Authors: Hervé Fernandez¹; Giséla Kobelt²; Amélie Gervaise¹

Source: Human Reproduction, Volume 18, Number 3, March 2003 , pp. 583-587(5)

Publisher: Oxford University Press

Abstract:

BACKGROUND: The study was carried out to compare the overall effectiveness and direct economic costs of vaginal hysterectomy (VH), endometrial ablation (EA) and thermo-coagulation (TC) for the treatment menorrhagia. METHODS: We treated 50, 50 and 47 women with menorrhagia (>150 points on the Higham pictorial chart) by VH, EA and TC respectively. The patients were treated consecutively by the same surgeon and the choice between the three procedures depended on the desire of the patients. Resource utilization for the interventions was collected retrospectively from the hospital charts. A study questionnaire was mailed to the patients 24–36 months after the primary surgery. Patients who reported that they had undergone a second procedure or who were still menorrhagic were considered as treatment failures. RESULTS: As expected, the failure rate was lowest for VH. The total cost (without re-intervention for persistent menorrhagia) was 5315 for VH, 1098 for EA and 921 for TC. The total cost with re-intervention was calculated based on therapeutic strategies used in 2001 and estimated at 5321 for VH, 1263 for EA and 1320 for TC. CONCLUSIONS: The two out-patient procedures are very comparable in terms of success rates and costs. Choices will depend on budgeting considerations, surgeon skill and patient preference. The results may give guidance to investment decisions.

Keywords: direct costs/endometrial ablation/hysterectomy/men

Document Type: Research article

DOI: http://dx.doi.org/10.1093/humrep/deg141

Affiliations: 1: Service de Gynécologie-Obstétrique, Université Paris-Sud, Hôpital Antoine Béclère (AP-HP), 157, Rue de la Porte de Trivaux, 92141 Clamart Cedex and 2: HDI France, 492 chemin des Laurens, 06530 Spéracèdes, France

Publication date: 2003-03-01

More about this publication?

• Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.

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