Clinical Efficacy Analysis Of The Levonorgestrel-releasing Intrauterine System In Patients With Adenomyosis

Objective:To investigate the clinical effects(menstruation,dysmenorrhea,uterine volume),side-effects and the continuation rate of the levonorgestrel-releasing intrauterine system in patients with adenomyosis.Methods: Select patients treated from March 2008 to October 2013 at the Department of obstetrics and gynecology of the second hospital of Hebei Medical University, including outpatient and inpatient. They were diagnosed as adenomyosis according to the symptoms and signs,such as dysmenorrhea, heavy menstrual bleeding, menostaxis,the increase of volume of uterus,and the result of transvaginal ultrasound,and endometrial pathology results.We chose 318 patients who had sexual life,no fertility requirements,no contraindications about using LNG-IUS.They were voluntary to choise LNG-IUS to treat uterine adenomyosis. The pelvic examination and transvaginal ultrasound were done before the insertion of the LNG-IUS.At the same time,we recorded their menstruation, dysmenorrhea, uterine volume, etc.They were given LNG-IUS at the 1th to 7th of the menstruation according to the Bayer’s placed guide and were followed up at the time of 1,3,6,12,24,36,48,60 monthes postoperativly to evaluate LNG-IUS’ effects on menstruation, dysmenorrhea,the volume of uterine, the side-effects(irregular bleeding,amenorrhea,orarian cyst,weight gain,acne,pigmentation,vaginal secretion,etc) and the continuation rate.The data was presented as(`x±s), analyzed by method of paired- t tests with SPSS17.0 software.Result: The average dysmenorrhea score of the 318 patients:the VAS score before the administration of LNG-IUS was(78±11),after 1 months of the insertion LNG-IUS, the score was( 37±9),the symptoms of dysmenorrheal was significantly relieved, there’s significant difference decreased and the symptom of dysmenorrheal relieved,and the uterine volume diminished.It is an excellent alternative to treat adenomyosis.The side-effect was Vaginal irregular bleeding,but patients can accept it.In conclu- sion,LNG-IUS was an effective, safe, reversible,non-surgical treatment in patients with adnomyosis. statistically(P<0.01). After 3,6,12,24,36,48,60 months of LNG-IUS insertion, the VAS score were(21±7),(13±5),(8±5),(6±4),(5±4),(5±6),(5±4).Scoring of the menstrual quantity: After 3 months of LNG-IUS insertion,the menstrual quantity was(29±7)%,compared with that of the pre-insertion, the menstrual quantity was significantly decreased,there are significant difference(P<0.01). After 6,12,24,36,48,60 months of LNG-IUS insertion, the menstrual quantity were( 16±5) %,( 8±4) %,(5±4)%,(4±3)%,(3±3)%,(4±4)%,compared with that of the pre-insertion, there are significant difference(P<0.05). Some of them were amenorrhea or oligomenorrhea.The change of uterine volume: 12 months after the insertion, the average uterine volume declined from the(151.58±50.62)cm3 before the insertion to(120.99±40.26)cm3.24 months after the insertion, the average uterine volume was(113.06±38.21)cm3,there’s significant difference compared with the last test.After that,there’s no significant difference(P<0.01).After 36,48,60 months of the insertion,the uterine volume was( 110.94±41.37) cm3,(117.15±49.24)cm3,(131.46±52.06)cm3.The rate of side effects: Vaginal irregular bleeding(61.64%) occurred in 6 months after the insertion of LNG-IUS.But over time,it was relieved or disappear gradually,amenorrhea(23.58%)occurred in 6-24 months after the insertion of LNG-IUS.weight gain(9.12%),acne,pigmentation and vaginal secretion(4.09%)were occurred in the early days. It were relieved after 1-3months’ observation.orarian cyst( 2.20%) had not symptoms,it can disappear without treatment.Dropping(0.94%)was be concerned with heavy Menstrual quantity and large uterine volume.The continuation rate:98.41%,2 patients took LNG-IUS because of menopause.15 patients changed another one at 53 months to 60 months.The turnorer was 11.90%.The others were amenorrhea or oligomenorrhea,they express that it is effect to continue to use.But they will insert another one if it is needed.Conclusions: LNG-IUS can make the menstrual quantity of all patients...