Hysterectomy, endometrial destruction, and levonorgestrel releasing intrauterine system (Mirena) for heavy menstrual bleeding: systematic review and meta-analysis of data from individual patients.

Differences from absolute values (not adjusted for baseline score) were highly significant (P<0.001) in all eight domains in favour of satisfied patients.

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First v second generation endometrial destruction techniques —The proportion of women with amenorrhoea or still experiencing heavy bleeding was similar in both groups at all time points, apart from at two years, where there was a difference of borderline significance in favour of second generation techniques (odds ratio 0.64, 0.41 to 0.99, P=0.04, for amenorrhea; 0.54, 0.30 to 0.97, P=0.04, for heavy bleeding) (see appendix 6 on bmj.com).

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Absence of fibroids/polyps also showed a trend towards reduced dissatisfaction (P=0.07), although no further adjusted estimates including both parameters were attempted as only three studies had data on fibroids/polyps.

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