Suture fixation of the levonorgestrel-releasing intrauterine device with hysteroscope for the treatment of adenomyosis in patients at high risk of device expulsion

Min Mao, Yuan-Qin Gou, Ning Xu, Min Li, Mengxi Li, Zhi-Gui Luo, Yuan-Hong Li, Tong Yu
In: Research Square · 2023 · doi:10.21203/rs.3.rs-3712735/v1 · W4389573275
preprint OA: green CC0
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

Hysteroscopic suture fixation of the levonorgestrel-releasing intrauterine device in adenomyosis patients at high risk of expulsion successfully reduced bleeding and pain without complications.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-06 ⓘ

This preprint investigated the safety and efficacy of hysteroscopic suture fixation of a levonorgestrel-releasing intrauterine device (LNG-IUD) in 21 patients with symptomatic adenomyosis who were at high risk of device expulsion, including 10 with prior LNG-IUD expulsion and 11 with no prior placement but elevated expulsion risk. Using hysteroscopy under general anesthesia, the LNG-IUD was fixed to the uterine wall near the uterine base with an ethibond suture; the study reported successful fixation in all participants, minimal blood loss, no expulsion or perforation during the observed perioperative period, and significant reductions in menstrual blood loss (PBAC) and pain (VAS) at 1 and 3 months, alongside improved hemoglobin levels in anemic patients. A key limitation stated implicitly by the design is the small, single-center preprint experience with follow-up only reported through about 3 months (and one early loss to follow-up due to pelvic infection and persistent dysmenorrhea). This paper is centrally about adenomyosis — it evaluates hysteroscopic suture fixation of an LNG-IUD to prevent expulsion and reduce adenomyosis symptoms in high-risk patients.

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Abstract

Abstract Objective: This study aimed to investigate the safety and efficacy of suture fixation of the levonorgestrel-releasing intrauterine device (LNG-IUD) through hysteroscope fortreatment of adenomyosis in patients at high risk of device expulsion. Methods: 21 patients with adenomyosis were fixed with the LNG-IUD on the uterine wall close to the base of the uterus by hysteroscopy. Subjects: with adenomyosis who are at high risk of device expulsion. Results: All 21 patients were successfully fixed with the LNG-IUD on the uterine wall close to the base of the uterus by hysteroscopy. Pictorial Blood Loss Assessment Chart (PBAC) and visual analogue scale (VAS) scores showed a significant decrease after 1 and 3 months after surgery compared with the baseline value. Serious IUD complications including expulsion and perforation were not observed. Conclusion:Suture fixation of the LNG-IUD through hysteroscope is a safe, effective, and minimally invasive surgical procedure to prevent IUD expulsion for the treatment of adenomyosis in patients who are at high risk of device expulsion.

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Condition tags

adenomyosis

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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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