The effect of levonorgestrel-releasing intrauterine system in ovarian endometriosis after laparoscopic operation / 中国医师进修杂志

ABSTRACT

Objective To discuss the effect of levonorgestrel-releasing intrauterine system (LNG-IUS) in ovarian endometriosis after laparoscopic operation.Methods One hundred and fifty patients with ovarian endometriosis were treated by placement of LNG-IUS after laparoscopic operation (study group).The therapeutic effect and adverse reaction were observed.Fifty patients with ovarian endometriosis only treated by orally gestrinone were as control group.The rate of recurrence was compared.Results After placement of LNG-IUS for 3,6,12 months,the thickness of endometrium in study group was significantly thinner [(6.02 ± 1.84),(5.68 ± 1.38),(4.04 ± 1.24) mm vs.(7.85 ± 1.62) mm],the amount of menorrhea and the scores of visual analogue scale (VAS) was significantly decreased [(48.29 ± 7.04),(32.64 ± 6.09),(19.74 ± 4.78) ml vs.(65.63 ± 7.83) ml,(35.74 ± 16.34),(20.54 ± 12.29),(13.79 ± 10.38) scores vs.(78.13 ± 15.69) scores],there was significantly difference compared with that before treatment (P ＜ 0.05).After placement of LNG-IUS for 3 months,the menstrual period in study group was significandy longer than that before treatment [(9.42 ± 3.75) d vs.(6.69 ± 2.83) d],and after placement of LNG-IUS for 12 months,the menstrual period in study group [(4.53 ± 1.37) d] was significantly shorter than that before eatment (P ＜ 0.05).In study group,the menstrual cycle had no significant difference among different time point (P ＞0.05).In follow-up period,the adverse reaction in study group was mainly intermenstrual bleeding,and the rate of intermenstrual bleeding was gradually decreased (P ＜ 0.05).Others adverse reaction was rare,and the incidence rate was gradually decreased.The rate of recurrence in study group was significandy lower than that in control group [14.7％(22/150) vs.30.0％(15/50)](P＜0.05).Conclusion Placement of LNG-IUS after laparoscopic operation can reduce symptoms and signs,and can play important role in preventing recurrence.