Comparison of combined transcervical resection of the endometrium and levonorgestrel-containing intrauterine system treatment versus levonorgestrel-containing intrauterine system treatment alone in women with adenomyosis: a prospective clinical trial.
OBJECTIVE
To compare the effect of transcervical resection of the endometrium (TCRE) combined with levonorgestrel-containing intrauterine system (LNG-IUS) versus LNG-IUS alone in the treatment of adenomyosis.


METHODS
A total of 43 patients with adenomyosis, suffering from dysmenorrhea and menorrhagia, were recruited. Twenty patients underwent TCRE first followed by insertion of the LNG-IUS (group 1), while 23 patients were managed with the LNG-IUS alone (group 2). Both groups were followed up at 3, 6 and 12 months with regard to menstrual characteristics. Visual analogue scores, transvaginal ultrasound scans and routine gynecological examinations were performed on all patients during the follow-up visits.


RESULTS
There was a significant reduction in menstrual flow and pain in both groups following treatment. The reduction in menstrual flow in group 1 was significantly (p < 0.001) greater than that of group 2 at 3, 6 and 12 months posttreatment. On the other hand, there was no significant difference (p = 0.061) in the reduction of pain between the two groups.


CONCLUSIONS
TCRE combined with LNG-IUS for the treatment ofadenomyosis is more effective in reducing menstrual flow compared with the LNG-IUS alone. However, there was no demonstrable difference in the amount of pain reduction between the two treatment strategies.
Hysteroscopic Center, Fuxing Hospital, Capital Medical University, #20 Fuxingmen Wai Street, Xicheng District, Beijing 100038, China. namezjie@126.com
Jie
J
Zheng
Enlan
E
Xia
Tin Chiu
TC
Li
Xia
X
Sun
D062788:Adenomyosis / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D000328:Adult; D003131:Combined Modality Therapy; D004412:Dysmenorrhea / Q000628:therapy; D004717:Endometrium / Q000601:surgery*; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D008595:Menorrhagia / Q000628:therapy; D008875:Middle Aged; D010146:Pain; D059408:Pain Management; D011446:Prospective Studies
D016912:Levonorgestrel