Abstract Heavy menstrual bleeding poses an important health problem, which can be managed, besides other treat-ments, with endometrial ablation. Nowadays, the bipolar radio frequency device (NovaSure) is the most commonly used de-vice for endometrial ablation, followed by the thermal balloon device (ThermaChoice III). Thus far, studies looking at treat-ment outcomes have mainly been done comparing NovaSure with the older ThermaChoice (I–II) devices. The aim of this study is to compare the effectiveness of the improved ThermaChoice III with NovaSure. Patients treated with ThermaChoice III at the Ziekenhuisgroep Twente hospital and NovaSure at the Medisch SpectrumTwente hospital were included in the study. The primary outcome measure was pa-tient satisfaction after treatment, measured by the condition-specific menorrhagia multi-attribute scale (MMAS). The sec-ondary outcome measure was effectiveness of the treatment, measured by the amenorrhea rate and the hysterectomy rate. Five hundred fourteen patients were included in this study; of these, 216 patients were treated with ThermaChoice III and 289 patients with NovaSure. The score on the condition-specific MMAS was high for both groups, without a signifi-cant difference between the groups (88.8 vs 86.5,p=0.183).The amenorrhea rate was significantly higher in the NovaSur group (45 vs 27 %,p=0.001). The hysterectomy rate wasslightly higher in the ThermaChoice III group, without a sig-nificant difference between the groups (19 compared to 13%,p=0.066). Patient satisfaction is comparable in patients treatedwith ThermaChoice III or NovaSure. However, NovaSure en-dometrial ablation leads to a significantly higher amenorrhea
rate.