Conclusion
The application of LNG-IUD is
superior to hysteroscopic niche resection in the treatment of
postmenstrual spotting in women with niche in the uterine CS scar and
with lower direct medical costs. Therefore, this therapy should be
offered as a first line therapy in women with a niche and postmenstrual
spotting without the desire to conceive within one year.
The effect of LNG-IUD increased over
time during the first year while the optimal effect of a hysteroscopic
niche resection is reached after 3 months. Proper counseling of patients
receiving LNG-IUD prevents unneeded premature removal of the IUD.