Clinical study of the treatment of levonorgestrel-releasing intrauterine system combined with GnRH analogue in 38 cases with large adenomyosis

Objective:To study the effects of levonorgestrel-releasing intrauterine system(LNG-IUS) combined with GnRH analogue(GnRH-a) in the treatment of adenomyosis with uterine body enlargement. Methods:A total of 38 cases(measured uterine length≥10 cm,average age 36.7 years) with adenomyosis received injections of GnRH-a(Da Feilin) every 4 weeks,and after the uterine cavity depth was reduced to below 9 cm,LNG-IUS was deployed.VAS pain score,PBAC bleeding score,uterine volume,and hemoglobin levels of the women were measured before the treatment and at 6,12,18 and 24 months after LNG-IUS placement. Results:The VAS pain score and PBAC bleeding score were significantly lowered at 6,12,18 and 24 months after LNG-IUS placement(P0.05),and the score at 12,18 and 24 month were significantly lower than that at 6 month.The uterine volume decreased significantly at the time of LNG-IUS placement,6 and 12 month after LNG-IUS placement as compared with that before the treatment of GnRH-a,but was significantly greater at 6 and 12 month than that at the time of LNG-IUS placement(P0.05).And the uterine volume decreased significantly at 18 and 24 month in comparison with that at 6 and 12 month after LNG-IUS placement and before the treatment of GnRH-a,but was not statistically significant in comparison with that at the time of LNG-IUS placement.Serum hemoglobin levels was increased gradually to normal after combined treatment(P0.05).The difference of the VAS pain score,PBAC bleeding score serum and the hemoglobin levels were not significant from each other(6,12,18,24 months after LNG-IUS placement,P0.05). Conclusion:The therapeutic alliance of LNG-IUS placement after GnRH analogue injection can be effective for the large adenomyosis with dysmenorrhea and hypermenorrhea.