First-Versus Second-Generation Endometrial Ablation Devices For Treatment Of Menorrhagia In Pre-menopausal Women

Objective:To estimate the clinical effect of using second-generation endometrial ablation devices compared to first-generation devices for treatment of menorrhagia in pre-menopausal women. Methods:We searched for Cochrane Library,MEDLINE, EMBASE,ISI Web,BMJ,CBM,Chinese biomedical literature database,Wanfang medicine database,CNKI.We included only randomized controlled trials of treatment for premenopausal women with menorrhagia by endometrial ablation using first-generation compared with second-generation devices.The data were analyzed with RevMan5.0software.Results:Seven trials involving1218patients were included.The quality of the included studies was evaluated based on the randomization method,allocation concealment,blind,loss of follow-up, compared with the baseline and grade description. Eight articles were considered as high quality articles. Meta analysis found that:There was no difference in PBAC between first-and second-generation ablation (P=0.71>0.05,I2=0%, RR=-9.05,95%CI=[-24.92,6.82])There was no difference in the rate of amenorrhea between first-and second-generation ablation (OR=0.49,95%CI=[0.10,2.41], P=0.38>0.05).There was no difference in patient’s satisfaction between first-and second-generation ablation (OR=4.37,95%CI=[0.24,81.14],P=0.32>0.05). Second-generation endometrial ablation devices likely reduce operative time (RR=-14.78,95%CI=[-18.67,-10.88],P<0.00001).Conclusion:Second-generation endometrial ablation devices seem to be as effective as first-generation devices but likely reduce operating time,can be used more often with local anesthesia,besides it’s further clinical effect is better than first-generation devices.