).

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

9 Return to normal activities (days) Show forest plot

Other data

No numeric data
Analysis 11.9

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

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

10 Intraoperative complications (continuous data) Show forest plot

1

82

Mean Difference (IV, Fixed, 95% CI)

‐81.8 [‐93.33, ‐70.27]
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 10 Intraoperative complications (continuous data).

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
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 11 Intraoperative complications (dichotomous data).

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

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

13 Postoperative pain (descriptive data) Show forest plot

Other data

No numeric data
Analysis 11.13

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

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

14 Postoperative complications Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only
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 14 Postoperative complications.

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
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 15 Requirement for further surgery.

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

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

16.1 At 12 months follow up

1

45

Odds Ratio (M‐H, Fixed, 95% CI)

0.11 [0.00, 2.41]
Open in table viewer
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
Analysis 12.1
Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 1 Amenorrhoea rate.

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

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
Analysis 12.2

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

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

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

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

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
Analysis 12.4

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

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

5 Operative difficulties Show forest plot

1

55

Odds Ratio (M‐H, Fixed, 95% CI)

0.71 [0.11, 4.65]
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 5 Operative difficulties.

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]
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 6 SF12 physical score.

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]
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 7 SF12 mental score.

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
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 8 SF‐36 Physical function score.

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
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 9 SF‐36 Role physical.

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
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 10 SF‐36 Role emotional.

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
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 11 SF‐36 Social functioning.

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
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 12 SF‐36 Mental health.

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
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 13 SF‐36 Energy/vitality.

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
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 14 SF‐36 Pain.

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
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 15 SF‐36 General health.

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
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 16 RSCL Physical symptoms.

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
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 17 RSCL Psychological distress.

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
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 18 RSCL Activity level.

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
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 19 RSCL Overall quality of life.

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
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 20 SDS Depression.

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

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

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
Analysis 12.22

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

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

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
Analysis 12.23

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

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

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
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 24 Requirement for further surgery (ablation or hyst).

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

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 25 Requirement for further surgery (hyst 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]
Open in table viewer
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
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 1 Amenorrhoea rate.

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
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 2 Satisfaction rate.

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
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 3 Operative difficulties.

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]
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 4 Duration of operation (mins).

5 Proportion having local anaesthesia (%) Show forest plot

6

1434

Odds Ratio (M‐H, Random, 95% CI)

6.40 [2.99, 13.68]
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 5 Proportion having local anaesthesia (%).

6 Inability to work Show forest plot

2

479

Odds Ratio (M‐H, Random, 95% CI)

0.83 [0.29, 2.40]
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 6 Inability to work.

7 Operative or postoperative complication rate Show forest plot

11

Odds Ratio (M‐H, Random, 95% CI)

Subtotals only
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 7 Operative or postoperative complication rate.

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
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 8 Requirement for any additional surgery.

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

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

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
Figuras y tablas -
Figure 1

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 1 Amenorrhoea rate.
Figuras y tablas -
Analysis 1.1

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 2 Amenorrhoea/hypomenorrhoea rate.
Figuras y tablas -
Analysis 1.2

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

Figuras y tablas -
Analysis 1.3

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

Ir a la figura de la revisión

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 5 Duration of operation (mins).
Figuras y tablas -
Analysis 1.5

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 6 Operative difficulties (%).
Figuras y tablas -
Analysis 1.6

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 7 Good general health (proportion of women).
Figuras y tablas -
Analysis 1.7

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 8 Improvement in symptoms (proportion of women).
Figuras y tablas -
Analysis 1.8

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 9 Improvement in dysmenorrhea.
Figuras y tablas -
Analysis 1.9

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 LASER ABLATION (1st G) versus TCRE (1st G), Outcome 10 Complication rate (proportion of women).
Figuras y tablas -
Analysis 1.10

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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.

Figuras y tablas -
Analysis 2.3

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

Ir a la figura de la revisión

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 2 VAPORISING ELECTRODE ABLATION (1st G) versus TCRE (1st G), Outcome 5 Duration of operation (mins).
Figuras y tablas -
Analysis 2.5

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 2 VAPORISING ELECTRODE ABLATION (1st G) versus TCRE (1st G), Outcome 6 Operative difficulties.
Figuras y tablas -
Analysis 2.6

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 3 ROLLERBALL (1st G) versus TCRE (1st G), Outcome 1 Duration of operation (mins).
Figuras y tablas -
Analysis 3.1

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

Figuras y tablas -
Analysis 3.2

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

Ir a la figura de la revisión

Comparison 3 ROLLERBALL (1st G) versus TCRE (1st G), Outcome 3 Complication rate.
Figuras y tablas -
Analysis 3.3

