Treatment of symptomatic adenomyosis with the levonorgestrel‐releasing intrauterine system

Lei Li, Jinhua Leng, Shuangzheng Jia, Jinghe Lang
International Journal of Gynecology & Obstetrics · 2019 · vol. 146(3) , pp. 357–363 · doi:10.1002/ijgo.12887 · PMID:31194884 · W2951839410
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Long-term use of the levonorgestrel-releasing intrauterine system significantly improved pain, bleeding, uterine volume, and CA125 levels in women with symptomatic adenomyosis.

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Abstract

OBJECTIVE: To determine the long-term effects of using the levonorgestrel-releasing intrauterine system (LNG-IUS) to treat symptomatic adenomyosis. METHOD: A prospective longitudinal study was conducted among 1100 women who received the LNG-IUS at a tertiary teaching hospital in China between December 10, 2006, and December 24, 2014. All participants had symptomatic adenomyosis (visual analogue scale [VAS] ≥7 and/or pictorial blood loss assessment chart [PBAC] score >100) diagnosed by transvaginal sonography. Follow-up was at 3, 6, 12, 24, 36, 48, and 60 months after LNG-IUS placement. The primary outcome was symptom relief. Secondary outcomes included LNG-IUS retention status; changes in uterine volume; serum levels of cancer antigen 125 (CA125); menstruation pattern; and adverse events. RESULTS: In all, 374 (33.7%) participants completed 60 months of LNG-IUS treatment. The VAS, verbal rating scale, PBAC score, hemoglobin level, uterine volume, and serum CA125 level all showed marked improvements at this time point when compared with baseline (P<0.05 for all comparisons). The cumulative retention rate of LNG-IUS was 56.2%. Changes in menstruation pattern at 60 months included amenorrhea (n=97, 25.9%) and shortened periods (n=82, 21.9%). The incidence of adverse events was <10% and not considered notable. CONCLUSIONS: Long-term use of LNG-IUS was effective and acceptable for the treatment of symptomatic adenomyosis. Registered at clinicaltrials.gov (NCT03027648).

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Outcome instruments

VAS-pain

Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Intrauterine Devices, Medicated Levonorgestrel Adenomyosis Adenomyosis Adult CA-125 Antigen CA-125 Antigen China Female Humans Levonorgestrel Longitudinal Studies Menstruation Menstruation Middle Aged Prospective Studies Treatment Outcome Ultrasonography Visual Analog Scale

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Cited by (34)

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