| Sumario: | RESEARCH QUESTION: The aim of the present investigation is - to assess the benefit of treatment with radiofrequency endometrial ablation using a mesh electrode versus other treatment methods for endometrial resection or ablation commonly used in German health care (loop resection and/or rollerball ablation as well as balloon ablation) in patients with menorrhagia and a medical indication for ablative therapy. The focus of the assessment was on patient-relevant outcomes. CONCLUSION: COMPARISON OF RADIOFREQUENCY ABLATION VERSUS LOOP RESECTION / ROLLERBALL ABLATION: Two studies were available comparing radiofrequency ablation and loop resection combined with rollerball ablation. In each case, the data provide a hint of greater benefit with regard to dysmenorrhoea and for less harm with regard to adverse events (AEs) of radiofrequency ablation versus loop resection/rollerball ablation. Less harm in terms of AEs is primarily due to advantages with regard to intraoperative complications. The data provide no hint of greater benefit or harm for the outcomes of bleeding severity, premenstrual syndrome, activities of daily living, and surgical re-interventions. For bleeding severity, the leading symptom, comparable benefit can be seen for both procedures. No data were available for other morbidity outcomes, health-related quality of life, and mortality, so that the data provide no hint of greater benefit or harm for any of these outcomes. Overall, across outcomes, the data provide a hint of greater benefit of radiofrequency ablation versus loop resection combined with rollerball ablation. COMPARISON OF RADIOFREQUENCY ABLATION VERSUS BALLOON ABLATION: Four studies were available comparing radiofrequency ablation and balloon ablation. For bleeding severity, the data provide proof and for premenstrual syndrome, the data provide a hint of greater benefit of radiofrequency ablation versus balloon ablation. The data provide no hint of greater benefit or harm for the outcomes of dysmenorrhoea/pain, depressive symptoms, anxiety symptoms, state of health, postoperative pain, workdays missed after surgery, surgical re-interventions, AEs, health-related quality of life, and mortality. No usable data were available for activities of daily living, so again the data provide no hint of greater benefit or harm. Overall, across outcomes, the data provide an indication of greater benefit of radiofrequency ablation versus balloon ablation.
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