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. 2020 Jun 12;2020(6):CD002126. doi: 10.1002/14651858.CD002126.pub4

Comparison 3. LNG‐IUS versus endometrial ablation.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
3.1 Mean menstrual blood loss at end of study 2   Mean Difference (IV, Fixed, 95% CI) Totals not selected
3.1.1 Mean PBAC score at 12 months 2   Mean Difference (IV, Fixed, 95% CI) Totals not selected
3.2 Improvement in HMB 8   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
3.2.1 Amenorrhoea within 12 months 8 431 Risk Ratio (M‐H, Fixed, 95% CI) 1.21 [0.85, 1.72]
3.2.2 Hypomenorrhoea within 12 months 4 200 Risk Ratio (M‐H, Fixed, 95% CI) 0.98 [0.73, 1.33]
3.2.3 Eumenorrhoea within 12 months 3 160 Risk Ratio (M‐H, Fixed, 95% CI) 0.55 [0.30, 1.00]
3.2.4 Improvement in bleeding pattern within 12 months 3 172 Risk Ratio (M‐H, Fixed, 95% CI) 1.20 [1.02, 1.41]
3.3 PBAC score after treatment (descriptive results) 6   Other data No numeric data
3.4 Proportion of women satisfied with treatment 7   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
3.4.1 Within one year follow‐up 5 317 Risk Ratio (M‐H, Fixed, 95% CI) 0.95 [0.85, 1.07]
3.4.2 At 2 years follow up 2 319 Risk Ratio (M‐H, Fixed, 95% CI) 0.89 [0.80, 1.00]
3.4.3 At 5 years follow‐up 1 52 Risk Ratio (M‐H, Fixed, 95% CI) 1.25 [1.01, 1.53]
3.5 Quality of life (SF36) within 12 months follow‐up 2   Mean Difference (IV, Fixed, 95% CI) Subtotals only
3.5.1 Physical functioning 1 33 Mean Difference (IV, Fixed, 95% CI) ‐3.10 [‐11.10, 4.90]
3.5.2 Role limitation (physical) 1 33 Mean Difference (IV, Fixed, 95% CI) ‐2.50 [‐9.32, 4.32]
3.5.3 Bodily pain 1 33 Mean Difference (IV, Fixed, 95% CI) 0.40 [‐6.43, 7.23]
3.5.4 General health 1 33 Mean Difference (IV, Fixed, 95% CI) ‐14.40 [‐22.63, ‐6.17]
3.5.5 Vitality 1 33 Mean Difference (IV, Fixed, 95% CI) ‐5.20 [‐11.46, 1.06]
3.5.6 Social functioning 1 33 Mean Difference (IV, Fixed, 95% CI) ‐6.70 [‐12.82, ‐0.58]
3.5.7 Role limitation (emotional) 1 33 Mean Difference (IV, Fixed, 95% CI) ‐10.10 [‐17.03, ‐3.17]
3.5.8 Mental health 1 33 Mean Difference (IV, Fixed, 95% CI) ‐11.20 [‐17.08, ‐5.32]
3.5.9 Overall SF36 score 1 79 Mean Difference (IV, Fixed, 95% CI) 2.60 [‐5.98, 11.18]
3.6 Quality of life (QOL) scores at 12 months (SF36) ‐ descriptive results 2   Other data No numeric data
3.7 Quality of life within 5 years follow‐up (proportion with improved wellbeing) 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
3.7.1 Physical 1 52 Risk Ratio (M‐H, Fixed, 95% CI) 1.46 [1.11, 1.92]
3.7.2 Emotional 1 52 Risk Ratio (M‐H, Fixed, 95% CI) 1.59 [1.09, 2.30]
3.8 Quality of life within 5 years ‐ psychological wellbeing (continuous) 1 28 Mean Difference (IV, Fixed, 95% CI) 10.30 [‐6.18, 26.78]
3.9 Total proportion of women with adverse events 3 201 Risk Ratio (M‐H, Fixed, 95% CI) 2.06 [1.44, 2.94]
3.10 Individual adverse events 6   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
3.10.1 Endometritis 2 120 Risk Ratio (M‐H, Fixed, 95% CI) 0.70 [0.21, 2.35]
