Assessing the efficacy of combining Transcervical resection of the endometrium and Levonorgestrel intrauterine system treatment for abnormal uterine bleeding

Abnormal uterine bleeding (AUB) occurs in approximately 10%-35% of womenand is commonly associated with restriction of daily activity and a substantial effect on quality of life. Transcervical resection of the endometrium (TCRE) is minimally invasive, as it preserves the uterus, is associated with fewer complications, and is safer compared with hysterectomy. TCRE is widely acknowledged as the first-line surgical treatment of AUB but has a high failure rate. Studies have shown failure rates of between 21% and 36% with Levonorgestrel Intrauterine System (LNG-IUS) as a monotherapy treatment for AUB.

Women with AUB may benefit from adding LNG-IUS to TCRE. The aim of this study is to assess the effectiveness of combination treatment with TCRE + LNG-IUS compared with TCRE alone in patients with AUB with/without dysmenorrhea.

TCRE will be done with a hysteroscopic resectoscope. The first follow-up time will be one month, and the second follow-up will be three months after their initial surgery. During the follow-up period, patients will be questioned about their menstrual bleeding pattern and dysmenorrhea. Expected outcome - Combined TCRE and LNG-IUS will be superior to either treatment alone.