COMPARATIVE STUDY OF LEVONORGESTREL INTRA-UTERINE SYSTEM (LNG-IUS) VERSUS THERMAL BALLOON ENDOMETRIAL ABLATION (TBEA) IN PERI-MENOPAUSAL WOMEN WITH HEAVY MENSTRUAL BLEEDING: A PROSPECTIVE OBSERVATIONAL STUDY.

Dr. Namrata Kulkarni; Dr. Leena S Kamat; Dr. Rathnamala M Desai; Dr. Rashmi Desai; Dr. Deeksha Samani

Volume : VIII, Issue : II, February - 2018

COMPARATIVE STUDY OF LEVONORGESTREL INTRA-UTERINE SYSTEM (LNG-IUS) VERSUS THERMAL BALLOON ENDOMETRIAL ABLATION (TBEA) IN PERI-MENOPAUSAL WOMEN WITH HEAVY MENSTRUAL BLEEDING: A PROSPECTIVE OBSERVATIONAL STUDY.

Dr. Namrata Kulkarni, Dr. Leena S Kamat, Dr. Rathnamala M Desai, Dr. Rashmi Desai, Dr. Deeksha Samani,

Abstract :

Background: To compare the effectiveness of LevonorgestrelIntra–uterine System (LNG–IUS) versusThermal Balloon Endometrial Ablation inperimenopausal women with Heavy MenstrualBleeding (HMB).

Methods: A prospective comparative study was conducted in the Department of Obstetrics and Gynaecology atSDMCollege of Medical Science and Hospital, Dharwad, India. The studyincluded 80 peri–menopausal women with heavy menstrual bleeding, aged between 40 and 55 years, over a period of 2 years. 40 women had undergone TBEA (Thermachoice) and 40 women had LNG–IUS inserted.All patients had undergone trans–vaginal ultrasound, Pap smear, endometrial biopsy,and PBAC (Pictorial Blood loss Assessment Chart) scoring before the treatment. Only those cases with uterine size less than 12 weeks, no submucousfioid, with negative Pap smear and those with endometrial biopsy negative for malignancy were included. Patients were followed up at intervals of 3 months, 6 months and at 12 months. At each visit, the patients were evaluated for bleeding per vagina, spotting, amenorrhea, pain abdomen, expulsion of LNG–IUS, cycle regularity and PBAC score.

Results: Follow up was possible in 37 women with LNG–IUS and 38 women with TBEA. Both the study groups were statistically comparable in terms of age, parity, PBAC score, and endometrial pattern. On followup, there was no statistically significant difference in the outcome in terms of PBAC score and therapy failure. Student sample t test was used for analysis.

Conclusion:Both LNG–IUS and TBEA are equally effective and safe in the treatment of heavy menstrual bleeding. The choice of treatment should be individualized according to the woman’s needs and choice and depending on risk factors.