Relative costs of gynecologic endoscopy vs traditional surgery for treatment of abnormal uterine bleeding.

BACKGROUND

The traditional treatment for abnormal uterine bleeding when medical therapy fails has been abdominal or vaginal hysterectomy. More recently, operative gynecologic endoscopy (laparoscopy and hysteroscopy) has partially replaced this traditional approach. The cost and healthcare utilization of endoscopy compared with traditional surgical methods are poorly understood.

OBJECTIVE

To compare the cost and healthcare utilization associated with different gynecologic endoscopic therapies vs traditional methods for the treatment of abnormal uterine bleeding.

STUDY DESIGN

Review of the available medical literature.

RESULTS

Vaginal hysterectomy is the least costly of all hysterectomy techniques. The direct costs of laparoscopically assisted vaginal hysterectomy are higher than those of abdominal hysterectomy, but the indirect costs are significantly less. The direct and indirect costs of endometrial ablation/resection are significantly lower than those of hysterectomy even when the cost of treatment failures is included.

CONCLUSION

Endometrial ablation/resection might be chosen over hysterectomy to treat abnormal uterine bleeding because it avoids major surgery, significantly shortens hospitalization, and allows rapid return to normal functioning.