Roller-ball endometrial ablation versus levonorgestrel releasing intrauterine system in the management of abnormal uterine bleeding

B. Ergun, O. Kuru, S. Sen, Y. Kilic, E. Bastu

Abstract: The aim of this study was to evaluate the efficacy of the levonorgestrel intrauterine system (LNG-IUS) of abnormal uterine bleeding management in comparison to endometrial ablation. This prospective study was conducted on 58 patients. They randomly received either surgical treatment as roller-ball endometrial ablation (31 patients, group 1) or drug therapy as LNG-IUS (27 patients, group 2). Pictorial blood assessment chart (PBAC) scores and hemoglobin levels were measured before roller-ball endometrial ablation or LNG-IUS treatment. Both measurements were taken before and after one year. PBAC scores dropped, while hemoglobin levels increased in both groups after one year. There was no statistical difference between the two groups (p>0.05). No major complications occurred with either treatment modality. In the management of abnormal uterine bleeding, LNG-IUS and endometrial ablation appear to have similar therapeutic effects up to one year after treatment. Therefore, treatment should be tailored to the individual needs and preferences of the woman.
Keywords: levonorgestrel, uterine bleeding, endometrial ablation, hemoglobin, therapy