Evidence map›Paper›PMID 37075458›Full record

Observational studyEinstein (Sao Paulo, Brazil)2023

Comparative study of the levonorgestrel intrauterine system and laparoscopic hysterectomy for the treatment of heavy menstrual bleeding in enlarged uteri.

Daniella De Batista Depes, Marcos Vinícius Maia da Mata, Ana Maria Gomes Pereira, João Alfredo Martins, Maíta Poli de Araújo, Reginaldo Guedes Coelho Lopes, Zsuzsanna Ilona Katalin de Jármy-Di Bella

Open access · diamondAbstract readObservational Study
In one paragraph

Observational study in Einstein (Sao Paulo, Brazil), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.3field-weighted citation impact, top 41% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 1 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Daniella De Batista DepesInstituto de Assistência Médica ao Servidor Público Estadual, Hospital do Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brazil.ORCID http://orcid.org/0000-0002-6496-3389
Marcos Vinícius Maia da MataInstituto de Assistência Médica ao Servidor Público Estadual, Hospital do Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brazil.ORCID http://orcid.org/0000-0001-6375-3315
Ana Maria Gomes PereiraInstituto de Assistência Médica ao Servidor Público Estadual, Hospital do Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brazil.ORCID http://orcid.org/0000-0003-2697-2791
João Alfredo MartinsInstituto de Assistência Médica ao Servidor Público Estadual, Hospital do Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brazil.ORCID http://orcid.org/0000-0003-2854-6614
Maíta Poli de AraújoEscola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.ORCID http://orcid.org/0000-0003-4717-0106
Reginaldo Guedes Coelho LopesInstituto de Assistência Médica ao Servidor Público Estadual, Hospital do Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brazil.ORCID http://orcid.org/0000-0002-7735-8698
Zsuzsanna Ilona Katalin de Jármy-Di BellaEscola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.ORCID http://orcid.org/0000-0001-9179-3023
Bayer (United States) · USHospital do Servidor Público Estadual · BRUniversidade Federal de São Paulo · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe levonorgestrel intrauterine system treatment prevents 67.7% of surgeries in patients with heavy menstrual bleeding and enlarged uteri. To evaluate the effectiveness of the levonorgestrel intrauterine system in the treatment of patients with heavy menstrual bleeding and an enlarged uterus and to compare satisfaction and its complications with hysterectomy.

methodsThis was a comparative cross-sectional observational study of women with heavy menstrual bleeding and an enlarged uterus. Sixty-two women were treated and followed up for four years. Insertion of the levonorgestrel intrauterine system was performed in Group 1, and laparoscopic hysterectomy was performed in Group 2.

resultsIn Group 1 (n=31), 21 patients (67.7%) showed improvement in the bleeding pattern, and 11 patients (35.5%) had amenorrhea. Five patients (16.1%) remained with heavy bleeding and were considered to have experienced treatment failure. There were seven expulsions (22.6%); in five patients, bleeding remained heavy, but in two patients the bleeding returned to that of normal menstruation. No relationship was found between treatment failure and greater hysterometries (p=0.40) or greater uterine volumes (p=0.50), whereas expulsion was greater in uteri with smaller hysterometries (p=0.04). There were 13 (21%) complications, seven (53.8%) in the group that underwent insertion of the levonorgestrel intrauterine system (all were device expulsions), and six (46.2%) in the surgical group, which were the most severe ones (p=0.76). Regarding satisfaction, 12 patients (38.7%) were dissatisfied with the levonorgestrel intrauterine system and one (3.23%) was dissatisfied with the surgical treatment (p=0.00).

conclusionTreatment with the levonorgestrel intrauterine system in patients with heavy menstrual bleeding and an enlarged uterus was effective, and when compared with laparoscopic hysterectomy, it had a lower rate of satisfaction and the same rate of complications, although less severe.

Indexed as

LaparoscopyMenorrhagiaCross-Sectional StudiesFemaleHumansHysterectomyLevonorgestrelUrogenital AbnormalitiesUterusLevonorgestrel

Identifiers

PMID37075458
PMCPMC10118365
OpenAlexW4361981959

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.