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 4 THERMAL LASER (2nd G) versus TCRE (1st G), Outcome 1 Amenorrhoea rate.
Figuras y tablas -
Analysis 4.1

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 4 THERMAL LASER (2nd G) versus TCRE (1st G), Outcome 2 Satisfaction rate.
Figuras y tablas -
Analysis 4.2

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 4 THERMAL LASER (2nd G) versus TCRE (1st G), Outcome 3 Duration of operation.
Figuras y tablas -
Analysis 4.3

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 4 THERMAL LASER (2nd G) versus TCRE (1st G), Outcome 5 Intraoperative complication rate.
Figuras y tablas -
Analysis 4.5

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 1 Amenorrhoea rate.
Figuras y tablas -
Analysis 5.1

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 4 Satisfaction rate.
Figuras y tablas -
Analysis 5.4

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 6 Intraoperative complication rate.
Figuras y tablas -
Analysis 5.6

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 5 HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 7 Postoperative complication rate.
Figuras y tablas -
Analysis 5.7

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 6 CRYOABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 1 Amenorrhoea rate.
Figuras y tablas -
Analysis 6.1

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 6 CRYOABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 2 Satisfaction rate.
Figuras y tablas -
Analysis 6.2

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 6 CRYOABLATION (2nd G) versus ROLLERBALL (1st G), Outcome 4 Intraoperative complication rate.
Figuras y tablas -
Analysis 6.4

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

Figuras y tablas -
Analysis 7.3

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

Ir a la figura de la revisión

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 8 MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G), Outcome 1 Amenorrhea rate.
Figuras y tablas -
Analysis 8.1

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

Figuras y tablas -
Analysis 8.4

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

Ir a la figura de la revisión

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

Figuras y tablas -
Analysis 8.7

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

Ir a la figura de la revisión

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

Figuras y tablas -
Analysis 8.9

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

Ir a la figura de la revisión

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 1 Amenorrhea rate.
Figuras y tablas -
Analysis 9.1

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

Figuras y tablas -
Analysis 9.3

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

Ir a la figura de la revisión

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 7 Satisfaction rate.
Figuras y tablas -
Analysis 9.7

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 9 BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G), Outcome 9 Operative difficulties.
Figuras y tablas -
Analysis 9.9

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 1 Amenorrhoea rate.
Figuras y tablas -
Analysis 10.1

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

Figuras y tablas -
Analysis 10.2

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

Ir a la figura de la revisión

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 3 Satisfaction rate.
Figuras y tablas -
Analysis 10.3

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 4 Operative difficulties.
Figuras y tablas -
Analysis 10.4

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 5 Euroquol 5D.
Figuras y tablas -
Analysis 10.5

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 6 Euroquol 5D VAS.
Figuras y tablas -
Analysis 10.6

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 7 SF12 Physical Scale.
Figuras y tablas -
Analysis 10.7

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 8 SF12 Mental Scale.
Figuras y tablas -
Analysis 10.8

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 9 SAQ pleasure scale.
Figuras y tablas -
Analysis 10.9

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 10 SAQ habit scale.
Figuras y tablas -
Analysis 10.10

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 11 SAQ discomfort scale.
Figuras y tablas -
Analysis 10.11

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

Figuras y tablas -
Analysis 10.12

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

Ir a la figura de la revisión

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

Figuras y tablas -
Analysis 10.13

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

Ir a la figura de la revisión

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 14 Pain score.
Figuras y tablas -
Analysis 10.14

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 10 BALLOON (2nd G) versus LASER (1st G), Outcome 15 Requirement for further surgery.
Figuras y tablas -
Analysis 10.15

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 1 Amenorrhoea rate.
Figuras y tablas -
Analysis 11.1

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 2 Satisfaction rate.
Figuras y tablas -
Analysis 11.2

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 3 Duration of operation (mins).
Figuras y tablas -
Analysis 11.3

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

Figuras y tablas -
Analysis 11.4

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

Ir a la figura de la revisión

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 5 Operative difficulties.
Figuras y tablas -
Analysis 11.5

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 6 Hospital stay (days).
Figuras y tablas -
Analysis 11.6

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

Figuras y tablas -
Analysis 11.7

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

Ir a la figura de la revisión

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

Figuras y tablas -
Analysis 11.9

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

Ir a la figura de la revisión

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 10 Intraoperative complications (continuous data).
Figuras y tablas -
Analysis 11.10

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 11 Intraoperative complications (dichotomous data).
Figuras y tablas -
Analysis 11.11

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 12 Postoperative pain (continuous data).
Figuras y tablas -
Analysis 11.12

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

Figuras y tablas -
Analysis 11.13

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

Ir a la figura de la revisión

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 14 Postoperative complications.
Figuras y tablas -
Analysis 11.14

