Ritva Hurskainen, M.D., Ph.D., from the Helsinki University Hospital, Finland, and colleagues evaluated the outcomes of 236 women, average age of 43 years, who were referred to 5 university hospitals in Finland for complaints of menorrhagia between October 1, 1994 and October 6, 2002. The participants were randomized to treatment with the LNG-IUS (n=119) or hysterectomy (n=117) and were monitored for five years. The researchers used the 5-Dimensional EuroQol and the RAND 36-Item Short-Form Health Survey to measure health-related quality of life (HRQL), as well as psychosocial well-being (anxiety, depression, and sexual function).
"After 5 years of follow-up, 232 women (99 percent) were analyzed for the primary outcomes," the authors report. "The two groups did not differ substantially in terms of HRQL or psychosocial well-being. Although 50 (42 percent) of the women assigned to the LNG-IUS group eventually underwent hysterectomy, the discounted direct and indirect costs in the LNG-IUS group ($2,817 per participant) remained substantially lower than in the hysterectomy group ($4,660). Satisfaction with treatment was similar in both groups."
"Because menorraghia is often a reason for seeking medical attention, it is important to consider the outcomes and costs of various treatment options to provide the most appropriate care. The LNG-IUS may improve HRQL at relatively low cost, undoubtedly enhances patient choice, and may reduce surgery-related costs," the authors write in conclusion.
(JAMA. 2004; 291:1456-1463. Available post-embargo at JAMA.com)
Editor's Note: This study was supported by grants from the Academy of Finland, STAKES, and the Research Funds of the University Hospitals, Finland. The LNG-IUSs were provided free of charge by Leiras Co. (now Schering Co.), Turku, Finland. Please see JAMA st
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