GG-19 : Association between the uterine volume and efficacy in patients with adenomyosis treated with levonorgestrel-releasing intrauterine device

The objective of this study is to evaluate the relationship between the uterine volume and the effects of levonorgestrel-releasing intrauterine device (LNG-IUD) treatment in patients with adenomyosis A total of 171 women with adenomysis were treated with LNG-IUD between November 2009 and December 2011. The amount of menorrhagia, degree of dysmenorrhea, uterine volume before and after insertion of LNG-IUD, and treatment failure of LNG-IUD were observed. The mean uterine volume of patients with adenomyosis which was treated by LNG-IUD was 158 mL (range, 46-769 mL). Visual analog pain scales, pictorial blood assessment chart scores and mean uterine volume were decreased after insertion of LNG-IUD significantly in 6 months (p=0.001, p=0.005, and p=0.005, respectively). There was significant difference of uterine volume between treatment failure group and success group (178 mL and 141mL p=0.010). Based on receiver operator characteristic curve analysis, optimum cutoff value of uterine volume more than 150 mL was significantly associated with failure of treatment after LNG-IUD insertion (area under receiver operator characteristic curve: 0.763, 95% confidence interval [CI]: 0.669-0.856). In univariate analysis, uterine volume more than 150 mL was the only independent factor for treatment failure after insertion of LNG-IUD (odds ratio 6.76, 95% CI: 1.20-38.02, p=0.030). The LNG-IUD might be an effective expectant management for patients with adenomyosis. However, the patients who have uterine volume more than 150 mL is recommended to avoid the insertion of LNG-IUD in adenomyosis.