Feasibility and Effectiveness of Hysteroscopic Suture Fixation of the Levonorgestrel-Releasing Intrauterine System in the Treatment of Adenomyosis.
J Minim Invasive Gynecol
; 31(1): 57-63, 2024 01.
Article
in En
| MEDLINE
| ID: mdl-37838016
ABSTRACT
STUDY OBJECTIVE:
To evaluate the feasibility and effectiveness of hysteroscopic suture fixation of the levonorgestrel-releasing intrauterine system (LNG-IUS) for the treatment of adenomyosis.DESIGN:
A retrospective case series.SETTING:
Two teaching hospitals with the technology of hysteroscopic suture fixation of the LNG-IUS. PATIENTS The study reviewed 79 adenomyosis patients who received the hysteroscopic suture fixation of the LNG-IUS from January 2021 to May 2022. INTERVENTION Hysteroscopic suture fixation of the LNG-IUS to the posterior uterine wall with nondissolvable suture. MEASUREMENTS AND MAINRESULTS:
All patients underwent one-year postoperative follow-up to evaluate the LNG-IUS expulsion rate, postoperative efficacy, and side effects. Two patients (2.6%) experienced expulsion of the LNG-IUS at 8 months and 12 months postoperatively, respectively. The visual analog pain scale, pictorial blood loss assessment chart score and carbohydrate antigen 125 markedly decreased after the suture fixation of the LNG-IUS compared with baseline in all patients (p <.001). Hemoglobin increased significantly (p <.001). The most common side effect was irregular bleeding, which accounted for 44.3%. The second common side effect was weight gain, which accounted for 29.2%. The composite effectiveness based on pain and bleeding showed that the effective treatment rates at 1, 3, 6, and 12 months after surgery were 92.4%, 97.4%, 96.2%, and 97.4% respectively.CONCLUSIONS:
Hysteroscopic suture fixation of the LNG-IUS to the uterine fundus was associated with low expulsion rates and significantly improved dysmenorrhea and bleeding.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Adenomyosis
/
Intrauterine Devices, Medicated
Limits:
Female
/
Humans
Language:
En
Journal:
J Minim Invasive Gynecol
Journal subject:
GINECOLOGIA
Year:
2024
Document type:
Article