title: [Use of progesterone-releasing intra-uterine system in menhorragia relapse prevention after laparoscopic myomectomy].
abstract: OBJECTIVE
  Abnormal uterine bleeding (AUB) affects about 30% of women in childbearing age with negative impact on patient's quality of life and uterine myomas represent one of the major cause of AUB. Laparoscopic myomectomy has proven to be efficient to reduce uterine bleeding and pelvic pain, but some patients presents postsurgery menhorragia with anemia. To reduce it, the combined use of levonorgestrel releasing intrauterine system (LNG-IUS) positioned at the end of surgery, seems to produce a clinically relevant decrease in AUB with a symptomatology improvement. The aim of this study was to retrospectively evaluate if postsurgery placement of LNG-IUS improves hematological outcomes (hemoglobin and ferritin level) in woman submitted to laparoscopic myomectomy.
  
  
  METHODS
  We retrospectively collected data from 58 women who underwent laparoscopic myomectomy from September 2010 to September 2011. Twenty-six patients were treated by laparoscopic myomectomy followed by LNG-IUS positioning at the end of surgery (Experimental group) and thirty-two patients were treated by surgery alone (Control group). We compared blood hemoglobin and ferritin levels assessed preoperatively, in day one and 6, 12 and 18 months after surgery.
  
  
  RESULTS
  There was a statistically significant improvement in terms of post-surgery hemoglobin and ferritin levels at 6 month follow up (P=0.02 and P=0.002 respectively) and 12 month follow-up (P=0.001 and P=0.001, respectively) in experimental group vs. control group and a positive trend, but not statistically significant, in ferritin levels at 18 month-follow-up (P=0.1).
  
  
  CONCLUSIONS
  Our data suggest that combined treatment with laparoscopic myomectomy followed by LNG-IUS produces a clinically relevant improvement in hematological values.
authors.affiliation: Cattedra di Ostetricia e Ginecologia, Università Magna Graecia, Catanzaro, Italia - dott.laferrera@me.com.
authors.forename: M
authors.initials: M
authors.lastname: Morelli
authors.forename: N
authors.initials: N
authors.lastname: La Ferrera
authors.forename: F
authors.initials: F
authors.lastname: Gallo
authors.forename: R
authors.initials: R
authors.lastname: Venturella
authors.forename: A
authors.initials: A
authors.lastname: Di Cello
authors.forename: V
authors.initials: V
authors.lastname: Russo
authors.forename: E
authors.initials: E
authors.lastname: De Trana
authors.forename: A
authors.initials: A
authors.lastname: Albano
authors.forename: F
authors.initials: F
authors.lastname: Zullo
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007436:Intrauterine Devices, Medicated; D010535:Laparoscopy / Q000379:methods; D007889:Leiomyoma / Q000150:complications / Q000601:surgery; D016912:Levonorgestrel / Q000008:administration & dosage*; D008595:Menorrhagia / Q000209:etiology / Q000628:therapy*; D017699:Pelvic Pain / Q000209:etiology; D011788:Quality of Life; D012189:Retrospective Studies; D055502:Secondary Prevention / Q000379:methods; D013997:Time Factors; D063186:Uterine Myomectomy / Q000379:methods*
chemical_list: D016912:Levonorgestrel