Comparison of Clinical Outcomes with Low-Voltage (Cut) Versus High-Voltage (Coag) Waveforms during Hysteroscopic Endometrial Ablation with the Rollerball: A Pilot Study

Abstract Study Objective To compare efficacy of rollerball endometrial ablation with low-voltage (cut) versus high-voltage (coag) waveforms. Design Pilot comparative clinical study (Canadian Task Force Classification II-1). Setting University-affiliated teaching hospital. Patients Fifty premenopausal women with menorrhagia. Intervention Women with menorrhagia were allocated randomly to thermal destruction of the endometrium by a 5-mm rollerball with unmodulated cutting current or modulated coagulating current. Complication rate, clinical outcomes, and need for reintervention were evaluated. Measurements and Main Results At 2 years of follow-up, the reintervention rate was 26.3% in the cutting waveform group versus 31.4% in the coagulating waveform group. This difference was not statistically significant. Hysterectomy was performed in 3 (14%) women in the cutting waveform group and 5 (20%) women in the coagulating waveform group. There were no complications in either group. Conclusion Both cutting and coagulating waveforms are equally effective for hysteroscopic endometrial ablation with the rollerball.