Background
CONDITION AND TARGET POPULATION Abnormal uterine bleeding is defined as an increase in the frequency of menstruation, duration of flow or amount of blood loss. (1) DUB is a diagnosis of exclusion when there is no pelvic pathology or underlying medical cause for the increased bleeding. (1) It is characterized by heavy prolonged flow with or without breakthrough bleeding. It may occur as frequent, irregular, or unpredictable bleeding; lengthy menstrual periods; bleeding between periods; or a heavy flow during periods. Menorrhagia, cyclical HMB over several consecutive cycles during the reproductive years, is the most frequent form of DUB. The incidence of DUB has not been reported in the literature. For Ontario, an expert estimated that about 15% to 20% of women over 30 years have DUB. The prevalence increases with age and peaks just before menopause. (1) Using 2001 Ontario census-based population estimates, there are about 2 million women between the ages of 30 and 49 years; therefore, of these, about 290,965 to 387,953 may have DUB. The technology being reviewed: THERMAL BALLOON ENDOMETRIAL ABLATION Since the 1990s, second-generation endometrial ablation (EA) techniques developed, the
Conclusions
TBEA is effective, safe, and cost-effective for patients with DUB.For women who are not worried about amenorrhea, first-generation techniques offer advantages over hysterectomy.TBEA is a better alternative to first-generation techniques for DUB, because it is associated with fewer intraoperative adverse effects.