title: Efficacy of the levonorgestrel-releasing intrauterine device in the treatment of recurrent pelvic pain in multitreated endometriosis.
abstract: OBJECTIVE
  To assess the value of the levonorgestrel-releasing intrauterine device (LNG-IUD) in the treatment of pelvic pain in patients with endometriosis in which previous medical and surgical treatments have failed.
  
  
  METHODS
  This prospective study evaluated pelvic pain by means of both a visual analog grading scale and a verbal descriptive grading scale. Pain was evaluated before insertion of the LNG-IUD and afterwards, at 3-month intervals. Adverse effects and reasons for removal were recorded. Me dian follow-up was 22 months (range, 3-36 months). Response rates were expressed as a percentage of the initial cohort in whom the LNG-IUD was inserted, including cases in which the LNG-IUD was extracted.
  
  
  RESULTS
  Three months after LNG-IUD insertion, almost 50% of patients reported an improvement in pain symptoms, with this figure rising to 60% after 6 months and almost 70% by the end of follow-up. A trend of better responses was observed when endometriosis was diagnosed <10 years before, as well as in stage I-II endometriosis, but these differences were not statistically significant.
  
  
  CONCLUSIONS
  In endometriosis patients with recurrent pelvic pain in whom previous medical and surgical treatments have failed, LNG-IUD insertion should be considered before radical surgery is performed.
authors.affiliation: Human Reproduction Unit, Department of Obstetrics and Gynecology, Cruces Hospital, País Vasco University, Baracaldo, Vizcaya, Spain. roberto.matorras@osakidetza.net
authors.forename: Roberto
authors.initials: R
authors.lastname: Matorras
authors.forename: Alejandro
authors.initials: A
authors.lastname: Ballesteros
authors.forename: Begoña
authors.initials: B
authors.lastname: Prieto
authors.forename: Iratxe
authors.initials: I
authors.lastname: Ocerin
authors.forename: Antonia
authors.initials: A
authors.lastname: Expósito
authors.forename: José Ignacio
authors.initials: JI
authors.lastname: Pijoan
authors.forename: Lorena
authors.initials: L
authors.lastname: Crisol
mesh_terms: D000293:Adolescent; D000328:Adult; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D004715:Endometriosis / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage*; D008875:Middle Aged; D010147:Pain Measurement; D017699:Pelvic Pain / Q000188:drug therapy*; D011446:Prospective Studies; D012008:Recurrence; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel