Postoperative Levonorgestrel-Releasing Intrauterine System Insertion After Gonadotropin-Releasing Hormone Agonist Treatment for Preventing Endometriotic Cyst Recurrence: A Prospective Observational Study
- Authors
- Kim, Min Kyoung; Chon, Seung Joo; Lee, Jae Hoon; Yun, Bo Hyon; Cho, SiHyun; Choi, Young Sik; Lee, Byung Seok; Seo, Seok Kyo
- Issue Date
- Jan-2018
- Publisher
- SAGE PUBLICATIONS INC
- Keywords
- endometriosis; levonorgestrel-releasing intrauterine system; gonadotropin-releasing hormone agonist; endometrioma recurrence
- Citation
- REPRODUCTIVE SCIENCES, v.25, no.1, pp.39 - 43
- Journal Title
- REPRODUCTIVE SCIENCES
- Volume
- 25
- Number
- 1
- Start Page
- 39
- End Page
- 43
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/4184
- DOI
- 10.1177/1933719117718274
- ISSN
- 1933-7191
- Abstract
- Objective: The aim of this study was to evaluate the effectiveness of postoperative levonorgestrel-releasing intrauterine system (LNG-IUS) insertion after gonadotropin-releasing hormone agonist (GnRH-a) treatment for preventing endometriotic cyst recurrence. Study Design: The LNG-IUS was applied to 28 women who had undergone surgery for endometriosis followed by 6 cycles of GnRH-a treatment. Clinical characteristics, endometriosis recurrence, and adverse effects were analyzed. Student t test was performed for analysis. Results: Before surgery, 20 (71.4%) patients had dysmenorrhea, and the mean pain score (visual analog scale [VAS]) was 4.26. The numbers of women diagnosed with stage III endometriosis and stage IV endometriosis were 15 (53.6%) and 13 (46.4%), respectively, according to the revised American Fertility Society scoring system. The mean cancer antigen 125 levels and VAS scores were significantly lower after treatment than before treatment (11.61 vs 75.66 U/mL, P < .0001 and 0.50 vs 4.26 U/mL, P < .0001, respectively). Of the 28 patients, 13 (46.4%) simultaneously had adenomyosis, and 2 (7.1%) underwent LNG-IUS removal because of unresolved vaginal bleeding and dysmenorrhea. Recurrence was noted in 2 (7.1%) women. Conclusion: Postoperative LNG-IUS insertion after GnRH-a treatment is an effective approach for preventing endometriotic cyst recurrence, especially in women who do not desire to conceive.
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