OPEN RANDOMIZED STUDY OF USE OF LEVONORGESTREL RELEASING INTRAUTERINESYSTEM AS ALTERNATIVE TO HYSTERECTOMY

Objectives: To assess whether the levonorgestrel intrauterine system c ould provide a conservative alternative to hysterectomy in the treatme nt of excessive uterine bleeding. Design: Open randomised multicentre study with two parallel groups: a levonorgestrel intrauterine system g roup and a control group. Setting Gynaecology departments of three hos pitals in Finland, Subjects: Fifty six women aged 33-49 years schedule d to undergo hysterectomy for treatment of excessive uterine bleeding. Interventions: Women were randomised either to continue with their cu rrent medical treatment or to have a levonorgestrel intrauterine syste m inserted. Main outcome measure: Proportion of women cancelling their decision to undergo hysterectomy. Results: At 6 months, 64.3% (95% co nfidence interval 44.1 to 81.4%) of the women in the levonorgestrel in trauterine system group and 14.3% (4.0 to 32.7%) in the control group had cancelled their decision to undergo hysterectomy (P < 0.001). Conc lusions: The use of the levonorgestrel intrauterine system is a good c onservative alternative to hysterectomy in the treatment of menorrhagi a and should be considered before hysterectomy or other invasive treat ments.