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.