Resources and procedures in the treatment of heavy menstrual bleeding with the levonorgestrel-releasing intrauterine system (LNG-IUS) or hysterectomy in Brazil

dc.creatorBahamondes, MV
dc.creatorde Lima, Y
dc.creatorTeich, V
dc.creatorBahamondes, L
dc.creatorMonteiro, I
dc.date2012
dc.dateSEP
dc.date2014-07-30T18:23:24Z
dc.date2015-11-26T17:48:22Z
dc.date2014-07-30T18:23:24Z
dc.date2015-11-26T17:48:22Z
dc.date.accessioned2018-03-29T00:31:13Z
dc.date.available2018-03-29T00:31:13Z
dc.identifierContraception. Elsevier Science Inc, v. 86, n. 3, n. 244, n. 250, 2012.
dc.identifier0010-7824
dc.identifierWOS:000308282600011
dc.identifier10.1016/j.contraception.2011.12.005
dc.identifierhttp://www.repositorio.unicamp.br/jspui/handle/REPOSIP/71028
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/71028
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1289070
dc.descriptionConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
dc.descriptionBackground: Heavy menstrual bleeding (HMB) is the most common complaint of women seeking gynecological care. Treatments included surgical or medical options including hysterectomy and the levonorgestrel-releasing intrauterine system (LNG-IUS) due to the profound suppression of endometrial growth that intrauterine LNG exerts which results in amenorrhea or in a reduction of blood loss. Objective: The study was conducted to evaluate the resources and procedures involved in inserting an LNG-IUS compared to performing hysterectomy in women with HMB in a public sector hospital in Brazil. Study design: Two cohorts of women were studied: women who accepted an LNG-IUS (n=124) and matched women who underwent hysterectomy on the same day (n=122). We evaluate the number of procedures carried out in each group of women, including those performed before the decision was made to insert an LNG-IUS or to perform hysterectomy, the insertion of the device itself and the surgical procedure, in addition to the procedures and complications registered up to I year after LNG-IUS insertion or hysterectomy. Results: Age and the duration of HMB were significantly lower in the LNG-IUS acceptors than women at the hysterectomy group. The numbers of gynecological consultations and Pap smears were similar in both groups; however, women in the hysterectomy group also underwent laboratory tests, ultrasonography, chest X-ray and electrocardiogram. In the hysterectomy group, the main complications were hemorrhage (six), bladder/bowel perforation (four), complications with anesthesia (one), ureteral reimplantation required (one) and abdominal pain (two). At I year, HMB was controlled in 83.1% of women in the LNG-IUS group, and 106 women continued with the device. Conclusions: Both treatments were effective in HMB control. Fewer resources and complications were observed in LNG-IUS acceptors when compared to hysterectomy. The LNG-IUS represents a good strategy for reducing the number of hysterectomies and the resources required for women with HMB. (C) 2012 Elsevier Inc. All rights reserved.
dc.description86
dc.description3
dc.description244
dc.description250
dc.descriptionConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
dc.descriptionConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
dc.descriptionCNPq [573747/2008-3]
dc.languageen
dc.publisherElsevier Science Inc
dc.publisherNew York
dc.publisherEUA
dc.relationContraception
dc.relationContraception
dc.rightsfechado
dc.rightshttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.sourceWeb of Science
dc.subjectPharmacoeconomics
dc.subjectLevonorgestrel-releasing intrauterine system
dc.subjectMirena
dc.subjectHeavy menstrual bleeding
dc.subjectHysterectomy
dc.subjectRandomized-controlled-trial
dc.subjectCost-effectiveness
dc.subjectFollow-up
dc.subjectMenorrhagia
dc.subjectAblation
dc.subjectSymptoms
dc.subjectWomen
dc.subjectContraception
dc.subjectUtility
dc.titleResources and procedures in the treatment of heavy menstrual bleeding with the levonorgestrel-releasing intrauterine system (LNG-IUS) or hysterectomy in Brazil
dc.typeArtículos de revistas


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