Long-term effects of endometrial resection or ablation in combination with levonorgestrel intrauterine device on bleeding patterns

Objective

Endometrial resection and ablation are minimal invasive surgeries used to treat women with abnormal uterine bleeding (AUB). Both may be followed by a high reoperation rate up to 24%. However, some studies suggest that this may be improved by adding a levonorgestrel intrauterine device (LNG-IUD) immediately following surgery. The aim of this studyPl was to evaluate the long-term (12 months) effect of combined LNG-IUD and endometrial resection (TCRE) or ablation (NovaSure) on the rate of amenorrhea in women treated for AUB.

Study design

This study was conducted as a prospective cohort study. A total of 119 women answered the questionnaire regarding bleeding patterns 12 months postoperatively and were eligible for statistical analysis.

Results

The rate of amenorrhea 12 months postoperatively was 11% for TCRE and 58% for TCRE in combination with LNG-IUD (OR 24.71; 95% CI 2.32–262.94; p = 0.008). For the group of women, who underwent NovaSure alone, the incident of amenorrhea 12 months postoperatively was 48, and 62% in combination with an LNG-IUD (OR 1.24; 95% CI 0.34–4.58; p = 0.744).

Conclusion

Our study disclosed a low effect of TCRE in respect to the amenorrhea rate, whereas the combination with LNG-IUD increased the effect thereby comparable to NovaSure, where no significant beneficial effect was observed from the combination with LNG-IUD.