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.