Effectiveness of the levonorgestrel-releasing intrauterine system in the treatment of adenomyosis diagnosed and monitored by magnetic resonance imaging

Bragheto AM, Aristides M Bragheto, Aristides Manoel dos Santos Bragheto, Caserta N, Nelson Caserta, Nelson Marcio Gomes Caserta, Bahamondes L, Luis Bahamondes, Luís Bahamondes, Petta CA, Carlos Alberto Petta, Carlos A Petta
Contraception · 2007 · vol. 76(3) , pp. 195–199 · doi:10.1016/j.contraception.2007.05.091 · PMID:17707716 · W2055038924
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This study evaluated the effectiveness of levonorgestrel-releasing intrauterine systems in managing adenomyosis, a condition diagnosed and monitored using magnetic resonance imaging.

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Abstract

BackgroundThis study was conducted to evaluate the effect of the levonorgestrel-releasing intrauterine system (LNG-IUS) on adenomyotic lesions diagnosed and monitored by magnetic resonance imaging (MRI).Study designLNG-IUS was inserted during menstrual bleeding in 29 women, 24 to 46 years of age, with MRI-diagnosed adenomyosis associated with menorrhagia and dysmenorrhea. Clinical evaluations were carried out at baseline and at 3 and 6 months postinsertion. MRI was performed at baseline and at 6 months postinsertion and was used to calculate junctional zone thickness (in mm), to define the junctional zone borders, to identify the presence of high-signal foci on T(2)-weighted images and to calculate uterine volume (in mL).ResultsA significant reduction of 24.2% in junctional zone thickness was observed (p<.0001); however, no significant decrease in uterine volume was observed (142.6 mL vs. 136.4 mL; p=.2077) between baseline and the 6-month evaluation. A significant decrease in pain score was observed at 3 and 6 months after insertion (p3 at 6 months of observation. At 3 months of use, the most common bleeding pattern was spotting, and at 6 months of observation, oligomenorrhea was the most common pattern observed, although spotting was present in one third of the women.ConclusionsThe insertion of an LNG-IUS led to a reduction in pain and abnormal bleeding associated with adenomyosis. MRI was useful for monitoring response of adenomyotic lesions to the LNG-IUS.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Contraceptive Agents, Female Endometriosis Levonorgestrel Magnetic Resonance Imaging Uterine Diseases Uterus Adult Contraceptive Agents, Female Endometriosis Endometriosis Female Humans Intrauterine Devices, Medicated Levonorgestrel Middle Aged Uterine Diseases Uterine Diseases Uterus

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