Efficacy of levonorgestrel releasing intrauterine system as a postoperative maintenance therapy of endometriosis: A meta-analysis

Soo Youn Song, Song SY, Park M, Mia Park, Lee GW, Geon Woo Lee, Ki Hwan Lee, Lee KH, Chang HK, Ha Kyun Chang, Kwak SM, Sang Mi Kwak, Heon Jong Yoo
European journal of obstetrics, gynecology, and reproductive biology · 2018 · vol. 231 , pp. 85–92 · doi:10.1016/j.ejogrb.2018.10.014 · PMID:30336309 · W2896876425
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This meta-analysis evaluated the efficacy of levonorgestrel-releasing intrauterine systems in maintaining the postoperative treatment of endometriosis.

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Abstract

ObjectiveTo compare the efficacy of levonorgestrel releasing intrauterine system (LNG-IUS) with other treatments as a postoperative maintenance therapy for endometriosis in terms of pain reduction, recurrence prevention, side effects and patients' satisfaction.Study designWe searched MEDLINE, EMBASE, and the Cochrane Library from January 1986 until February 2018. Two evaluators independently extracted and reviewed prospective and retrospective articles based on pre-determined selection criteria. Outcomes were expressed as mean difference (MD), risk ratios (RR) or odds ratios (OR) in a meta-analysis model, using Revman software.ResultsAmong the 962 studies, 7 studies were selected: 7 studies included 4 randomized controlled trials with 212 patients, 1 prospective cohort study with 88 patients, and 2 retrospective studies with 191 patients. A meta-analysis showed that LNG-IUS was significantly effective in reducing pain after surgery (MD = 12.97, 95% confidence interval (CI): 5.55-20.39), with a comparable effect to gonadotropin-releasing hormone analogues (MD = -0.16, 95% CI: -2.02 to 1.70). LNG-IUS was also effective in decreasing the recurrence rate (RR = 0.40, 95% CI: 0.26-0.64), with an effect comparable to OC (OR = 1.00, 95% CI: 0.25-4.02) and danazol (RR = 0.30, 95% CI: 0.03-2.81). Furthermore, patients' satisfaction with LNG-IUS was significantly higher than that with OC (OR = 8.60, 95% CI: 1.03-71.86). However, vaginal bleeding was significantly higher in the LNG-IUS group than in the gonadotropin-releasing hormone analogue group (RR = 27.0, 95% CI: 1.71-425.36).ConclusionOur meta-analysis found a positive effect of LNG-IUS as a postoperative maintenance therapy for endometriosis on pain relief, prevention of dysmenorrhea recurrence, and patients' satisfaction.

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Condition tags

dysmenorrheaendometriosis

MeSH descriptors

Endometriosis Endometriosis Intrauterine Devices, Medicated Levonorgestrel Postoperative Care Dysmenorrhea Dysmenorrhea Endometriosis Endometriosis Female Humans Levonorgestrel MEDLINE Pain Management Patient Satisfaction Prospective Studies Randomized Controlled Trials as Topic Recurrence Retrospective Studies Secondary Prevention

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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