title: [Levonorgestrel-releasing intrauterine system in the treatment of dysfunctional uterine bleeding: A French multicenter study].
abstract: OBJECTIVE
  To evaluate the levonorgestrel-releasing intra-uterine system as an alternative to surgical treatment in patients presenting with menorrhagia.
  
  
  METHODS
  In the set of a prospective multicenter study, 49 patients with menorrhagia resistant to medical treatment and/or referred for hysterectomy or endometrial ablation were included. Medical visits were organized 3, 6, 12, 24 and 36 months after insertion of the levonorgestrel-releasing intra-uterine system. Visual score of menstrual bleeding and satisfaction index were noted on each visit. Transvaginal ultrasound, pap smear, endometrial biopsy, and clinical data were retrieved one month before and 12 months after inclusion for tolerance evaluation.
  
  
  RESULTS
  Renouncement rate was 90.0% (95% CI = 80.7-96.6%). After a twelve months follow-up, 86.1% of patients were satisfied or very satisfied with their clinical state. We found a significant increase of hemoglobin rates from baseline (14,0 versus 12,9 g/dl; P < 10(-4)). Similar increases were also found in serum iron and ferritin.
  
  
  CONCLUSIONS
  This study confirms the efficacy of the levonorgestrel-releasing intra-uterine system in the control and reduction of menstrual blood loss in patients with dysfunctional uterine bleeding. The high rate of surgery cancellation is a proof of the potential role of the levonorgestrel-releasing intra-uterine system as an alternative treatment in these patients.
authors.affiliation: Service de gynécologie-obstétrique, groupe hospitalier Bichat-Claude-Bernard, APHP, 46, rue Henri-Huchard, 75018 Paris, France. chadi.yazbeck@cyberia.net.lb
authors.forename: C
authors.initials: C
authors.lastname: Yazbeck
authors.forename: S
authors.initials: S
authors.lastname: Omnes
authors.forename: M-C
authors.initials: MC
authors.lastname: Vacher-Lavenu
authors.forename: P
authors.initials: P
authors.lastname: Madelenat
mesh_terms: D000328:Adult; D005260:Female; D005602:France; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage*; D008595:Menorrhagia / Q000188:drug therapy* / Q000601:surgery; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D016912:Levonorgestrel