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Background: Heavy menstrual bleeding (HMB) is a common problem affecting approximately 1.5 million women in England and Wales with a major impact on their physical, emotional, social and material quality of life. It is the fourth most common reason why women attend gynaecology outpatient clinics and accounts for one-fifth of all gynaecology outpatient referrals. Initial treatment in primary care is medical - either by means of oral or injected medication or the levonorgestrel-intrauterine system (Mirena®). If medical treatment fails then surgical treatment can be offered, either endometrial ablation (EA), which destroys the lining of the cavity of the uterus (endometrium), or hysterectomy, i.e. surgical removal of the uterus. While effective, conventional hysterectomy is invasive and carries a risk of complications due to injury to other pelvic structures. The procedure can be simplified and complications minimised by undertaking a 'supracervical' hysterectomy where the cervix is left in situ and only the body of the uterus removed. Recent advances in endoscopic technologies have facilitated increased use of laparoscopic supracervical hysterectomy (LASH) which can be performed as a day-case procedure and is relatively easy for the surgeon to learn. HEALTH (Hysterectomy or Endometrial AbLation Trial for Heavy menstrual bleeding) aims to address the question 'Is LASH superior to second generation EA for the treatment of HMB in terms of clinical and cost effectiveness?'Methods/design: Women aged < 50 years, with HMB, in whom medical treatment has failed and who are eligible for EA will be considered for trial entry. We aim to recruit women from approximately 30 active secondary care centres in the UK NHS who carry out both surgical procedures. All women who consent will complete a diary of pain symptoms from day 1 to day 14 after surgery, postal questionnaires at six weeks and six months after surgery and 15 months post randomisation. Healthcare utilisation questions will also be completed at the six-week, six-month and 15-month time-points.Discussion: Measuring the comparative effectiveness of LASH vs EA will provide the robust evidence required to determine whether the new technique should be adopted widely in the NHS.Trial Registration: International Standard Randomised Controlled Trials, ISRCTN49013893 . Registered on 28 January 2014. [ABSTRACT FROM AUTHOR]

: ObjectiveTo compare two second-generation endometrial ablation systems in women with dysfunctional uterine bleeding (DUB) who want conservative surgical treatment.: DesignA double-blind, randomized trial.: SettingA minimal access gynecological surgery unit in northeast England.: Patient(s)Fifty-seven women diagnosed with DUB were recruited, with 55 undergoing surgery and completing 12-month follow-up.: Intervention(s)Thirty-seven women underwent a NovaSure™ endometrial ablation, and 18 had a Cavaterm™ endometrial ablation. Clinical and quality of life data were collected 6 and 12 months after treatment.: Main outcome measure(s)Amenorrhea, menstrual change, quality of life, sexual activity, patient satisfaction, and procedure acceptability.: Result(s)Amenorrhea, hypomenorrhea, eumenorrhea, and menorrhagia rates for the Cavaterm™ and Novasure™ groups at 12 months were 2/18 (11%) vs. 16/37 (43%); 11/18 (61%) vs. 10/37 (27%); 5/18 (27%) vs. 6/37 (16%); and 0/18 vs. 5/37 (13%), respectively. At 12 months, 83% and 92% of women were either satisfied or very satisfied in the Cavaterm™ or Novasure™ groups, respectively. There were no major complications in either group.: Conclusion(s)Both the Cavaterm™ and the Novasure™ endometrial ablation systems are effective in reducing menstrual loss in women with DUB and achieve high rates of patient satisfaction. The Novasure™ system achieved a statistically significantly higher rate of amenorrhea in this study. [Copyright &y& Elsevier]