Levonorgestrel-releasing intrauterine system vs. transcervical endometrial resection for dysfunctional uterine bleeding.
OBJECTIVE
To compare the acceptability, efficacy, adverse effects, and user satisfaction of a levonorgestrel intrauterine system (LNG-IUS) and transcervical resection of the endometrium (TCRE) for the treatment of dysfunctional uterine bleeding.


METHODS
Of 50 women with a pictoral blood loss assessment chart (PBAC) score of 100 or greater, 25 had a LNG-IUS inserted (Mirena; Schering, Berlin, Germany) and 25 underwent TCRE. Procedure-related complications, PBAC score, hemoglobin levels, adverse effects, and rates of acceptability and satisfaction were recorded at 3-month intervals for a period of 12 months.


RESULTS
At the end of 1 year there were a 97% and a 94% reduction in menstrual blood loss in the LNG-IUS and TCRE groups, respectively, and hemoglobin concentration had increased by 5.5% in the LNG-IUS group and 5.2% in the TCRE group. Adverse effects were similar in both groups except for systemic effects, which were seen only in the LNG-IUS group. Satisfaction rates were about 80% in the 2 groups.


CONCLUSIONS
Both treatments were found to be equally effective but LNG-IUS placement requires less operator skill and entails no operative hazards, and the device provides effective contraception.
Gupta
B
B
Department of Obstetrics and Gynecology, All-India Institute of Medical Sciences, New Delhi, India. dr_bindiya_gupta@yahoo.co.in
Mittal
S
S
Misra
R
R
Deka
D
D
Dadhwal
V
V
D000328:Adult; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D004107:Dilatation and Curettage / Q000009:adverse effects; D004343:Drug Implants / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects; D016912:Levonorgestrel / Q000008:administration & dosage*; D008796:Metrorrhagia / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D017060:Patient Satisfaction; D016896:Treatment Outcome; D014463:Ultrasonography
D003271:Contraceptive Agents, Female; D004343:Drug Implants; D016912:Levonorgestrel