Title

Hysterectomy and Levonorgestrel Releasing Intrauterine System (LNG-IUS) in the Treatment of Menorrhagia
Hysterectomy and Levonorgestrel-releasing IUS in the Treatment of Menorrhagia
  • Phase

    Phase 3
  • Study Type

    Interventional
  • Intervention/Treatment

    norgestrel ...
  • Study Participants

    236
A randomised study including 236 women referred for essential menorrhagia to five university hospitals in Finland was conducted to compare the cost-effectiveness and the quality of life issues in the treatment of menorrhagia.Participants were randomly assigned to treatment with LNG-IUS (n=119), or hysterectomy (n=117), and were monitored for ten years. The primary outcome measures were health related quality of life (HRQoL), other measures of psychosocial well-being (anxiety, depression, sexual functioning), and costs.
A randomized VUOKKO trial was conducted between 1994-2008 to study hysterectomy and LNG-IUS in the treatment of menorrhagia.Overall, 236 women aged 35 to 49 years who were menstruating, had completed their family size, and were eligible for both treatments were randomized to either receive a LNG-IUS (n=119) or undergo hysterectomy (n=117). The follow-up visits took place six months and 12 months after the treatment, and again five and ten years after the randomization. The primary outcome measures were health related quality of life (HRQoL), other measures of psychosocial well-being (anxiety, depression, sexual functioning), and costs. The amount of menstrual blood loss was objectively measured before treatment and after one and five years. The one year the results were published in 2001 (Lancet 2001;357:273) and the five year results in 2004 (JAMA 2004; 291:1456).
Study Started
Oct 31
1994
Primary Completion
Oct 31
2008
Study Completion
Oct 31
2008
Results Posted
Aug 26
2009
Estimate
Last Update
Sep 02
2009
Estimate

Drug LNG-IUS

LNG-IUS releasing 25 microg of levonorgestrel

  • Other names: Mirena

Procedure Hysterectomy

operation

  • Other names: Removal of uterus by laparoscopy, vaginally or abdominally

LNG-IUS Active Comparator

Levonorgestrel releasing intrauterine system

Hysterectomy Other

Hysterectomy

Criteria

Inclusion Criteria:

heavy menstrual bleeding
35-49 years
were menstruating
had completed their family size
were eligible for both treatments

Exclusion Criteria:

submucous fibroids
endometrial polyps
ovarian tumours or cysts,
cervical pathology
urinary and bowel symptoms or pain due to large fibroids
lack of indication for hysterectomy
history of malignancies
menopause
severe depression
metrorrhagia as a main complaint
previous treatment failure with LNG-IUS
severe acne
uterine malformation

Summary

LNG-IUS

Hysterectomy

All Events

Event Type Organ System Event Term LNG-IUS Hysterectomy

HRQoL (Health Related Quality of Life)

HRQoL was measured by the 5-Dimensional EuroQol (EQ-5D) questionnaire which measures HRQoL in 5 dimensions of life (scale 0-1)(from very poor=0 to very good=5). The results are the change of HRQoL from baseline at 5 years (EQ-5D score at 5 years - EQ-5D score at baseline)

LNG-IUS

0.08
points on a scale (Mean)
95% Confidence Interval: 0.03 to 0.13

Hysterectomy

0.1
points on a scale (Mean)
95% Confidence Interval: 0.05 to 0.15

Costs

Outcome Measure Data Not Reported

Depression

Outcome Measure Data Not Reported

Total

236
Participants

Age Continuous

43
years (Mean)
Standard Deviation: 3.3

Age, Categorical

Sex: Female, Male

Overall Study

LNG-IUS

Hysterectomy

Drop/Withdrawal Reasons

LNG-IUS

Hysterectomy