Assessing patient satisfaction levels following endometrial ablations in the treatment of abnormal uterine bleeding to determine effectiveness

Abstract

OBJECTIVE: The objective of this study was to evaluate outcomes for women following endometrial ablations due to abnormal uterine bleeding (AUB). These outcomes included patient-reported quality of life, satisfaction with the procedure, and treatment failure. Women experiencing heavy/regular bleeding were compared with women experiencing heavy/irregular bleeding. DESIGN: The study was designed as a prospective cohort study of women aged 18-55 years presenting to Women and Infants Hospital (WIH) in Providence, Rhode Island, for endometrial ablations due to AUB. Sixty-three participants in the study completed the Baseline Health Form, the Short Form-36 Health Survey (SF-36), and the Menstrual Bleeding Questionnaire (MBQ) upon enrollment. At the 3-month, 6-month, and 1-year follow-ups participants completed the SF-36 and the MBQ. RESULTS: Baseline responses from the participants who were undergoing endometrial ablation found that 95.2% of women (n = 60) identified their periods as being heavy. From the total participants, 60.3% of women (n = 38) indicated their periods as being irregular. The SF-36 total score results demonstrate women with heavy/irregular bleeding experienced a greater negative impact in their quality of life. When broken down to the physical component score (PCS) and the mental component score (MCS) this difference, between women with heavy/regular bleeding and women with heavy/irregular bleeding, was minimized. Results from the MBQ revealed that women with heavy/irregular menstrual bleeding experienced a greater negative impact on their quality of life compared with women with heavy/regular bleeding. DISCUSSION: Heavy bleeding is one of the defining factors in determining whether women seek further treatment for their menstrual bleeding, and when they do, they will usually attempt other therapies before pursuing surgery. The MBQ revealed a difference in quality of life between women with heavy/irregular bleeding and women with heavy/regular bleeding because this questionnaire measures bleeding and its impact on a woman’s life. The SF-36 total scores also showed a difference between heavy/irregular bleeding and heavy/regular bleeding. Breaking down the total SF-36 total score into the PCS and MCS minimized this difference. This questionnaire focused more on overall general health rather than bleeding and this focus may account for the smaller scoring differences among bleeding patterns. CONCLUSION: Similar proportions of women experiencing heavy/regular and heavy/irregular bleeding pursue endometrial ablations as a treatment for AUB. The SF-36 demonstrated a greater burden on women’s general health when they have heavy/irregular bleeding. The MBQ provides a better measure to compare both bleeding patterns, aspects of bleeding, and demonstrates a more negative impact on quality of life for women with heavy/irregular bleeding.