Comparison of Benefits, Recovery Time and Post-Procedural Effect, and Risks and Complications

	Hysterectomy	Drug/hormone therapy	Dilation and Curettage (D&C)	First-generation endometrial ablation	Second-generation endometrial ablation (including MEA)
Benefits	Complete elimination of menstrual bleeding	Relief for HMB Non-invasive – no procedure required Once therapy is stopped, patient can get pregnant	Reduction of heavy flow for next few cycles Removal of polyps (if they occur)	Light to moderate periods Possible elimination of bleeding	For 8 out of 10 women, periods are much lighter or stop altogether Avoid recovery time needed for hysterectomy No stitches or scars Can be done under local anaesthesia in theatre or office setting or under general anaesthesia in theatre Can avoid the risks associated with general anaesthesia Period pain related to heavy bleeding may be reduced No effect on hormone production by ovaries Operation takes less than 30 minutes
Recovery time/ post-procedural effects	Hospital stay required – 1-3 days for laparoscopic hysterectomy, 3-6 days for abdominal hysterectomy Bladder catheter for 1-3 days IV drip with fluids and painkillers for first 24 hours Discomfort and pain – several days Tiredness – up to six weeks Resume normal activity - four to eight weeks for abdominal hysterectomy, 1-2 weeks for laparoscopic hysterectomy	(See risks and complications below)	2-4 hours supervised recovery Resume normal activities 2-3 days Mild cramping Spotting or light bleeding Nausea and vomiting from general anaesthesia	2-4 hours supervised recovery Resume normal activities 2-3 days Mild to moderate cramping – lasting one to two weeks Vaginal discharge – two to four weeks Nausea and vomiting (general anaesthetic “Over-all” aching and soreness – 48 - 72 hours	For general anaesthesia, 2-4 hours supervised recovery For local anaesthesia, 1-2 hours supervised recovery For general anaesthesia, avoid driving for 24 hours For local anaesthesia, return to normal as soon as feel like it Some women experience mild cramping for a day or two Some women experience mild bleeding, like a period, for 7-10 days Watery discharge for 3-4 weeks Return to normal sexual activity after bleeding has settled If hormonal pre-treatment, may have hot flushes for a month or so

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