Comparative effectiveness and impact on health-related quality of life of hysterectomy vs. levonorgestrel intra-uterine system for abnormal uterine bleeding

OBJECTIVE: To compare hysterectomy and levonorgestrel intra-uterine system (LNG-IUS) for the treatment of abnormal uterine bleeding (AUB) and iron deficiency anemia. PATIENTS AND METHODS: Retrospective study evaluating quality of life, sexual function, satisfaction and blood hemoglobin concentration improvement in 60 pre-menopausal women treated with hysterectomy or LNG-IUS. All analysis was performed with statistical software SPSS 21.0 (SPSS Inc., Chicago, IL, USA). RESULTS: Despite superior control of bleeding and dysmenorrhea observed after hysterectomy, LNG-IUS showed similar impact on blood hemoglobin levels, quality of life, satisfaction and sexual function resulting more cost-effective. CONCLUSIONS: In the absence of contraindications, LNG-IUS should always be the first therapeutic choice for chronic AUB. Surgical treatment must be considered as an “extrema ratio”.