Clinical Practice Guideline for Abnormal Uterine Bleeding: Hysterectomy versus Alternative Therapy Article

Full Text via DOI: 10.1016/j.jmig.2011.10.001 PMID: 22078016 Web of Science: 000299305100015

Cited authors

  • Wheeler, Thomas L., II; Murphy, Miles; Rogers, Rebecca G.; Gala, Rajiv; Washington, Blair; Bradley, Linda; Uhlig, Katrin


  • Study Objective: To develop recommendations in selecting treatments for abnormal uterine bleeding (AUB).; Design: Clinical practice guidelines.; Setting: Randomized clinical trials compared bleeding, quality of life, pain, sexual health, satisfaction, the need for subsequent surgery, and adverse events between hysterectomy and less-invasive treatment options.; Patients: Women with AUB, predominantly from ovulatory disorders and endometrial causes.; Interventions: On the basis of findings from a systematic review, clinical practice guidelines were developed. Rating the quality of evidence and the strength of recommendations followed the Grades for Recommendation Assessment, Development, and Evaluation system.; Measurements and Main Results: This paper identified few high-quality studies that directly compared uterus-preserving treatments (endometrial ablation, levonorgestrel intrauterine system and systemically administered medications) with hysterectomy. The evidence from these randomized clinical trials demonstrated that there are trade-offs between hysterectomy and uterus-preserving treatments in terms of efficacy and adverse events.; Conclusion: Selecting an appropriate treatment for AUB requires identifying a woman's most burdensome symptoms and incorporating her values and preferences when weighing the relative benefits and harms of hysterectomy versus other treatment options. Journal of Minimally Invasive Gynecology (2012) 19, 81-88 (C) 2012 AAGL. All rights reserved,


Publication date

  • 2012

International Standard Serial Number (ISSN)

  • 1553-4650

Start page

  • 81

End page

  • 88


  • 19


  • 1