Background: Heavy menstrual bleeding (HMB) is a common complaint in women. It is physically and psychologically disturbing. It causes deterioration of health and quality of life. Causes of HMB are adenomyosis, fibroids, polyps, endometrial hyperplasia etc. Most patients seek for hysterectomy. Hysteroscopy and Mirena insertion can be a definite alternative. Hence this study was conducted with the objectives to evaluate the effectiveness of hysteroscopy followed by Mirena (levonorgestrel intrauterine system) insertion as an alternative to hysterectomy in women presenting with abnormal uterine bleeding (AUB)/heavy menstrual bleeding (HMB).
Materials and Methods: A retrospective observational study was conducted on 115 patients from January 2021 to December 2021 at Apollo Hospitals, Hyderabad. Patients underwent Hysteroscopy and Mirena insertion. Few patients (N=66) received Inj. Medroxy Progesterone acetate (MPA) 150mg post-operatively and remaining (N=49) did not receive any medication. All patients were followed up at 1 month, 6 months and 12 months post-operatively. Results were taken based on relief in symptoms and any benefit in giving hormonal injection post operatively.
Results: At 1 month, 86.1% (99/115) patients were relieved. 90.9% (60/66) patients who received Inj.MPA post-operatively were relieved. P value was 0.083, though not significant but a trend can be established to use this medication post-operatively. The satisfaction rate was similar at 6months in both groups with P value of 0.921. At 1 year, 3 patients had no relief in symptoms and underwent Hysterectomy. Over all 97.4% (112/115) patients were symptomatically relieved.
Conclusion: Hysteroscopy showed the exact cause of bleeding and Mirena insertion reduced the problem. Most patients had irregular bleeding for 2 to 3 months for which they were reassured. Over all acceptance rate was high. Additional Inj.MPA post-operatively can be considered.
International Journal of Clinical Obstetrics and Gynaecology
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Research Journals