Hysterectomy vs. endometrial ablation for bleeding

Hysterectomy is more effective than endometrial ablation for arresting dysfunctional uterine bleeding without any additional intervention. But it's also associated with more adverse events. This according to the STOP-DUB (Surgical Treatments Outcomes Project for Dysfunctional Uterine Bleeding) study, a randomized controlled trial.

Researchers followed 237 women, most younger than 45 years. At 24 months, endometrial ablation was slightly less effective than hysterectomy (84.9% vs. 94.4%) at solving the problem that led the women to seek care, and by 48 months, one third of the women initially receiving endometrial ablation required reoperation.

On the flip side, almost four times as many adverse events were reported in the group of women receiving hysterectomy as there were in the group of women receiving endometrial ablation, and there were almost six times as many postoperative infections.

Dickersin K, Munro MG, Clark M, et al. Hysterectomy compared with endometrial ablation for dysfunctional uterine bleeding: a randomized controlled trial. Obstet Gynecol. 2007;110:1279-1289.