Comparative Efficacy of NovaSure, the Levonorgestrel-Releasing Intrauterine System, and Hysteroscopic Endometrial Resection in the Treatment of Menorrhagia: A Randomized Clinical Trial

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Objective: The aim of this study was to determine the efficacy of NovaSure, the levonorgestrel-releasing intrauterine system (Mirena), and hysteroscopic endometrial resection in the treatment of menorrhagia. Design: The study was a prospective, randomized, clinical trial. Materials and Methods: A total of 110 consecutive patients with menorrhagia were included and divided randomly into three groups. Forty-eight subjects were in the Mirena group, 30 were in the NovaSure endometrial ablation group, and 32 were in the hysteroscopic endometrial resection group. Successful results (according to decreased blood loss and less interaction between bleeding and normal activity), complications, and patient satisfaction were compared between the three groups. Results: After treatment, there was no hemorrhage in 44.8% of patients in the NovaSure group, 12.2% in the Mirena group, and 43.3% in the hysteroscopic endometrial resection group (p=0.005). There was no interaction between normal activity and menorrhagia in 96.7% of patients in the NovaSure group, 63.2% in the Mirena group, and 96.7% in the hysteroscopic endometrial resection group (p=0.003). The patients were more satisfied with NovaSure compared with the two other treatment modalities (p=0.014). Conclusions: According to the results obtained in our study, it may be concluded that NovaSure is a better treatment for menorrhagia with good safety compared with the Mirena and hysteroscopic endometrial resection. (J GYNECOL SURG 28:215)