title: Relationship between uterine volume and discontinuation of treatment with levonorgestrel-releasing intrauterine devices in patients with adenomyosis.
abstract: This study is to evaluate the relationship between the uterine volume and the failure of levonorgestrel-releasing intrauterine device (LNG-IUD) in patients with adenomyosis.
  
  
  
  A total of 171 women with adenomysis were treated with LNG-IUD from November 2009 to December 2011. The amount of menorrhagia, degree of dysmenorrhea, and the uterine volume were compared before and after insertion of LNG-IUD, and the treatment failure of LNG-IUD was observed.
  
  
  
  The mean age of the participants was 42.5 years (range 29-53 years). The mean uterine volume was 158 mL (range 46-769 mL). Among the total participants, 37 (21.6 %) discontinued the treatment prematurely. There were no different characteristics between the ongoing treatment group and treatment failure group with LNG-IUD. However, there was significant difference of uterine volume between two groups (178 ± 14 and 141 ± 7 mL, P = 0.010). Based on the receiver operator characteristic analysis, the optimum cutoff value of uterine volume more than 150 mL was significantly associated with failure of LNG-IUD (area under curve: 0.763, 95 % CI 0.669-0.856). In univariate analysis, the uterine volume more than 150 mL was the only independent factor for the failure of LNG-IUD (odds ratio 6.76, 95 % CI 1.20-38.02, P = 0.030).
  
  
  
  The rate of treatment failure after LNG-IUD insertion for the patients with adenomyosis was related to the uterine volume. Specifically, the treatment failure rate of large volume uterus (>150 mL) with LNG-IUD was significantly higher than that of small volume uterus.
authors.affiliation: Department of Obstetrics and Gynecology, Chungnam National University, 33, Munhwa-ro, Jung-gu, Deajeon, 301-721, Republic of Korea.
authors.forename: Ki Hwan
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Chungnam National University, 33, Munhwa-ro, Jung-gu, Deajeon, 301-721, Republic of Korea.
authors.forename: Jang Kew
authors.initials: JK
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Chungnam National University, 33, Munhwa-ro, Jung-gu, Deajeon, 301-721, Republic of Korea.
authors.forename: Min A
authors.initials: MA
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Chungnam National University, 33, Munhwa-ro, Jung-gu, Deajeon, 301-721, Republic of Korea.
authors.forename: Young Bok
authors.initials: YB
authors.lastname: Ko
authors.affiliation: Department of Obstetrics and Gynecology, Chungnam National University, 33, Munhwa-ro, Jung-gu, Deajeon, 301-721, Republic of Korea.
authors.forename: Jung Bo
authors.initials: JB
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynecology, Chungnam National University, 33, Munhwa-ro, Jung-gu, Deajeon, 301-721, Republic of Korea.
authors.forename: Byung Hun
authors.initials: BH
authors.lastname: Kang
authors.affiliation: Department of Obstetrics and Gynecology, Chungnam National University, 33, Munhwa-ro, Jung-gu, Deajeon, 301-721, Republic of Korea. bell4184@cnuh.co.kr.
authors.forename: Heon Jong
authors.initials: HJ
authors.lastname: Yoo
mesh_terms: D062788:Adenomyosis / Q000188:drug therapy* / Q000473:pathology; D000328:Adult; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects*; D016912:Levonorgestrel / Q000008:administration & dosage*; D008875:Middle Aged; D012189:Retrospective Studies; D017211:Treatment Failure; D014599:Uterus / Q000473:pathology*
chemical_list: D016912:Levonorgestrel
keywords: Adenomyosis; Levonorgestrel-releasing intrauterine device; Uterine volume