Hysterectomy or a minimal invasive alternative? A systematic review on quality of life and satisfaction

Table 5 Semiquantitative ranking based on statistical significance of treatment effect (difference between treatment arms) in terms of symptom relief (satisfaction) and quality of life (++, +, ±, −)

	Difference between treatment arms in favor of hysterectomy
Treatment compared with hysterectomy	Relief of symptoms (satisfaction)		Quality of life		Crossover to hysterectomy (%)
Treatment compared with hysterectomy	++, +, ±, −	p value or CI	++, +, ±, −	p value
Medical treatment [5]^a	++	<0.001	+	0.04	53
LNG-IUS (Mirena) [8]^b	−	Not stated	−	0.60	42
Endometrial ablation (1st generation) [9]^c	+	Significant	±	NS	38
Uterine artery embolization [6]^d	+	0.04	−	0.62	25

^aAfter 6 months of follow-up. QoL SF-36 mental component score, satisfaction symptom list of SF-36 physical component score
^bWith the Euroqol 5 after 2 years of follow-up. Satisfaction was only mentioned in the abstract.
^cAfter 2 years of follow-up, the Euroqol 5 showed no difference between groups; however, general health perception in the SF-36 did
^dAfter 2 years of follow-up. The p value is of the Euroqol 5 QoL questionnaire. No other QoL instruments showed a significant difference between groups.