Comparison of a levonorgestrel-releasing intrauterine device versus expectant management after conservative surgery for symptomatic endometriosis: a pilot study

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This pilot study compared the effectiveness of a levonorgestrel-releasing intrauterine device to expectant management following conservative surgery for symptomatic endometriosis.

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Abstract

ObjectiveTo determine whether the frequency and severity of dysmenorrhea are reduced in women with symptomatic endometriosis in whom a levonorgestrel-releasing intrauterine device (Lng-IUD) is inserted after operative laparoscopy compared with those treated with surgery only.DesignOpen-label, parallel-group, randomized, controlled trial.SettingA tertiary care and referral center for patients with endometriosis.Patients(s)Parous women with moderate or severe dysmenorrhea undergoing first-line operative laparoscopy for symptomatic endometriosis.Intervention(s)Randomization to immediate Lng-IUD insertion or expectant management after laparoscopic treatment of endometriotic lesions. Proportions of women with recurrence of moderate or severe dysmenorrhea in the two study groups 1 year after surgery and overall degree of satisfaction with treatment. Moderate or severe dysmenorrhea recurred in 2 of 20 (10%) subjects in the postoperative Lng-IUD group and 9/20 (45%) in the surgery-only group. Thus, a medicated device inserted postoperatively will prevent the recurrence of moderate or severe dysmenorrhea in one out of three patients 1 year after surgery. A total of 15/20 (75%) women in the Lng-IUD group and 10/20 (50%) in the expectant management group were satisfied or very satisfied with the treatment received.Conclusion(s)Insertion of an Lng-IUD after laparoscopic surgery for symptomatic endometriosis significantly reduced the medium-term risk of recurrence of moderate or severe dysmenorrhea.

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Condition tags

dysmenorrheaendometriosis

MeSH descriptors

Dysmenorrhea Endometriosis Endometriosis Intrauterine Devices, Medicated Levonorgestrel Postoperative Care Progesterone Congeners Adult Dysmenorrhea Dysmenorrhea Endometriosis Endometriosis Female Humans Levonorgestrel Patient Satisfaction Pilot Projects Progesterone Congeners Secondary Prevention

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