Objectives

1. Analysis of 1 year outcomes of 36 patients with heavy menstrual bleeding who underwent a novasure procedure in a district general hospital. Jan H, Patak H, PooleyA Kingston Hospital NHS Trust Results Results cont.. Objectives Results cont.. Would you recommend the procedure to a friend? • 62 sets of notes were obtained out of 66 patients 94%. Out of the patient survey, we received a response of 36 out of 66 - 55% • Complications: • No intra operative or immediate post operative complications were reported • At 1 Year: • 1 (3%) infection diagnosed by the GP and given antibiotics vs (6%) standard • 3 (9%) had symptoms of bloating • 2 (6%) had pelvic pain vs (3%) standard • No other compilations • Failed Procedures: • 2 (3%) aborted procedures and 5 (8%) unsuccessful procedures higher than the standard 2% • 2 Not attempted as on measurement the cavity was too large for novasure • 4 unsuccessful procedures failed a cavity test because of fibroids • 1 unable to get an adequate seal - previous cevical surgery LLETZ The effect of novasure on periods is highlighted below. Menorrhagia is defined as “excessive menstrual blood loss which interferes with the woman’s physical, emotional, social and material quality of life” Nice 2007 In the 1990s, it was estimated that at least 60% of women presenting went on to have a hysterectomy. Novasure is a procedure performed as a day case under general anaesthetic that uses radio frequency ablation to cauterize the lining of the womb and so reduce the amount of bleeding during periods. It is a second generation endometrial ablation technique used as an alternative to hysterectomy. 91 % would recommend the procedure to a friend Conclusions • Novasure was a safe and effective treatment at Kingston hospital • Standards were exceeded regarding: • immediate and short term complications • effectiveness of the procedure • patient satisfaction • The long term complication rate and hysterectomy rate were very comparable to the standards • The failed procedure rate was higher at Kingston so we recommend not attempt the procedure in those who are found to have distorted cavity at hysteroscopy to improve our success rates. Symptoms improved over time, At 12 months the amenorrhoea rate is 59% much higher than 36% standard Significant reduction in bleeding was 95% much higher than 78% standard 5 (8%) had a hysterectomy vs 6.3% standard Our objective was to assess success, complications and patient satisfaction of novasure ablation in the treatment of menorrhagia at Kingston hospital as part of a registered audit following introduction of this procedure. How would you rate overall effectiveness of the procedure in controlling your symptoms? Methods List of patients who had Novasure procedure obtained from theatre logs between 04/2008 to 07/2010 identified, Total no. of patients 66. Notes requested via the audit department. In addition, questionnaires sent to all patients in stamped self-addressed envelopes to report on follow up immediately post procedure, 6 months, 12 months. The data was collected and analysed in Excel and was compared to the standard which are the figures quoted by novasure themselves. References 30 (48%) had Mirena IUS prior to the novasure and found it unsatisfactory. National Institute for Health and Clinical Excellence (Y2007) [CG44]. London: National Institute for Health and Clinical Excellence. Cooper J, Gimpelson R, Laberge P et al. A randomized, multicenter trial of safety and efficacy of the Novasure System in the treatment of menorrhagia. J Am AssocGynecolLaparosc. 2002;9:418-428 Overall patient satisfaction 97% vs 91% standard.