The Efficacy of Levonorgestrel-Releasing Intrauterine Device in Selected Cases of Myoma-Related Menorrhagia: A Prospective Controlled Trial

Abstract

To determine the efficacy of levonorgestrel-releasing intrauterine device (LNG-IUD) insertion in menorrhagic patients who have at least one type II myoma according to the European Society of Hysteroscopy. The primary outcome measures were menstrual blood flow reduction and increase in hemoglobin values. The secondary outcome measures were hysterectomy rates and patient satisfaction.In menorrhagic women (documented by a validated pad scoring system) with a myomatous uterus <380 ml at ultrasonography, LNG-IUD was inserted after the diagnostic triage. Patients were evaluated at 3, 6 and 12 months after the insertion. The primary outcome measures were compared to those of a matched group of historical controls that underwent thermal balloon ablation (TBA).Following LNG-IUD insertion, statistically significant decreases in menstrual blood flow and increases in hemoglobin values were noted. LNG-IUD insertion was found to be as effective as historical controls of TBA applications.This prospective controlled trial demonstrates the effectiveness of LNG-IUD in this setting and equivalent results are obtained as compared to TBA.