{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T21:07:06Z","timestamp":1793308026921,"version":"4.5.0"},"reference-count":51,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T00:00:00Z","timestamp":1668643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Hysteroscopic endometrial resection (ER) or global endometrial ablation (GEA) are feasible methods to treat heavy menstrual bleeding (HMB). The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to assess patient\u2019s quality of life (QoL) in women treated with ER\/GEA compared to hysterectomy. Materials and Methods: Electronic searches in MEDLINE Scopus, ClinicalTrials.gov, EMBASE, PROSPERO and Cochrane CENTRAL were conducted from their inception to July 2022. Inclusion criteria were RCTs of premenopausal women with HMB randomized to conservative surgical treatment (ER\/GEA) or hysterectomy. The primary outcome was the evaluation of QoL using the SF-36 score. Results: Twelve RCTs (2773 women) were included in the analysis. Women treated with hysteroscopic ER\/GEA showed significantly lower scores for the SF-36 general health perception (mean difference (MD) \u22128.56 [95% CI \u221211.75 to \u22125.36]; I2 = 0%), social function (MD \u221212.90 [95% CI \u221223.90 to \u22121.68]; I2 = 91%), emotional role limitation (MD \u22124.64 [95% CI \u22128.43 to \u22120.85]; I2 = 0%) and vitality (MD \u22128.01 [95% CI \u221214.73 to \u22121.30]; I2 = 74%) domains relative to hysterectomy. Anxiety, depression scores and complication rates were similar between treatments. Relative to uterine balloon therapy, amenorrhea was more common with EA\/GER (relative risk 1.51 [95% CI 1.03 to 1.20] I2 = 28%), but posttreatment satisfaction was similar. Conclusions: Women\u2019s perception of QoL might be seen to be less improved after hysteroscopic ER\/GEA rather than hysterectomy. However, such findings need to be confirmed by additional trials due to the high number of outdated studies and recent improvements in hysteroscopic instrumentation and techniques.<\/jats:p>","DOI":"10.3390\/medicina58111664","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T03:31:10Z","timestamp":1668742270000},"page":"1664","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Quality of Life, Anxiety and Depression in Women Treated with Hysteroscopic Endometrial Resection or Ablation for Heavy Menstrual Bleeding: Systematic Review and Meta-Analysis of Randomized Controlled Trials"],"prefix":"10.3390","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6871-6097","authenticated-orcid":false,"given":"Salvatore","family":"Vitale","sequence":"first","affiliation":[{"name":"Division of Gynecology and Obstetrics, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3676-7716","authenticated-orcid":false,"given":"Gaetano","family":"Riemma","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania \u201cLuigi Vanvitelli\u201d, 80128 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1365-8704","authenticated-orcid":false,"given":"Mislav","family":"Miku\u0161","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital Center Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Carugno","sequence":"additional","affiliation":[{"name":"Obstetrics, Gynecology and Reproductive Sciences Department, Minimally Invasive Gynecology Unit, University of Miami, Miller School of Medicine, Miami, FL 33124, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Torella","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania \u201cLuigi Vanvitelli\u201d, 80128 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5304-7476","authenticated-orcid":false,"given":"Enrique","family":"Reyes-Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Department of Gynecological and Perinatal Endocrinology, Instituto Nacional de Perinatolog\u00eda, Mexico City 11000, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"Cela","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Obstetrics, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7440-6941","authenticated-orcid":false,"given":"Tirso","family":"Perez Medina","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital Puerta de Hierro Majadahonda, Autonoma University of Madrid, 28001 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0584-2181","authenticated-orcid":false,"given":"Luigi","family":"Della Corte","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8521-3675","authenticated-orcid":false,"given":"Luis","family":"Pacheco","sequence":"additional","affiliation":[{"name":"Unidad de Endoscopia Ginecol\u00f3gica, Centro Gutenberg, 29010 M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Haimovich","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Laniado University Hospital, Netanya, Israel and Adelson School of Medicine, Ariel University, Ariel 98603, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"De Franciscis","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania \u201cLuigi Vanvitelli\u201d, 80128 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2314-0028","authenticated-orcid":false,"given":"Stefano","family":"Angioni","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Obstetrics, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/s10397-011-0695-3","article-title":"Indications of diagnostic hysteroscopy, a brief review of the literature","volume":"9","author":"Daniilidis","year":"2011","journal-title":"Gynecol. 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