Min Kyoung Kim1, Seung Joo Chon2, Jae Hoon Lee3,4, Bo Hyon Yun3,4, SiHyun Cho4,5, Young Sik Choi3,4, Byung Seok Lee3,4, Seok Kyo Seo3,4. 1. 1 Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University, Gangnam-gu, Seoul, Republic of Korea. 2. 2 Department of Obstetrics and Gynecology, Gil Hospital, Gachon University College of Medicine, Namdong-gu, Incheon, Republic of Korea. 3. 3 Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea. 4. 4 Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea. 5. 5 Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Gangnam-gu, Seoul, Republic of Korea.
Abstract
OBJECTIVE: The aim of this study was to evaluate the effectiveness of postoperative levonorgestrel-releasing intrauterine system (LNG-IUS) insertion after gonadotropin-releasing hormone agonist (GnRH-a) treatment for preventing endometriotic cyst recurrence. STUDY DESIGN: The LNG-IUS was applied to 28 women who had undergone surgery for endometriosis followed by 6 cycles of GnRH-a treatment. Clinical characteristics, endometriosis recurrence, and adverse effects were analyzed. Student t test was performed for analysis. RESULTS: Before surgery, 20 (71.4%) patients had dysmenorrhea, and the mean pain score (visual analog scale [VAS]) was 4.26. The numbers of women diagnosed with stage III endometriosis and stage IV endometriosis were 15 (53.6%) and 13 (46.4%), respectively, according to the revised American Fertility Society scoring system. The mean cancer antigen 125 levels and VAS scores were significantly lower after treatment than before treatment (11.61 vs 75.66 U/mL, P < .0001 and 0.50 vs 4.26 U/mL, P < .0001, respectively). Of the 28 patients, 13 (46.4%) simultaneously had adenomyosis, and 2 (7.1%) underwent LNG-IUS removal because of unresolved vaginal bleeding and dysmenorrhea. Recurrence was noted in 2 (7.1%) women. CONCLUSION: Postoperative LNG-IUS insertion after GnRH-a treatment is an effective approach for preventing endometriotic cyst recurrence, especially in women who do not desire to conceive.
OBJECTIVE: The aim of this study was to evaluate the effectiveness of postoperative levonorgestrel-releasing intrauterine system (LNG-IUS) insertion after gonadotropin-releasing hormone agonist (GnRH-a) treatment for preventing endometriotic cyst recurrence. STUDY DESIGN: The LNG-IUS was applied to 28 women who had undergone surgery for endometriosis followed by 6 cycles of GnRH-a treatment. Clinical characteristics, endometriosis recurrence, and adverse effects were analyzed. Student t test was performed for analysis. RESULTS: Before surgery, 20 (71.4%) patients had dysmenorrhea, and the mean pain score (visual analog scale [VAS]) was 4.26. The numbers of women diagnosed with stage III endometriosis and stage IV endometriosis were 15 (53.6%) and 13 (46.4%), respectively, according to the revised American Fertility Society scoring system. The mean cancer antigen 125 levels and VAS scores were significantly lower after treatment than before treatment (11.61 vs 75.66 U/mL, P < .0001 and 0.50 vs 4.26 U/mL, P < .0001, respectively). Of the 28 patients, 13 (46.4%) simultaneously had adenomyosis, and 2 (7.1%) underwent LNG-IUS removal because of unresolved vaginal bleeding and dysmenorrhea. Recurrence was noted in 2 (7.1%) women. CONCLUSION: Postoperative LNG-IUS insertion after GnRH-a treatment is an effective approach for preventing endometriotic cyst recurrence, especially in women who do not desire to conceive.
Entities:
Keywords:
endometrioma recurrence; endometriosis; gonadotropin-releasing hormone agonist; levonorgestrel-releasing intrauterine system