Session 54: Early development

Objectives: To evaluate the effect of the levonorgestrel-releasing intrauterine system (LNG-IUS) on adenomyotic lesions diagnosed and monitored by magnetic resonance imaging (MRI). Design: A prospective descriptive study. Setting: Tertiary university center. Patients: Twenty-nine women, 24 to 46 years of age, with MRI-diagnosed adenomyosis associated with menorrhagia and dysmenorrhea. Interventions: A LNG-IUS was inserted during menstrual bleeding. Main outcome measure(s): Clinical evaluations were carried out at baseline, and at 3 and 6 months post-insertion. MRI was performed at baseline and at 6 months post-insertion and was used to calculate junctional zone thickness (mm), to define the junctional zone borders, to identify the presence of high signal foci on T2 weighted images and to calculate uterine volume (in mL). Results: Significant reduction of 24.2% in junctional zone thickness was observed (P, 0.0001); however, no decrease in uterine volume was observed (142.6 mL vs. 136.4 mL) (P0.2077) between baseline and the 6-month evaluation. Decrease in pain score was observed at 3 and 6 months after insertion (P,0.0001); however, 6 women reported score .3 at 6 months of observation. Conclusions: The insertion of a LNG-IUS led to a reduction in adenomyotic lesions. MRI was useful for monitoring follow-up.