Comparison between the levonorgestrel intrauterine system (LNG-IUS) and thermal balloon ablation in the treatment of menorrhagia.
OBJECTIVE
To compare the effectiveness of endometrial thermal ablation and the levonorgestrel intrauterine system (LNG-IUS) in the management of menorrhagia.


METHODS
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.


CONCLUSIONS
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.
Barrington
Julian W
JW
Department of Obstetrics and Gynaecology, Torbay Hospital, Torquay, Devon, UK. julian.barrington@sdevonhc-tr.swest.nhs.uk
Arunkalaivanan
Angamuthu S
AS
Abdel-Fattah
Mohammed
M
D001706:Biopsy; D002404:Catheterization; D004717:Endometrium / Q000473:pathology; D005260:Female; D006358:Hot Temperature; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage*; D008595:Menorrhagia / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D014599:Uterus / Q000187:drug effects*
D016912:Levonorgestrel