Cochrane · systematic review · CD003855
Surgery versus medical therapy for heavy menstrual bleeding
Marjoribanks, J, Lethaby, A, Farquhar, C · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
Gynaecology and FertilityAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
11
current version
GRADE rated
11
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 2 · 18.2%Low 4 · 36.4%Moderate 5 · 45.5%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Surgery versus oral medication for women with heavy menstrual bleeding
Population: women with heavy menstrual bleeding
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Control of bleeding (cure or improvement to acceptable level) At 4 months Surgery vs oral medication | RR 2.66 [1.94, 3.64] | 1 study · 186 participants | Moderate Downgraded: risk of bias |
Control of bleeding (cure or improvement to acceptable level) At 2 years Surgery vs oral medication | RR 1.29 [1.06, 1.57] | 1 study · 173 participants | Low Downgraded: risk of bias |
Control of bleeding (cure or improvement to acceptable level) At 5 years Surgery vs oral medication | RR 1.14 [0.97, 1.34] | 1 study · 140 participants | Very low Downgraded: risk of bias |
Overall satisfaction with treatment At 2 years Surgery vs oral medication | RR 1.4 [1.13, 1.74] | 1 study · 173 participants | Moderate Downgraded: risk of bias |
Overall satisfaction with treatment At 5 years Surgery vs oral medication | RR 1.13 [0.94, 1.37] | 1 study · 141 participants | Very low Downgraded: risk of bias |
Adverse events at 4 months Surgery vs oral medication | RR 0.26 [0.15, 0.46] | 1 study · 186 participants | Moderate Downgraded: risk of bias |
Surgery versus LNG‐IUS for women with heavy menstrual bleeding
Population: women with heavy menstrual bleeding
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Objective control of bleeding: menstrual loss under 80 ml per cycle LNG‐IUS versus hysterectomy At 1 year Surgery vs LNG‐IUS | RR 1.11 [1.05, 1.19] | 1 study · 223 participants | Moderate |
Subjective control of bleeding: PBAC no more than 75 per cycle Endometrial resection or ablation versus LNG‐IUS At 1 year Surgery vs LNG‐IUS | RR 1.19 [1.07, 1.32] | 5 studies · 281 participants | Low |
Satisfaction rate: surgery versus LNG‐IUS Endometrial ablation versus LNG‐IUS At 1 year Surgery vs LNG‐IUS | RR 1.1 [0.98, 1.24] | 5 studies · 332 participants | Low |
Satisfaction rate: surgery versus LNG‐IUS Endometrial ablation versus LNG‐IUS At 2 years Surgery vs LNG‐IUS | RR 0.93 [0.81, 1.08] | 2 studies · 117 participants | Low |
Proportion of women with adverse events Endometrial ablation versus LNG‐IUS. At one year Surgery vs LNG‐IUS | RR 0.51 [0.36, 0.74] | 3 studies · 201 participants | Moderate |