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.