Clinical research of GnRH-a combined with LNG-IUS in treating adenomyosis

Objective To observe the clinical effect of gonadotropin releasing hormone agonist(GnRH-a) combined with the levonorgestrel-releasing intrauterine system(LNG-IUS) in treating adenomyosis. Methods Made a retrospective analysis of the clinical and pathological data of 45 cases of patients with adenomyosis whose uterine cavity depth was longer than 11cm. Treatment group (n=26) received goserelin 3.6 mg, once four weeks. After the third injection, LNG-IUS was used. Control group(n=19) only placed LNG-IUS in 7 days of menses. The dysmenorrhea relief degree, hemoglobin change, uterine volume change, the rate of LNG-IUS ring dropped and vaginal bleeding of dysmenorrhea patients before treatment and after treatment for 3 months, 6 months, 12 months and 2 years were compared between two groups. Results With the treatment time extension, the dysmenorrhea relief rate of treatment group gradually increased. Compared with the control group, the differences were not statistically significant(χ 2 =0.23,0.12,0.23,1.46,P0.05). Compared with prior treatment, the levels of hemoglobin after treatment of treatment group increased significantly(t=2.49,3.12,3.14,3.07,P0.05). Compared with prior treatment, The uterine volume of treatment group was significantly reduced after treatment (t = 1.87,1.81,2.02,2.32,P0.05). Uterine volume of the treatment group in 3 months after treatment was less than that of the control group, the difference was statistically significant (t=1.93, P0.05)while the difference between two group was not statistically significant in 6 months,12 months and 2 years after treatment (t=1.02,1.53,1.36,P0.05). The rate of the LNG-IUS ring down, fall off and vaginal bleeding of treatment group were lower than the control group,the differences were statistically significant (χ2 =5.83,4.18,P 0.05). Conclusions GnRH-a combined with LNG-IUS is an effective mothod in the treatment of adenomyosis with dysmenorrhea and hypermenorrhea. It also can reduce the rate of vaginal bleeding and LNG-IUS down ocurring in large uterus.