Prathima Chowdary1, Peter Maher2, Tony Ma2, Marsali Newman3, Lenore Ellett2, Emma Readman2. 1. i3 Waitemata District Health Board, Auckland, New Zealand (Dr. Chowdary); University of Auckland, Auckland, New Zealand (Dr. Chowdary). Electronic address: prath1mak@yahoo.co.in. 2. Mercy Hospital for Women, Victoria, Australia (Drs. Maher, Ma, Ellett, and Readman). 3. Austin Hospital, Victoria, Australia (Dr. Newman).
Abstract
STUDY OBJECTIVE: To study the hypothesis that the levonorgestrel intrauterine device (LNG-IUD) can have a role in the treatment of endometrial polyps confirmed at outpatient hysteroscopy in premenopausal women. DESIGN: Canadian Task Force classification level II1 (a controlled trial that is not randomised). SETTING: Outpatient hysteroscopy. PATIENTS: Premenopausal women who had a polyp diagnosed at outpatient hysteroscopy. INTERVENTIONS:Premenopausal women who had a polyp diagnosed at outpatient hysteroscopy and had a LNG-IUD inserted were booked for general anesthesia hysteroscopy and polypectomy through the standard booking process. A contemporaneous control was taken sequentially from the outpatient hysteroscopy database to match the case. MEASUREMENTS AND MAIN RESULTS: The presence of a polyp at hysteroscopy under general anesthesia. A total of 39 patients were included in the study, with 19 in the intervention group and 20 in the control group. The mean age was 43.6 (standard deviation = 5.6) and 43.2 (standard deviation = 8.1) years in the 2 groups, respectively. No difference was found in the time interval between the 2 procedures in the intervention and control groups (mean = 92 vs 84 days, p = .73). However, the proportion of polyps present at the second procedure was significantly higher in the control group (80% vs 37%; relative risk = 2.17; 95% confidence interval, 1.16-4.07; p = .0062). CONCLUSION: Our case-control study found that the LNG-IUD can have a role in the treatment of polyps for women who have heavy menstrual bleeding. This is the first study to show regression of endometrial polyps after treatment with LNG-IUD by direct visualisation at hysteroscopy.
RCT Entities:
STUDY OBJECTIVE: To study the hypothesis that the levonorgestrel intrauterine device (LNG-IUD) can have a role in the treatment of endometrial polyps confirmed at outpatient hysteroscopy in premenopausal women. DESIGN: Canadian Task Force classification level II1 (a controlled trial that is not randomised). SETTING:Outpatient hysteroscopy. PATIENTS: Premenopausal women who had a polyp diagnosed at outpatient hysteroscopy. INTERVENTIONS: Premenopausal women who had a polyp diagnosed at outpatient hysteroscopy and had a LNG-IUD inserted were booked for general anesthesia hysteroscopy and polypectomy through the standard booking process. A contemporaneous control was taken sequentially from the outpatient hysteroscopy database to match the case. MEASUREMENTS AND MAIN RESULTS: The presence of a polyp at hysteroscopy under general anesthesia. A total of 39 patients were included in the study, with 19 in the intervention group and 20 in the control group. The mean age was 43.6 (standard deviation = 5.6) and 43.2 (standard deviation = 8.1) years in the 2 groups, respectively. No difference was found in the time interval between the 2 procedures in the intervention and control groups (mean = 92 vs 84 days, p = .73). However, the proportion of polyps present at the second procedure was significantly higher in the control group (80% vs 37%; relative risk = 2.17; 95% confidence interval, 1.16-4.07; p = .0062). CONCLUSION: Our case-control study found that the LNG-IUD can have a role in the treatment of polyps for women who have heavy menstrual bleeding. This is the first study to show regression of endometrial polyps after treatment with LNG-IUD by direct visualisation at hysteroscopy.