3.10.2 Pelvic pain or PID 3 180 Risk Ratio (M‐H, Fixed, 95% CI) 1.18 [0.46, 3.01]
3.10.3 Myometritis 1 41 Risk Ratio (M‐H, Fixed, 95% CI) 0.38 [0.02, 8.89]
3.10.4 Adenomyosis 1 41 Risk Ratio (M‐H, Fixed, 95% CI) 0.38 [0.02, 8.89]
3.10.5 Abnormal PAP 1 41 Risk Ratio (M‐H, Fixed, 95% CI) 0.16 [0.01, 2.99]
3.10.6 Oedema 1 41 Risk Ratio (M‐H, Fixed, 95% CI) 3.45 [0.15, 80.03]
3.10.7 Breast pain 3 201 Risk Ratio (M‐H, Fixed, 95% CI) 7.57 [1.78, 32.23]
3.10.8 Weight gain 2 141 Risk Ratio (M‐H, Fixed, 95% CI) 2.60 [1.16, 5.84]
3.10.9 Mood swings 2 132 Risk Ratio (M‐H, Fixed, 95% CI) 2.33 [0.36, 15.32]
3.10.10 Bloating 2 141 Risk Ratio (M‐H, Fixed, 95% CI) 4.57 [1.63, 12.82]
3.10.11 Acne or greasy skin 3 201 Risk Ratio (M‐H, Fixed, 95% CI) 8.40 [1.57, 44.76]
3.10.12 Nausea 1 72 Risk Ratio (M‐H, Fixed, 95% CI) 9.00 [0.50, 161.29]
3.10.13 Headache 3 201 Risk Ratio (M‐H, Fixed, 95% CI) 2.04 [0.64, 6.50]
3.10.14 Leg pain 2 141 Risk Ratio (M‐H, Fixed, 95% CI) 3.04 [0.32, 28.57]
3.10.15 Dysmenorrhoea 2 151 Risk Ratio (M‐H, Fixed, 95% CI) 0.25 [0.03, 2.17]
3.10.16 Lower abdominal pain 4 242 Risk Ratio (M‐H, Fixed, 95% CI) 1.65 [0.55, 4.97]
3.10.17 Actinomycoses 1 79 Risk Ratio (M‐H, Fixed, 95% CI) 2.93 [0.12, 69.74]
3.10.18 Decreased libido 1 69 Risk Ratio (M‐H, Fixed, 95% CI) 1.03 [0.15, 6.90]
3.10.19 Hair loss 1 69 Risk Ratio (M‐H, Fixed, 95% CI) 5.14 [0.26, 103.35]
3.10.20 Anxiety or depression 1 69 Risk Ratio (M‐H, Fixed, 95% CI) 2.06 [0.20, 21.67]
3.10.21 Hypertension 1 69 Risk Ratio (M‐H, Fixed, 95% CI) 3.09 [0.13, 73.21]
3.10.22 Endometriosis 1 41 Risk Ratio (M‐H, Fixed, 95% CI) 0.38 [0.02, 8.89]
3.10.23 Bleeding or spotting 4 241 Risk Ratio (M‐H, Fixed, 95% CI) 1.39 [0.74, 2.58]
3.10.24 Hematometra 1 60 Risk Ratio (M‐H, Fixed, 95% CI) 0.33 [0.01, 7.87]
3.10.25 Vaginitis 1 60 Risk Ratio (M‐H, Fixed, 95% CI) 2.00 [0.40, 10.11]
3.10.26 Genital ulceration 1 60 Risk Ratio (M‐H, Fixed, 95% CI) 0.33 [0.01, 7.87]
3.11 Treatment failure: discontinuation of initial treatment, adjunct medical therapy or persistent HMB) 5   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
3.11.1 at 12 months 5 320 Risk Ratio (M‐H, Fixed, 95% CI) 1.78 [1.09, 2.90]
3.11.2 at 24 months 3 199 Risk Ratio (M‐H, Fixed, 95% CI) 1.51 [0.94, 2.42]
3.11.3 at 36 months 1 60 Risk Ratio (M‐H, Fixed, 95% CI) 1.50 [0.61, 3.69]
3.12 Treatment failure: requirement for surgery for the treatment of HMB (ablation or hysterectomy) 4   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
3.12.1 at 12 months 3 174 Risk Ratio (M‐H, Fixed, 95% CI) 1.47 [0.67, 3.23]
3.12.2 at 24 months 2 139 Risk Ratio (M‐H, Fixed, 95% CI) 0.77 [0.31, 1.91]
3.12.3 at 36 months 1 60 Risk Ratio (M‐H, Fixed, 95% CI) 0.11 [0.01, 1.98]
3.13 Treatment failure: requirement for hysterectomy 6   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
3.13.1 at 12 months 3 400 Risk Ratio (M‐H, Fixed, 95% CI) 2.56 [1.48, 4.42]
3.13.2 at 24 months 2 142 Risk Ratio (M‐H, Fixed, 95% CI) 1.14 [0.50, 2.60]
3.13.3 at 5 years 1 58 Risk Ratio (M‐H, Fixed, 95% CI) 0.16 [0.02, 1.21]
3.14 Total cost per woman 1   Other data No numeric data