Mirena as an Alternative to Hysterectomy in Cases of Dub

Abstract

Abstract Introduction: Dysfunctional uterine bleeding is the leading cause of hysterectomy due to conventional treatment failure. Levonorgestrel releasing intra ute-rine device (Mirena) is found to solve this issue by better control of bleeding and thus reducing hysterec-tomy rate. Objective: To measure the efficacy of Mirena as compared to OCP's in control of DUB and to deter-mine that it is an alternative to hysterectomy. Study Design: It was an interventional (experimental) type of study. Setting: Department of Obstetrics and gynecology Unit 11 Lady Willingdon Hospital, Lahore. Duration with Dates: In a total of 60 patients pre-senting with DUB in out patient department from 7 th April 2004 to 31 st December 2005. Subjects and Methods: In a total of 60 patients sele-cted were randomly allocated to Group A and B to receive Mirena and OCP's respectively. Both groups were followed at 6 months and 1 year of treatment. Main outcome measures were patient satisfaction with current treatment and their decision to continue or opt for hysterectomy. 80.7% women receiving Mirena were satisfied with their treatment, while only 30% in the OCP's group (p-value < 0.05) at the end of study. 7.69% was the discontinuation rate of treatment in Mirena group while it was 50% in the control group (p-value < 0.05). Conclusion: Mirena is a better option in the treatment of DUB and it can prove to be an alternative to hyste-rectomy, while we want a more conservative type of treatment. Keywords: 1. Dysfunctional uterine bleeding. 2. Menorrhagia. 3. Abnormal uterine bleeding. 4. Levonorgestrel. 5. Oral contraceptive pills. 6. Tranexamic acid. 7. Estrogens.