Purpose of review
The aim of this systematic review is to summarize the current evidence regarding the effectiveness of hysterectomy
and hysteroscopic endometrial resection
in improving quality of life
(QoL), sexual function and psychological wellbeing of women abnormal uterine bleeding
We performed a systematic literature search in PubMed/MEDLINE and Embase for original studies written in English (registered in PROSPERO 2019 CRD42019133632), using the terms ‘endometrial ablation’, ‘endometrial destruction’, ‘endometrial resection
’, ‘menorrhagia’, ‘dysfunctional uterine bleeding’, ‘quality of life
’, ‘sexuality’ published up to April 2019. Our literature search produced 159 records. After exclusions, nine studies were included showing the following results: both types of treatment significantly improve QoL and psychological wellbeing; hysterectomy
is associated with higher rates of satisfaction; hysterectomy
is not associated with a significant deterioration in sexual function.
is currently more advantageous in terms of improving abnormal uterine bleeding
and satisfaction rates than hysteroscopic endometrial destruction techniques. Furthermore, there is some evidence of a greater improvement in general health for women undergoing hysterectomy
. However, high-quality prospective randomized controlled trials should be implemented to investigate the effectiveness of hysterectomy
and endometrial ablation in the improvement of QoL outcomes in larger patient cohorts.