Quality of Life, Anxiety and Depression in Women Treated with Hysteroscopic Endometrial Resection or Ablation for Heavy Menstrual Bleeding: Systematic Review and Meta-Analysis of Randomized Controlled Trials
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Sources
2.2. Eligibility Criteria and Data Collection
2.3. Risk of Bias
2.4. Main Outcome Measures
2.5. Data Analysis
3. Results
3.1. Study Characteristics
3.2. Quality Assessment
3.3. EA/ER vs. Hysterectomy
3.3.1. QoL
3.3.2. Anxiety and Depression
3.3.3. Postsurgical Complications
3.4. EA/ER vs. UBT
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Study, Year | Single Center/Multicentric | Design, Blinding | Duration | Location | Hysteroscopic Surgery | Intervention 2 | Intervention 3 | SS Hysteroscopy | SS Intervention 2 | SS Intervention 3 | Primary Outcome | Secondary Outcomes |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Pinion, 1994 [27] | Single center | RCT, single | 12 months | Scotland | 26Fr resectoscopic endometrial resection | Laser Ablation | Hysterectomy (unspecified) | 52 | 53 | 99 | Complications | Procedure time |
Alexander, 1996 [28] | Single center | RCT, single | 12 months | Scotland | 26Fr resectoscopic endometrial resection | Laser ablation | Hysterectomy (unspecified) | 52 | 53 | 99 | Anxiety and depression score (HADS) | NA |
Bhattacharya, 1997 [26] | Single center | RCT, single | 12 months | Scotland | 26Fr resectoscopic endometrial resection | Laser ablation | / | 184 | 188 | / | Procedure time, fluid overload rate | Amenorrhea rate, 2nd look rate, anxiety and depression score (HADS), dysmenorrhea rate |
Brun, 2006 [29] | Multicentric | RCT, single | 22 months | France | 26Fr resectoscopic endometrial resection | Uterine balloon therapy | / | 20 | 31 | / | menorrhea rate and the amount of uterine bleeding. | Satisfaction rate |
Crosignani, 1997 [30] | Single center | RCT, single | 24 months | Italy | 26Fr resectoscopic endometrial resection | Vaginal hysterectomy | / | 41 | 44 | / | Anxiety and depression state (HADS) | Sexual function, SF-36 |
Dwyer, 1993 [31] | Single center | RCT, single | NA | England | 26Fr resectoscopic endometrial resection | Abdominal hysterectomy | / | 100 | 100 | / | Patient satisfaction, complications; length of hospital stay; change in premenstrual symptoms. | NA |
Loffer, 2002 [32] | Single center | RCT, single | 12 months | USA | 26Fr resectoscopic endometrial resection | Uterine balloon therapy | / | 131 | 124 | / | Need for hysterectomy, | Bleeding, satisfaction rate |
Zupi, 2003 [33] | Single center | RCT, single | 24 months | Italy | 26Fr resectoscopic endometrial resection | Laparoscopic supracervical hysterectomy | / | 89 | 92 | / | SF-36, operative time | Postoperative course |
Zupi, 2015 [34] | Single center | RCT, single | 24 months | Italy | 26Fr resectoscopic endometrial resection | Laparoscopic supracervical hysterectomy | / | 89 | 92 | / | Reintervention rate | SF-36 |
Sculpher, 1996 [36] | Single center | RCT, single | NA | England | 26Fr resectoscopic endometrial resection | Hysterectomy (unspecified) | / | 88 | 97 | / | SF-36, operative time | Symptoms, complications, cost-analysis |
Cooper, 2019 [37] | Multicentric | RCT, single | 34 months | UK | 26Fr resectoscopic endometrial resection | Laparoscopic supracervical hysterectomy | / | 307 | 309 | / | Patient satisfaction, quality of life (MMAS scale) | Pain, symptoms, complications |
Meyer, 1998 [35] | Multicentric | RCT, single | 12 months | USA | 26Fr resectoscopic endometrial resection | Uterine balloon therapy | / | 117 | 128 | Menstrual pattern improvement | Satisfaction, Dysmenorrhea |
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Vitale, S.G.; Riemma, G.; Mikuš, M.; Carugno, J.; Torella, M.; Reyes-Muñoz, E.; Cela, V.; Perez Medina, T.; Della Corte, L.; Pacheco, L.A.; et al. Quality of Life, Anxiety and Depression in Women Treated with Hysteroscopic Endometrial Resection or Ablation for Heavy Menstrual Bleeding: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Medicina 2022, 58, 1664. https://doi.org/10.3390/medicina58111664
Vitale SG, Riemma G, Mikuš M, Carugno J, Torella M, Reyes-Muñoz E, Cela V, Perez Medina T, Della Corte L, Pacheco LA, et al. Quality of Life, Anxiety and Depression in Women Treated with Hysteroscopic Endometrial Resection or Ablation for Heavy Menstrual Bleeding: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Medicina. 2022; 58(11):1664. https://doi.org/10.3390/medicina58111664
Chicago/Turabian StyleVitale, Salvatore Giovanni, Gaetano Riemma, Mislav Mikuš, Jose Carugno, Marco Torella, Enrique Reyes-Muñoz, Vito Cela, Tirso Perez Medina, Luigi Della Corte, Luis Alonso Pacheco, and et al. 2022. "Quality of Life, Anxiety and Depression in Women Treated with Hysteroscopic Endometrial Resection or Ablation for Heavy Menstrual Bleeding: Systematic Review and Meta-Analysis of Randomized Controlled Trials" Medicina 58, no. 11: 1664. https://doi.org/10.3390/medicina58111664