Randomized trial of medical treatment versus hysterectomy for abnormal uterine bleeding: resource use in the Medicine or Surgery (Ms) trial

Am J Obstet Gynecol. 2006 Feb;194(2):332-8. doi: 10.1016/j.ajog.2005.08.014.


Objective: This study was undertaken to compare resource use outcomes for participants in the Medicine or Surgery (Ms) randomized trial.

Study design: In a randomized controlled trial, we compared resources used during a 24-month follow-up period by women with abnormal uterine bleeding who were randomly assigned to either expanded medical treatment or hysterectomy.

Results: Women randomly assigned to hysterectomy used significantly more resources (medicine = $4479, hysterectomy = $6777; P = .03), with almost all the difference caused by the hysterectomy procedure. Fifty-three percent of women randomly assigned to medicine had a hysterectomy during the follow-up period; women who were able to continue on medical therapy had mean total resource use of $2595 compared with $6128 for medicine patients who eventually had surgery.

Conclusion: For women with abnormal uterine bleeding refractory to cyclic medroxyprogesterone acetate, compared with expanded medical treatment, hysterectomy increases resource use significantly and results in better clinical and 6-month quality-of-life outcomes.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Diagnosis-Related Groups
  • Female
  • Health Resources / statistics & numerical data*
  • Humans
  • Hysterectomy / economics*
  • Menorrhagia / drug therapy*
  • Menorrhagia / economics
  • Menorrhagia / surgery*
  • Middle Aged
  • Pregnancy
  • Quality of Life
  • Relative Value Scales
  • Treatment Outcome
  • United States