A randomized, multicenter trial of safety and efficacy of the NovaSure system in the treatment of menorrhagia

Study Objective. To compare the safety and effectiveness of the NovaSure impedance-controlled endometrial ablation system with hysteroscopic wire loop resection plus rollerball ablation for treatment of excessive uterine bleeding in premenopausal women. Design. Randomized, multicenter, double-arm study (Canadian Task Force classification 1). Setting. Nine academic medical centers and private offices. Patients. Two hundred sixty-five premenopausal women with symptomatic menorrhagia. Intervention. Ablation performed with the NovaSure system or wire loop resection and rollerball. Measurements and Main Results. Success [pictorial blood loss-assessment chart (PBLAC) score 5751 was achieved in 88.3% of NovaSure-treated and 81.7% of rollerball-treated patients. One year after treatment 90.9% and 87.8%, respectively, reported normal bleeding or less (PBLAC less than or equal to 100) and 41% and 35%, respectively, experienced amenorrhea (PBLAC = 0). Mean procedure time was 4.2 minutes (average 84 sec) in the NovaSure group and 24.2 minutes in the rollerball group. Local and/or intravenous sedation was administered in 73% of NovaSure patients and 18% of rollerball patients. Intraoperative adverse events occurred less frequently with NovaSure (0.6%) than with rollerball (6.7%). Postoperative adverse events occurred in 13% and 25.3% of patients, respectively. Conclusion. The NovaSure system was safe and effective in treatment of women with menorrhagia. The procedure is both quick and effective, and eliminates the expense and side effects of endometrial pretreatment.