A prospective cohort study on effects of levonorgestrel-releasing intrauterine system for adenomyosis with severe dysmenorrhea
10.3760/cma.j.issn.0529-567x.2016.05.005
- VernacularTitle:LNG-IUS治疗子宫腺肌病相关重度痛经的前瞻性研究
- Author:
Lei LI
;
Jinhua LENG
;
Yi DAI
;
Junji ZHANG
;
Shuangzheng JIA
;
Xiaoyan LI
;
Jinghua SHI
;
Jiaren ZHANG
;
Ting LI
;
Xiaoxuan XU
;
Zhenzhen LIU
;
Shanshan YOU
;
Xiaoyan CHANG
;
Jinghe LANG
- Publication Type:Journal Article
- Keywords:
Adenomyosis;
Dysmenorrhea;
Levonorgestrel;
Drug delivery systems;
Prospective studies
- From:
Chinese Journal of Obstetrics and Gynecology
2016;51(5):345-351
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate treatment effects of levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis with severe dysmenorrhea in a prospective cohort study. Methods From December 2006 to December 2014, patients of symptomatic adenomyosis diagnosed by transvaginal ultrasound in outpatient or inpatient clinics of Peking Union Medical College Hospital were given the treatment of LNG-IUS. Before and after placement of LNG-IUS, all the patients′parameters were recorded prospectively, including symptoms and scores of dysmenorrhea, menstruation scores, biochemical indicators, physical parameters, carrying status of LNG-IUS, menstruation patterns and adverse effects. Changes of scores and patterns of pain during follow-up were analyzed. Results Totally 1 100 women meets inclusion criteria, among which 640 cases (58.18%, 640/1 100) had severe dysmeorrhea, with median follow-up period of 35 months (range 1-60 months), and accumulative carrying rate of 65% at 60 months follow-up. After placement of LNG-IUS, scores of pain and ratio of severe dysmenorrhea had decreased significantly compared with baselines (all P<0.01), the scroes of visual analog scale (VAS) were 8.1 ± 0.9, 5.5 ± 2.4, 4.6 ± 2.4, 3.3 ± 2.2, 2.2 ± 2.1, 2.2 ± 1.8, 1.4 ± 1.6 and 1.3 ± 1.3 at 0, 3, 6, 12, 24, 36, 48 and 60 months respectively. During 36 months after placement of LNG-IUS, scores of pain had improved significantly compared with preceding period (all P<0.01). We found no universal dependent factors predicting improvement of pain, which was neither relevant with simultaneous changes of menstruation patterns nor adverse effects (all P>0.05). Conclusion LNG-IUS is effective for adenomyosis of severe dysmenorrhea. Improvement of pain is independent on patients characters, menstruation patterns or adverse effects.
