Comparison of combined transcervical resection of the endometrium and levonorgestrel-containing intrauterine system treatment versus levonorgestrel-containing intrauterine system treatment alone in women with adenomyosis: a prospective clinical trial.

The Journal of reproductive medicine · 2013 · vol. 58(7-8) , pp. 285–90 · PMID:23947077 · W2410135351
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This trial found that combining transcervical resection of the endometrium with a levonorgestrel-containing intrauterine system significantly reduced menstrual flow more than the system alone in adenomyosis patients, with no difference in pain reduction.

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Abstract

OBJECTIVE: To compare the effect of transcervical resection of the endometrium (TCRE) combined with levonorgestrel-containing intrauterine system (LNG-IUS) versus LNG-IUS alone in the treatment of adenomyosis. STUDY DESIGN: A total of 43 patients with adenomyosis, suffering from dysmenorrhea and menorrhagia, were recruited. Twenty patients underwent TCRE first followed by insertion of the LNG-IUS (group 1), while 23 patients were managed with the LNG-IUS alone (group 2). Both groups were followed up at 3, 6 and 12 months with regard to menstrual characteristics. Visual analogue scores, transvaginal ultrasound scans and routine gynecological examinations were performed on all patients during the follow-up visits. RESULTS: There was a significant reduction in menstrual flow and pain in both groups following treatment. The reduction in menstrual flow in group 1 was significantly (p < 0.001) greater than that of group 2 at 3, 6 and 12 months posttreatment. On the other hand, there was no significant difference (p = 0.061) in the reduction of pain between the two groups. CONCLUSION: TCRE combined with LNG-IUS for the treatment ofadenomyosis is more effective in reducing menstrual flow compared with the LNG-IUS alone. However, there was no demonstrable difference in the amount of pain reduction between the two treatment strategies.

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Condition tags

dysmenorrheaadenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Endometrium Intrauterine Devices, Medicated Levonorgestrel Adenomyosis Adenomyosis Adult Combined Modality Therapy Dysmenorrhea Dysmenorrhea Endometrium Female Humans Levonorgestrel Levonorgestrel Levonorgestrel Menorrhagia Menorrhagia Middle Aged

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