Clinical effects of the levonorgestrel-releasing intrauterine device in patients with adenomyosis
Received 11 May 2007; accepted 12 October 2007. published online 21 January 2008.
Objective
The aim of this study was to evaluate the long-term clinical effects of a levonorgestrel-releasing intrauterine device (LNG-IUD) on adenomyosis.
Study Design
A LNG-IUD was inserted into 47 patients who were diagnosed with adenomyosis. Uterine volume, uterine artery blood flow, pictorial blood loss assessment chart (PBAC) scores, and the degree of dysmenorrhea were evaluated before and 36 months after insertion of the LNG-IUD.
Results
Pain scores and PBAC scores dropped dramatically in 6 months and showed significant decrease after 36 months. A significant decrease in mean uterine volume was noted 12 months (156.85 ± 49.79 mL to 118.64 ± 41.36 mL; P < .001) and 24 months (128.84 ± 48.70 mL; P < .001) after LNG-IUD insertion, but no significant differences were noted at 36 months. The mean pulsatility indices of both uterine arteries increased significantly 12 months after insertion (P = .002 for right; P = .011 for left) and decreased after 24 months without significance. Uterine volume and uterine blood flow were negatively correlated (Pearson’s correlation, P < .05). Significant increase of uterine volume, pain scores, and PBAC scores were noted at 36 months compared with 12 months after insertion(P = .034, .021, and .001, respectively).
Conclusion
For patients with clinical diagnosis of adenomyosis, the LNG-IUD is effective for the reduction of uterine volume with improvement of vascularity and relief of symptoms. However, the efficacy of LNG-IUD on uterine volume may begin to decrease 2 years after insertion.
aDepartment of Obstetrics and Gynecology, Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
bDepartment of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
cDepartment of Obstetrics and Gynecology, YongIn Severance Hospital, Yonsei University College of Medicine, Kyunggi-do, Korea.
Reprints: ByungSeok Lee, MD, Department of Obstetrics and Gynecology, Yongdong Severance Hospital, Yonsei University College of Medicine, 146-92 Dogok-dong, KangNam-gu, Seoul 135-720, Korea.
Cite this article as: Cho S, Nam A, Kim H, et al. Clinical effects of the levonorgestrel-releasing intrauterine device in patients with adenomyosis. Am J Obstet Gynecol 2008;198:373.e1-373.e7.
ABSTRACT
Clinical effects of the levonorgestrel-releasing intrauterine device in patients with adenomyosis