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 11 BALLOON (2nd G) versus TCRE (1st G), Outcome 15 Requirement for further surgery.
Figuras y tablas -
Analysis 11.15

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 1 Amenorrhoea rate.
Figuras y tablas -
Analysis 12.1

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

Figuras y tablas -
Analysis 12.2

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

Ir a la figura de la revisión

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 3 Satisfaction rate.
Figuras y tablas -
Analysis 12.3

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

Figuras y tablas -
Analysis 12.4

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

Ir a la figura de la revisión

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 5 Operative difficulties.
Figuras y tablas -
Analysis 12.5

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 6 SF12 physical score.
Figuras y tablas -
Analysis 12.6

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 7 SF12 mental score.
Figuras y tablas -
Analysis 12.7

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 12 SF‐36 Mental health.
Figuras y tablas -
Analysis 12.12

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 14 SF‐36 Pain.
Figuras y tablas -
Analysis 12.14

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 16 RSCL Physical symptoms.
Figuras y tablas -
Analysis 12.16

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 17 RSCL Psychological distress.
Figuras y tablas -
Analysis 12.17

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 18 RSCL Activity level.
Figuras y tablas -
Analysis 12.18

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 20 SDS Depression.
Figuras y tablas -
Analysis 12.20

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 12 BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G), Outcome 21 Dysmenorrhoea rate.
Figuras y tablas -
Analysis 12.21

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

Figuras y tablas -
Analysis 12.22

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

Ir a la figura de la revisión

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

Figuras y tablas -
Analysis 12.23

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

Ir a la figura de la revisión

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 1 Amenorrhoea rate.
Figuras y tablas -
Analysis 13.1

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 2 Satisfaction rate.
Figuras y tablas -
Analysis 13.2

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 3 Operative difficulties.
Figuras y tablas -
Analysis 13.3

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 6 Inability to work.
Figuras y tablas -
Analysis 13.6

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 7 Operative or postoperative complication rate.
Figuras y tablas -
Analysis 13.7

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 13 Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION, Outcome 8 Requirement for any additional surgery.
Figuras y tablas -
Analysis 13.8

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

Ir a la figura de la revisiónAbrir en una pestaña nueva

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

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

Ir a la figura de la revisiónAbrir en una pestaña nueva
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
Figuras y tablas -
Table 1. Risk of bias features of included studies
Ir a la tabla de la revisión
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.

Figuras y tablas -
Table 2. Summary of findings table: 2nd generation versus 1st generation ablation
Ir a la tabla de la revisión
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]
Figuras y tablas -
Comparison 1. LASER ABLATION (1st G) versus TCRE (1st G)
Ir a la tabla de la revisión
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]
Figuras y tablas -
Comparison 2. VAPORISING ELECTRODE ABLATION (1st G) versus TCRE (1st G)
Ir a la tabla de la revisión
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]
Figuras y tablas -
Comparison 3. ROLLERBALL (1st G) versus TCRE (1st G)
Ir a la tabla de la revisión
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]
Figuras y tablas -
Comparison 4. THERMAL LASER (2nd G) versus TCRE (1st G)
Ir a la tabla de la revisión
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]
Figuras y tablas -
Comparison 5. HYDROTHERMAL ABLATION (2nd G) versus ROLLERBALL (1st G)
Ir a la tabla de la revisión
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]
Figuras y tablas -
Comparison 6. CRYOABLATION (2nd G) versus ROLLERBALL (1st G)
Ir a la tabla de la revisión
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]
Figuras y tablas -
Comparison 7. ELECTRODE ABLATION (2nd G) versus TCRE + ROLLERBALL (1st G)
Ir a la tabla de la revisión
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]
Figuras y tablas -
Comparison 8. MICROWAVE ABLATION (2nd G) versus TCRE + RB(1st G)
Ir a la tabla de la revisión
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]
Figuras y tablas -
Comparison 9. BALLOON ENDOMETRIAL ABLATION (2nd G) versus ROLLERBALL ENDOMETRIAL ABLATION (1st G)
Ir a la tabla de la revisión
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]
Figuras y tablas -
Comparison 10. BALLOON (2nd G) versus LASER (1st G)
Ir a la tabla de la revisión
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]
Figuras y tablas -
Comparison 11. BALLOON (2nd G) versus TCRE (1st G)
Ir a la tabla de la revisión
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]
Figuras y tablas -
Comparison 12. BIPOLAR RF (2nd G) versus BALLOON ABLATION (2nd G)
Ir a la tabla de la revisión
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]
Figuras y tablas -
Comparison 13. Overall analyses: SECOND GENERATION ENDOMETRIAL ABLATION VS FIRST GENERATION ENDOMETRIAL ABLATION
Ir a la tabla de la revisión