4 Efficacy

4 Efficacy

This section describes efficacy outcomes from the published literature that the Committee considered as part of the evidence about this procedure. For more detailed information on the evidence, see the overview.

4.1 In a case series of 54 patients with adenomyosis, 78% (42/54) of whom presented with menorrhagia, resolution of menorrhagia was reported in 26% (10/39) of patients at a mean follow-up of 5 years. In a case series of 40 patients (90% [36/40] presenting with menorrhagia), symptoms had resolved in 78% (28/36) of patients at a median follow-up of 40 months.

4.2 In a case series of 27 patients, complete resolution of dysmenorrhoea was reported in 38% (7/18), 57% (9/16), 36% (4/11) and 64% (7/11) of patients at 6, 12, 24 and 36 months respectively.

4.3 In the case series of 54 patients with adenomyosis, 43% (23/54) presented with bulk-related symptoms. Complete resolution of these symptoms was reported in 35% (8/23) of patients at a mean follow-up of 5 years. In the case series of 27 patients, complete resolution of bulk-related symptoms was reported in 38% (7/18), 31% (5/16), 46% (5/11) and 55% (6/11) of patients at 6, 12, 24 and 36 months respectively.

4.4 In a case series of 15 patients, a significant improvement in quality of life was reported at a mean follow-up of 8 months in the following domains: ability to perform activities of daily life, ability to socialise outside the home, overall energy level, pain or cramping during menstruation (p<0.001), and pain during sexual intercourse (p=0.02).

4.5 In the case series of 54 patients with adenomyosis, 5 patients became pregnant (3 delivered successfully and 2 opted for abortion).

4.6 In a case series of 18 patients with adenomyosis, 44% (8/18) of patients had subsequent treatments because of treatment failure or recurrent symptoms. Twenty-eight per cent (5/18) of patients underwent hysterectomy (4 months after the procedure in 1 patient because of treatment failure, and between 9 and 27 months after the procedure in 4 patients because of recurrent symptoms). Eleven per cent (2/18) of patients needed additional treatments and 6% (1/18) of patients needed endometrial balloon thermocoagulation because of recurrent symptoms (timing unclear).

4.7 The specialist advisers listed key efficacy outcomes to be quality of life, symptom resolution and need for further treatment.

  • National Institute for Health and Care Excellence (NICE)