title: Levonorgestrel-releasing intrauterine system placement for severe uterine cervical stenosis after conization: two case reports.
abstract: BACKGROUND
  Several approaches for treating severe uterine cervical stenosis after conization for cervical intraepithelial neoplasia have been reported; yet, the condition can still be difficult to treat successfully.
  
  
  METHODS
  We performed uterine cervical dilation surgery in two patients with severe stenosis, followed by insertion of the levonorgestrel-releasing intrauterine system, which is used for dysmenorrhea or endometriosis-related pain because of its strong progesterone activity. Patient 1 was a 34-year-old Japanese woman who was diagnosed with dysmenorrhea caused by recurrent uterine cervical stenosis and hematometra after laser conization. Patient 2 was a 44-year-old Japanese woman who developed dysmenorrhea and prolonged menstruation caused by uterine cervical stenosis without hematometra. After providing informed consent, they underwent cervical dilation surgery followed by insertion of the levonorgestrel-releasing intrauterine system. After treatment, their symptoms immediately improved, and after removal of their devices, they remained asymptomatic.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first report to confirm the usefulness and easy applicability of the levonorgestrel-releasing intrauterine system for uterine cervical stenosis. Although we had success with the method, this study of two patients is preliminary. Further study with larger numbers of patients is necessary to confirm the usefulness of our technique.
authors.affiliation: Department of Obstetrics and Gynecology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Motegi
authors.affiliation: Department of Obstetrics and Gynecology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan. hasek@dokkyomed.ac.jp.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Hasegawa
authors.affiliation: Department of Obstetrics and Gynecology, Fujita Health University School of Medicine, Toyoake, Aichi, 470-1192, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kawai
authors.affiliation: Department of Obstetrics and Gynecology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Kiuchi
authors.affiliation: Department of Obstetrics and Gynecology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan.
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Kosaka
authors.affiliation: Department of Obstetrics and Gynecology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Mochizuki
authors.affiliation: Department of Obstetrics and Gynecology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan.
authors.forename: Ichio
authors.initials: I
authors.lastname: Fukasawa
mesh_terms: D000328:Adult; D019092:Conization / Q000009:adverse effects / Q000379:methods*; D003251:Constriction, Pathologic / Q000188:drug therapy* / Q000209:etiology; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D004412:Dysmenorrhea / Q000601:surgery*; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage*; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel