Discussion
Our study demonstrates that both the application of LNG-IUD and hysteroscopic niche resection are effective in reducing postmenstrual spotting and total duration of bleeding per month during the first year. However, from 6 months onwards LNG-IUD was more effective in reducing spotting and total menstrual bleeding days than the hysteroscopic niche resection. The effectiveness of LNG-IUD in reducing spotting increased during the first year while the effect of the hysteroscopic niche resection remained stable. From 6 months onwards reduction in postmenstrual spotting was 8 days in the LNG-IUD group and it was 5 days form 3 months onwards in the hysteroscopic niche resection group. Minor side effects were only reported in the LNG-IUD group. From a medical cost-effective perspective is the LNG-IUD superior to a hysteroscopic niche resection. Additionally, a LNG-IUD can be placed in an outpatient department without any delay and therefor gives less pressure on clinical capacity and facilities.