A Non-surgical lifeline for Abnormal uterine bleeding (AUB)-the LNG IUS

Abstract

Objective: To study effectiveness of LNG IUS (levonorgestrel releasing intrauterine system) insertion for patients with Abnormal uterine bleeding and to assess whether the LNG IUS can provide a conservative alternative to hysterectomy in the treatment of AUB. To correlate the cost effectiveness, symptomatic relief and psychological relief achieved with LNG IUS insertion. Materials and methods: It was a prospective non-comparative study with patients who had heavy menstrual bleeding and/or dysmenorrhea and diagnosed as adenomyosis or Idiopathic AUB (According to the FIGO PALM-COEIN Classification of AUB1). Thirty patients had LNG IUS insertion whereas another thirty patients opted for hysterectomy. We analyzed them in terms of symptomatic relief, cost effectiveness and psychological relief. Results: After LNG IUS insertion 93.33% of patients had significant decrease in blood loss and 76.6% had significant decrease in pain analyzed on visual analog score (VAS). Forty % of patients complained of inter-menstrual spotting but only 6.6 % had irregular heavy bleeding and only 2 patients out of 30 requested hysterectomy post LNG IUS insertion. 90% patients developed amenorrhea after 1year and only 1 woman required removal of LNG IUS as she was dissatisfied due to vaginal discharge. Hospital stay for LNG IUS was only 6-8 hours while it was 48-72 hours for patients who underwent hysterectomy. Conclusion: There is a significant relief in symptoms along with significant decrease in cost with LNG IUS insertion with a psychological satisfaction of conserving the uterus. Thus the LNG IUS is an excellent and cost effective alternative to surgical management in AUB