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Menopause. 2011 Apr;18(4):445-52. doi: 10.1097/gme.0b013e31820786f1.

The Surgical Treatments Outcomes Project for Dysfunctional Uterine Bleeding: summary of an Agency for Health Research and Quality-sponsored randomized trial of endometrial ablation versus hysterectomy for women with heavy menstrual bleeding.

Collaborators (247)

Dickersin K, Clark M, Cesnick CB, Martino A, Verma A, Anderson TD, Bayha S, Bernick E, Cook BC, Craig C, Dickenson AM, Giustozzi AA, Kelley SB, Li LC, Liu J, Lurye O, Ma F, Neaman JA, Pop P, Tout-Vincenty B, Walker J, Wieland LS, Wu N, Yu Z, Zhu J, Zhu Q, Langenberg P, Scherer RW, Fredman L, Kjerulff K, Scott J, Arida AU, Blatt L, Crawley BE, Perlmutter D, Evans C, Habeeb H, Hornbeck PC, Kelm HV, Lemaire GS, McCarter RJ, Mitchell KA, Pressley R, Reynolds MW, Shaffer C, Stepanian C, Waring M, Frick K, Steinwachs D, Munro M, Schnitker P, Clinic C, Weber A, Nichols J, Hale R, Larkins C, Sharp M, Hubbard H, Meikle S, Sayegh RA, Weiss RM, Epstein N, Vragovic O, Clinic C, Weber AM, Bradley LD, Falcone T, Hugney CM, Manganiello PD, Blanchette-Porter M, Mahlab BE, Hallock L, Soho SK, Shackelford D, Hayslip C, Stokes B, Tucker J, Nichols JE, Mills BB, Smith JD, Meyers C, Allen S, Stuber H, Mayberry IJ, Peters AJ, Lucente V, Glazerman L, Sheinberg M, Sobolewski C, Benham BN, DeFulvio JD, Greybush MT, McDermott AM, McIntyre PE, Sagullo CC, Sarma BA, Sokolowski M, Wiltchik KS, Druckenmiller J, Haff R, Hunsicker KD, Johnson LB, Curtis MG, Rogers C, Guido R, Portman MA, McQueen M, Cohen SA, Stovall D, Gregory C, Walsh B, Kerrigan SL, Soper DE, Hirschmann S, LeBoeuf F, Siegel F, Eckhart K, Irons S, Miller D, Lowe E, Kaufmann L, Antonio S, Sadler K, Saidi MH, Compton L, Hiller K, Montgomery H, Goldstein L, Myslow J, Chen BH, Brodzinsky L, Johnson BD, Ekdale MA, Ionel OA, Rahman SS, Volker WK, Hazen J, Litt RL, Kelly-Layton T, Donnelly K, Phyfer T, Yi L, Zetoony M, Rogers N, Purdon T, Jernigan B, Reiter R, Rogers D, Wellman B, Rice VM, Richardson M, Dressler M, Karst A, Boroditsky RS, Bernier MJ, Burnett MA, Gertenstein RT, Logan AC, Casiro ME, Whitted RW, Pietro PA, Byrne MR, Meeks G, Rivlin ME, Johnson V, Robinette LD, Wild RA, Crouse EA, Gazzaniga CA, Miles PS, Osburn JT, Puckett TG, Van Nostrand K, Goff DW, Chandler L, Liles E, Pedroja M, Snyder RR, Breitkopf DM, Enriquez L, Uckan EM, Yalcinkaya T, Heywood SG, Gilbert K, Khan F, Musgrave C, Seckman J, Dacey A, Peipert JF, Boardman L, Ferland RJ, Frishman G, DeMartino J, Cooper A, Corey P, Meers A, Montagno A, Love BR, McCorvey R, Frazier V, Norman B, Robinson M, Bornt M, Robinson L, Drolet J, Grim TP, Jackson J, Rutherford EA, Thomas MA, Unwin WM, Brodisch CS, Gallagher J, Nixon KA, Shirker AL, Siegel FM, Wright DS, Musser J, Munro M, Dickersin K, Baruch M, Hubbard H, Kjerulff K, Langenberg P, Meers A, Nichols J, Peipert JF, Weber A, Yalcinkaya T, Munro M, Dickersin K, Hubbard H, Langenberg P, Nichols J, Weber A, Dickersin K, Clark M, Langenberg P, Munro M, Zhu Q, Fisher M, Harlow S, Collins J, Jaffe R, Kelsey S, Ness R, Pearson C, Sherwin R.


Surgical Treatments Outcomes Project for Dysfunctional Uterine Bleeding is an agency for the Healthcare Research and Quality project built around a multicenter randomized clinical trial comparing hysterectomy and endometrial ablation (EA) for the treatment of heavy menstrual bleeding unrelated to structural causes. For inclusion, women self-defined their complaint, and the endometrial cavity was evaluated to exclude structural lesions. The primary outcomes were bleeding and major problem "solved" at 24 months, with length of institutional stay, surgical complications, quality of life, and reoperation included as secondary outcomes. Also measured was the baseline economic impact of heavy menstrual bleeding. The randomized controlled trial enrolled 237 women. Institutional stay was longer, and perioperative adverse events were more common and severe for those randomized to hysterectomy. At 24 months, 94.4% and 84.9% of women randomized to hysterectomy and EA, respectively, considered their major problem to be solved; at 48 months, the numbers were similar at 98.0% and 85.1%. Postprocedure quality-of-life measures (SF-36, EuroQOL) improved similarly in both groups, but reoperation was more common for women undergoing EA (34, or 30.9%, at 60 mo), with most (32 of 34) selecting hysterectomy.At baseline, women reported missed work as well as activity and leisure limitations. Excess monetary costs were $306 per patient-year (95% CI, $30-$1,872). Excess work and home management loss costs were $2,152 (95% CI, $1,862-$2,479). It was estimated that successful treatment, regardless of the type of intervention, could result in a gain of 1.8 quality-adjusted life years. Future studies will examine and compare the impact of the study interventions on economic outcomes.

© 2011 by The North American Menopause Society

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