Analysis of the Effects of Levonorgestrel Releasing Intrauterine System on Preventing the Recurrence of Adenomyosis after Transcervical Resection of Endometrium

Objective To analyze the effects of levonorgestrel releasing intrauterine system on preventing the recurrence of adenomyosis after Transcervical Resection of Endometrium(TCRE).Methods 168 adenomyosis patients who suffered from dysmenorrhea and menorrhagia were randomized allocated into experimental group and the control group(TCRE only),with 84 objects each group.Indicators including dysmenorrhea score(VAS),pictorial blood loss assessment chart(PBAC),size of uterine measured by B ultrosound and CA125 were followed up 3months,12months,24months and 36months after the operation respectively.Results There were 6 patients in the experimental group who recurred after the operation,the recurrence rate was 7.14%.Numbers of patients with recurrence were 0,2 and 4 respectively at 12 months,24 months and 36 months after operation.And of all the recurrent cases,4 cases were younger than 40 years old,accounting for 66.67%.18 patients recurred in the TCRE group,with the recurrence rate of 21.43%.It appeared 4,6 and 8 recurrent cases at 12 months,24 months and 36 months after operation respectively.And of all the recurrent cases,12 cases younger than 40 years old,accounted for 66.67%.10 patients,whose uterine sizes larger than 12 gestational weeks and with visible adenomyoma,recurred after operation,accounting for 41.67% of the total recurrence number.Conclusion The placement of levonorgestrel releasing intrauterine system after TCRE can degrade the recurrence rate of adnnomyosis.Patients whose uterine size was larger than 12 gestational weeks and with visible adenomyoma should be treated with another therapeutic methods.