29 Systematic review Polet et al12 Kanaoka et al17 Rubin et al14 El-Nashar et al16 Huq et al15 Baggish et al13 Halimeh S et al18 Alesci S et al20 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 0 0 2 2 2 2 2 2 2 2 1 1 1 1 1 1 1 1 2 2 2 2 2 2 0 0 2 2 2 2 2 2 0 0 0 0 0 0 0 0 0 0 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 13 13 13 13 13 13 7 7 Recurrence of HMB after initial EA Recurrence of HMB after initial EA described in 5 out of the 30 of the VWD women of which 3 (two type 1, one type 2A) underwent a hysterectomy 10, 11 and 26 months after the initial EA procedure. (16) The fourth patient developed recurrence of menorrhagia after initial hypomenorrhea following EA, but no surgical procedure was performed. (16) Another VWD patient (type unknown) underwent an electrosurgery EA but underwent a second ablation 6 months later for residual endometrium. (15) DISCUSSION The hysterectomy and EA techniques have evolved during the last 30 years, as women who underwent abdominal surgery experience higher rates of bleeding complications compared to vaginal or laparoscopic surgery. (25) In addition, bipolar radio frequency and microwave ablative devices appeared more effective than thermal balloon and free fluid ablation in the treatment of HMB. (6) However, the type of surgical procedure (hysterectomy vs EA) is still frequently reported as a risk factor for intraoperative bleeding. (26) In this systematic review, we included 12 studies to evaluate the association between prophylaxis and any (post)operative bleeding events in VWD women who either underwent EA or a hysterectomy. 2
RkJQdWJsaXNoZXIy MTk4NDMw