Yue Wang1, Min Yang2, Xiufeng Huang3, Xingmiao Li4, Enze Lin5, Ye Feng6. 1. Department of Ambulatory Surgery, Women's Hospital, Zhejiang University School of Medicine (Dr. Wang). 2. Department of Reproductive Endocrinology, Zhejiang University School of Medicine (Dr. Yang). 3. Department of Gynecology, Zhejiang University School of Medicine (Dr. Huang). 4. Department of Obstetrics, Zhejiang University School of Medicine (Dr. Li). 5. Institute of Translational Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine (Dr. Feng and Mr. Lin); Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province (Dr. Feng and Mr. Lin), Hangzhou, Zhejiang, China. 6. Institute of Translational Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine (Dr. Feng and Mr. Lin); Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province (Dr. Feng and Mr. Lin), Hangzhou, Zhejiang, China.. Electronic address: pandafengye@zju.edu.cn.
Abstract
STUDY OBJECTIVE: To evaluate the levonorgestrel-releasing intrauterine system (LNG-IUS) to prevent the recurrence of endometrial polyps (EPs) after hysteroscopic polypectomies in premenopausal female patients. DESIGN: A retrospective cohort study. SETTING: A tertiary-care women's hospital. PATIENTS: A total of 451 premenopausal female patients underwent hysteroscopic polypectomies between January 1, 2016, and December 31, 2017. INTERVENTIONS: Treatment with LNG-IUS after hysteroscopic polypectomies. MEASUREMENTS AND MAIN RESULTS: After the hysteroscopic polypectomies and placement of LNG-IUS, transvaginal ultrasounds were performed every 6 months to measure the recurrence of EPs. Overall, 5 (3.47%) of 144 patients in the LNG-IUS cohort and 49 (15.96%) of 307 patients in the control cohort experienced EP recurrence within the follow-up period of up to 3 years. The recurrence exhibited a strongly negative correlation when LNG-IUS was inserted (relative risk, 0.218; 95% confidence interval, 0.089-0.535; p <.05), but this did not significantly correlate with age, polyp size, number of polyps, previous history of polypectomy, and abnormal uterine bleeding. For the LNG-IUS and control cohorts, the recurrence in the first postoperative year was 1.39% and 6.19%, respectively, and 5.41% and 19.23% in the second postoperative year, respectively. CONCLUSION: LNG-IUS reduces the recurrence of postoperative EPs in premenopausal patients.
STUDY OBJECTIVE: To evaluate the levonorgestrel-releasing intrauterine system (LNG-IUS) to prevent the recurrence of endometrial polyps (EPs) after hysteroscopic polypectomies in premenopausal female patients. DESIGN: A retrospective cohort study. SETTING: A tertiary-care women's hospital. PATIENTS: A total of 451 premenopausal female patients underwent hysteroscopic polypectomies between January 1, 2016, and December 31, 2017. INTERVENTIONS: Treatment with LNG-IUS after hysteroscopic polypectomies. MEASUREMENTS AND MAIN RESULTS: After the hysteroscopic polypectomies and placement of LNG-IUS, transvaginal ultrasounds were performed every 6 months to measure the recurrence of EPs. Overall, 5 (3.47%) of 144 patients in the LNG-IUS cohort and 49 (15.96%) of 307 patients in the control cohort experienced EP recurrence within the follow-up period of up to 3 years. The recurrence exhibited a strongly negative correlation when LNG-IUS was inserted (relative risk, 0.218; 95% confidence interval, 0.089-0.535; p <.05), but this did not significantly correlate with age, polyp size, number of polyps, previous history of polypectomy, and abnormal uterine bleeding. For the LNG-IUS and control cohorts, the recurrence in the first postoperative year was 1.39% and 6.19%, respectively, and 5.41% and 19.23% in the second postoperative year, respectively. CONCLUSION: LNG-IUS reduces the recurrence of postoperative EPs in premenopausal patients.