ABSTRACT
OBJECTIVES: To compare the effectiveness of endometrial thermal ablation and the levonorgestrel intrauterine system (LNG-IUS) in the management of menorrhagia. STUDY DESIGN: Fifty women attending a gynaecology clinic at a District General Hospital in south-west England were randomised to either surgical treatment using thermal ablation (Thermochoice, Gynecare) or medical treatment using a LNG-IUS (Mirena, Schering Healthcare). A pictorial menstrual chart was completed pre-insertion/operatively and again at 6 months post-insertion/operatively. Non-parametric tests (Mann-Whitney) were used for statistical analysis. RESULTS: Follow-up analysis was possible in 23 women in the Thermochoice group and 21 women in the Mirena group. The menstrual scores were slightly higher in the Thermochoice group (median 101) than the Mirena group (median 75) (P=0.025) pre-insertion/operatively but this difference was lost post-insertion/operatively (P=0.689) with median menstrual scores of 27 for the Thermochoice group and 19 for the Mirena group, respectively. CONCLUSION: Both Thermochoice endometrial ablation and a Mirena LNG-IUS are equally effective in the management of menorrhagia. The choice of treatment should be tailored to the woman's needs and preferences.
Subject(s)
Catheterization , Hot Temperature , Levonorgestrel/administration & dosage , Menorrhagia/therapy , Uterus/drug effects , Biopsy , Endometrium/pathology , Female , Humans , Intrauterine Devices, Medicated , Menorrhagia/drug therapy , Menorrhagia/pathologyABSTRACT
Menorrhagia is a common gynaecological condition for which medical treatment is often ineffective and a large number of women undergo major surgery. Previous short term studies have shown a significant number of women with menstrual problems may avoid surgery if a levonorgestrel intrauterine system (LNG-IUS) is fitted but no long term studies exist to ascertain if this benefit is sustained. This four to five year long term follow up study showed 50% of women continued to use the device and 67.4% avoided surgery. The LNG-IUS is well accepted and effective in the management of menorrhagia and has major cost implications to the National Health Service.
