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Levonorgestrel intrauterine system versus thermal balloon ablation for the treatment of heavy menstrual bleeding: A meta-analysis of randomized controlled trials

  • Authors:
    • Bing‑Qing Yang
    • Jie‑Han Xu
    • Yin‑Cheng Teng

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  • Published online on: September 7, 2015     https://doi.org/10.3892/etm.2015.2733
  • Pages: 1665-1674

  • Copyright: © Yang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

At present, there have been no standard research outcomes as to whether the levonorgestrel intrauterine system (LNG-IUS) or thermal balloon ablation (TBA) is superior for the treatment of patients suffering from heavy menstrual bleeding (HMB). Therefore, in the present study, a meta‑analysis of randomized controlled trials (RCTs) was conducted in order to compare the effectiveness and affordability of the LNG‑IUS with TBA in the treatment of HMB. A literature search of the following electronic databases was conducted: PubMed, EMBASE, the Cochrane Library, Google Scholar, the Chinese Scientific Journals Database, and the China National Knowledge Infrastructure; and a statistical analysis was performed using RevMan 5.2 software. Seven RCTs involving 467 patients (235 LNG‑IUS, 232 TBA) met the inclusion criteria for the present study. As assessed by pictorial blood loss assessment chart (PBAC) scores, the LNG‑IUS significantly reduced menstrual bleeding after 24 months [standardized mean difference (SMD), ‑0.86; 95% confidence interval (CI), ‑1.22 to ‑0.50; P<0.00001]. Furthermore, the total treatment cost of the LNG‑IUS was lower than that of TBA (SMD, ‑2.35; 95% CI, ‑2.98 to ‑1.72; P<0.00001). However, at the 24 month follow‑up, side effects such as amenorrhea occurred more frequently in patients treated with the LNG‑IUS, as compared with TBA (relative risk, 2.49; 95% CI, 1.46‑4.25; P=0.0008). No significant differences in hemoglobin levels and quality of life were demonstrated between the two treatment groups. The results of the present meta‑analysis suggest that the LNG‑IUS may be more effective and affordable than TBA as a long‑term treatment (24 months) for HMB. However, following 12‑24 months of treatment, side effects such as amenorrhea may be more frequent in patients treated with the LNG-IUS. When considering short‑term treatment for HMB, controversy remains regarding the two methods and further studies are required to precisely evaluate the outcomes.
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November-2015
Volume 10 Issue 5

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Spandidos Publications style
Yang BQ, Xu JH and Teng YC: Levonorgestrel intrauterine system versus thermal balloon ablation for the treatment of heavy menstrual bleeding: A meta-analysis of randomized controlled trials. Exp Ther Med 10: 1665-1674, 2015.
APA
Yang, B., Xu, J., & Teng, Y. (2015). Levonorgestrel intrauterine system versus thermal balloon ablation for the treatment of heavy menstrual bleeding: A meta-analysis of randomized controlled trials. Experimental and Therapeutic Medicine, 10, 1665-1674. https://doi.org/10.3892/etm.2015.2733
MLA
Yang, B., Xu, J., Teng, Y."Levonorgestrel intrauterine system versus thermal balloon ablation for the treatment of heavy menstrual bleeding: A meta-analysis of randomized controlled trials". Experimental and Therapeutic Medicine 10.5 (2015): 1665-1674.
Chicago
Yang, B., Xu, J., Teng, Y."Levonorgestrel intrauterine system versus thermal balloon ablation for the treatment of heavy menstrual bleeding: A meta-analysis of randomized controlled trials". Experimental and Therapeutic Medicine 10, no. 5 (2015): 1665-1674. https://doi.org/10.3892/etm.2015.2733