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Clinical effects of the levonorgestrel-releasing intrauterine device in patients with adenomyosis

Authors
 SiHyun Cho  ;  Anna Nam  ;  HyeYeon Kim  ;  DooByung Chay  ;  KiHyun Park  ;  Dong Je Cho  ;  YongWon Park  ;  ByungSeok Lee 
Citation
 AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, Vol.198(4) : 373-7, 2008 
Journal Title
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
ISSN
 0002-9378 
Issue Date
2008
MeSH
Adult ; Dysmenorrhea/etiology ; Endometriosis/complications ; Endometriosis/drug therapy* ; Female ; Humans ; Intrauterine Devices, Medicated* ; Levonorgestrel/administration & dosage* ; Middle Aged ; Organ Size ; Pain Measurement ; Treatment Outcome ; Uterus/blood supply*
Keywords
adenomyosis ; Doppler color flow ; levonorgestrel intrauterine system ; uterine artery ; uterine volume
Abstract
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.
Full Text
http://www.sciencedirect.com/science/article/pii/S0002937807020200
DOI
10.1016/j.ajog.2007.10.798
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hye Yeon(김혜연)
Nam, An Na(남안나)
Park, Ki Hyun(박기현)
Park, Yong Won(박용원)
Lee, Byung Seok(이병석) ORCID logo https://orcid.org/0000-0001-6001-2079
Cho, Dong Je(조동제)
Cho, Si Hyun(조시현) ORCID logo https://orcid.org/0000-0003-2718-6645
Chay, Doo Byung(채두병) ORCID logo https://orcid.org/0000-0002-0648-4021
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/108233
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