Application Of LNG-IUS Pretreatment On Postoperative Therapy For Ovarian Endometriosis Cyst Removal Surgery

Objective: To observe the application of levonorgestrel-releasing intrauterine system(LNG-IUS) and Mifepristone pretreatment on postoperative therapy for ovarianendometrial cyst (OEC) removal surgery and further find an ideal and safe preventivetreatment with long controlling cycle and satisfactory effects.Methods: This was a prospective study. A total of84cases of patients received theremoval surgery of OEC confirmed by pathology with no reproductive requirementstemporarily in the Department of Gynecology of the Affiliated Hospital of Zunyi MedicalUniversity and the First People’s Hospital of Zunyi City from February,2012toSeptember,2013was included. According to the postoperative prevention treatment,patients were divided into the LNS-IUS group (n=42) given LNG-IUS within the3-5daysof the first menstruation after operation and the Mifepristone group (n=42) given oraladministration of Mifepristone (12.5mg, qd, total3months) from5-7days afteroperation.The scores of pain symptoms, serum CA125levels, recurrence rate, drug sideeffects and satisfaction rate before and after operation were compared.Results:1. LNG-IUS had better effects on the pain symptoms control than Mifepristone(P<0.05).2. The significant difference of serum CA125level between various preoperativeand postoperative time points in the two groups was detected (P<0.05).3.There wassignificant difference of the recurrence rate12months after operation between LNG-IUSgroup (2.38%) and the Mifepristone group (19.05%)(P<0.05).4.1) Four cases of slightliver function impairment were shown in Mifepristone group, while no liver functionimpairment was indicated in LNG-IUS group.2) Patients in Mifepristone group,hadamenorrhea within3months after operation and recovered to the normal menstruation at1-2months after drug withdrawal. Twenty-nine cases of different degrees of the quantityreduction or irregular menses and13cases of amenorrhoea between6and12months after vaginal ring operation in LNS-IUS group were shown.3) No significant difference of thebody weight changes and the acne incidence between the two groups was found (P>0.05).4) The incidence of breast distending pain was19.05%in LNG-IUS group with slightpremenstrual breast distending pain, while no breast distending pain was found inMifepristone group.5. The satisfaction rate in LNG-IUS group was higher than that inMifepristone group (P<0.05).Conclusions:1. LNG-IUS could be used in the postoperative prevention treatment ofOEC removal surgery.2. A lower recurrence rate1year after operation,the better ability ofthe pain control and the higher satisfaction rate are shown in LNG-IUS group than those inMifepristone group, indicating LNG-INS might be recommended to the OEC patients withno reproductive requirements as a conservative postoperative treatment.