54 Chapter 4 ABSTRACT Background The International Society on Thrombosis and Haemostasis bleeding assessment tool (ISTHBAT), is used during the diagnostic workup of bleeding disorders. Data on ISTH-BAT scores in women with heavy menstrual bleeding (HMB) undergoing endometrial ablation (EA) could be essential in optimizing HMB counselling. Objective To investigate the postsurgical incidence of amenorrhea, dysmenorrhea, quality of life, reintervention after EA and ISTH-BAT score. Methods This study included women who have undergone EA because of HMB. During a follow-up of 2-5 years, ISTH-BAT, pictorial blood assessment chart (PBAC) and Short Form-36 survey (SF-36) were administered. At 10 years follow-up surgical re-interventions were evaluated. Results Seventy-one women were included of whom 77% (n=55) had an ISTH-BAT score <6, vs. 23% (n=16) ISTH-BAT score ≥6 (mean age 46.3 vs. 42.3, p=0.004). In the ISTH-BAT ≥6 group vs. <6 group, amenorrhea occurred in 63% (10/16) vs. 82% (45/55) (p=0.111), dysmenorrhea in 38% (6/16) vs. 18% (10/55) (p=0.111), and surgical re-intervention in 19% (3/16) vs. 25% (14/55) (p=0.582). SF-36 item (Bodily) pain was lower in the ISTH-BAT ≥6 group vs. <6 (median score 58.7 vs. 80.0, p=0.104). Conclusions An ISTH-BAT score ≥6 may be related to a lower amenorrhea incidence and higher dysmenorrhea rate after EA.
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