Open randomised study of use of levonorgestrel releasing intrauterine system as alternative to hysterectomy.

OBJECTIVES

To assess whether the levonorgestrel intrauterine system could provide a conservative alternative to hysterectomy in the treatment of excessive uterine bleeding.

DESIGN

Open randomised multicentre study with two parallel groups: a levonorgestrel intrauterine system group and a control group.

SETTING

Gynaecology departments of three hospitals in Finland.

SUBJECTS

Fifty six women aged 33-49 years scheduled to undergo hysterectomy for treatment of excessive uterine bleeding.

INTERVENTIONS

Women were randomised either to continue with their current medical treatment or to have a levonorgestrel intrauterine system inserted.

MAIN OUTCOME MEASURE

Proportion of women cancelling their decision to undergo hysterectomy.

RESULTS

At 6 months, 64.3% (95% confidence interval 44.1 to 81.4%) of the women in the levonorgestrel intrauterine system group and 14.3% (4.0 to 32.7%) in the control group had cancelled their decision to undergo hysterectomy (P < 0.001).

CONCLUSIONS

The use of the levonorgestrel intrauterine system is a good conservative alternative to hysterectomy in the treatment of menorrhagia and should be considered before hysterectomy or other invasive treatments.