title: Effects of the levonorgestrel-releasing intrauterine system on urinary symptoms in patients with adenomyosis.
abstract: OBJECTIVE
  We hypothesized that treatment of adenomyosis with the levonorgestrel-releasing intrauterine system (LNG-IUS) can concurrently improve urinary incontinence along with irritative and obstructive symptoms and thus positively affect the patients' quality of life.
  
  
  METHODS
  Sixty-five patients suffering from heavy prolonged menstrual bleeding (menorrhagia) with dysmenorrhea diagnosed with uterine adenomyosis by ultrasound were enrolled in this study. LNG-IUS was inserted in the outpatient department for the treatment of the uterine adenomyosis. The patients filled out two validated questionnaires, the Urogenital Distress Inventory (UDI-6) and the Incontinence Impact Questionnaire (IIQ-7), before and 6 months after the insertion of the LNG-IUS. The before and after scores were compared using the non-parametric Mann-Whitney U test.
  
  
  RESULTS
  The mean (± SD) age of the patients was 44.5 ± 6.5 years. Both UDI and IIQ scores were significantly lower at 6 months after treatment with the LNG-IUS (P<0.0001). UDI scores revealed improvement rates of 14.3%, 35.7%, and 22.7% for urinary incontinence, irritative symptoms, and obstructive symptoms, respectively. Moreover, improvements in irritative and obstructive symptoms were significantly correlated with improvements in menorrhagia and dysmenorrhea (P<0.04). IIQ scores demonstrated improvement rates of 18.9%, 14.6%, 19.7%, and 18.5% for physical activity, travel, social relations, and emotional health, respectively.
  
  
  CONCLUSIONS
  LNG-IUS used for treating menorrhagia and dysmenorrhea improved urinary incontinence along with irritative and obstructive symptoms in patients with adenomyosis.
authors.affiliation: Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Ekin
authors.forename: Huseyin
authors.initials: H
authors.lastname: Cengiz
authors.forename: Mehmet Emin
authors.initials: ME
authors.lastname: Ayağ
authors.forename: Cihan
authors.initials: C
authors.lastname: Kaya
authors.forename: Levent
authors.initials: L
authors.lastname: Yasar
authors.forename: Kadir
authors.initials: K
authors.lastname: Savan
mesh_terms: D062788:Adenomyosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D000328:Adult; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007434:Intrauterine Devices; D016912:Levonorgestrel / Q000008:administration & dosage*; D008875:Middle Aged; D010865:Pilot Projects; D011788:Quality of Life; D014463:Ultrasonography; D014549:Urinary Incontinence / Q000209:etiology* / Q000628:therapy
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel
keywords: Adenomyosis; Intrauterine device; Levonorgestrel; Lower urinary tract symptoms; Menorrhagia