Menorrhagia Clinical Trial
Official title:
Surgical Treatments Outcomes Project for Dysfunctional Uterine Bleeding (STOP-DUB)
STOP-DUB is a multicenter randomized clinical trial that is assessing the efficacy and effectiveness of hysterectomy versus endometrial ablation (EA) for dysfunctional uterine bleeding (DUB) in women for whom medical management has not provided relief.
Status | Completed |
Enrollment | 242 |
Est. completion date | January 2004 |
Est. primary completion date | |
Accepts healthy volunteers | No |
Gender | Female |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - Abnormal uterine bleeding in the absence of structural pathology, pharmacologic agents, IUD use, or systemic disorders of hemostasis that could explain the condition. Exclusion Criteria: Prescreen - Age < 18 years - Postmenopausal status (or bilateral oophorectomy) - Bleeding not considered excessive by woman - Desire to retain fertility - Refusal to consider surgery - Known myoma (from prior examination) Eligibility Screen - Lack of willingness to have a gynecologic or ultrasound examination - Lack of willingness to be interviewed about bleeding or consider study - Pregnancy - Prior endometrial resection or ablation - Prior myomectomy, myolysis, or hysterectomy Medical History - No tentative diagnosis of DUB - History of malignancy of vagina, cervix, endometrium, or ovary - History of complex endometrial hyperplasia or simple hyperplasia with atypia - Current use of tamoxifen - < 6 months since onset of excessive uterine bleeding - < 9 months since stopping the use of IUD - < 9 months since stopping the use of implantable hormone agent - < 18 months since stopping use of Depo-Provera - < 6 months of anovulatory DUB after reaching euthyroid status for woman with diagnosis of hypothyroidism - < 3 months since pathology results indicate presence of endometrial polyp Baseline Gynecologic Examination - Enlarged (>= 14 weeks gestational age) uterus - Focal bleeding of genital, urinary, or gastrointestinal tract Ultrasound Examination - Presence of any submucosal myoma - Presence of any myoma >= 3 cm, any location - Presence of > 3 myomas, any size or location - Presence of endometrial polyp(s) - Malignancy of the vagina, cervix, endometrium, or ovary Laboratory and Ancillary Tests - FSH level in women ages > 45 years confirming postmenopausal status - Abnormal urinary tract or gastrointestinal tract imaging related to uterine bleeding - Evidence of cervical cancer (screened by Pap smear in last 12 months and confirmed by colposcopy) - Evidence of complex endometrial hyperplasia or simple hyperplasia with atypia or endometrial cancer (endometrial biopsy in last 12 months) - Any test value inconsistent with a diagnosis of DUB - Any test values, unlikely to change, compromising patient safety for surgery Other - Any existing medical condition, unlikely to change, putting patient at excessive risk for surgery - Request for prophylactic bilateral oophorectomy by woman aged <45 years - Lack of willingness to comply with study requirements - Uncooperative behavior - Any coexisting condition that may influence a patient's ability to comply with participation - Refusal to allow evaluation or follow-up - In process of scheduling surgery at time of baseline visit Provisional Eligibility Criteria - Refusal of randomization - < 3 months of medical management (excluding GnRH agonist therapy) within the past 2 years - Ongoing evaluation or treatment for abnormal cervical cytology (including endocervical polyps) - Gastrointestinal or urinary tract condition unrelated to uterine bleeding currently being treated - Any temporary test value compromising patient safety - Any temporary existing medical condition putting patient at excessive risk from surgery - Any coexisting condition requiring surgery (except tubal occlusion for any woman or oophorectomy for women >= 45 years of age) - Lack of willingness to proceed with surgery at this time - Lack of willingness to proceed with surgery likely to result in infertility |
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind, Primary Purpose: Treatment
Country | Name | City | State |
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n/a |
Lead Sponsor | Collaborator |
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Agency for Healthcare Research and Quality (AHRQ) |
Dickersin K, Munro M, Langenberg P, Scherer R, Frick KD, Weber AM, Johns A, Peipert JF, Clark M; Surgical Treatments Outcomes Project for Dysfunctional Uterine Bleeding Research Group. Surgical Treatments Outcomes Project for Dysfunctional Uterine Bleeding (STOP-DUB): design and methods. Control Clin Trials. 2003 Oct;24(5):591-609. — View Citation
Weber AM, Munro MG. Endometrial ablation versus hysterectomy: STOP-DUB. Medscape Womens Health. 1998 May;3(3):3. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Randomized trial: Impact of surgery on bleeding, pain, | |||
Primary | fatigue, and major problem (symptom) leading the woman to seek treatment for her condition. | |||
Primary | Observational study: changes over time in treatment selected, DUB-related symptoms, and quality of life. | |||
Secondary | Randomized trial: Impact of surgery on primary outcomes at time points after 1 year, quality of life, activity limitation, sexual functioning, urinary incontinence, surgical complications, additional surgery, resource utilization. |
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