Radiofrequency Ablation Combined with Levonorgestrel-releasing Intrauterine System in Treatment of Adenomyosis

Objective To explore the clinical value of radiofrequency ablation combined with levonorgestrel-releasing intrauterine system(LNG-IUS) in treatment of adenomyosis.Methods 62 patients with adenomyosis admitted during April 2007 and April 2009 were divided into therapy group(36 cases) and control group(26 cases) randomly.The therapy group was treated with radiofrequency ablation combined with LNG-IUS,and the control group was treated with LNG-IUS.All patients were followed up to observe dysmenorrheal grading(VAS),amenorrhea,menstrual blood volume,uterine volume and carbohydrate antigen 125(CA125) at the 1st,3rd,6th and 12th month after treatment.Results The therapy group had obvious advantages over the control group in improving indicators such as dysmenorrheal,amenorrhea,reducing menstrual blood volume,uterine volume,lower rate of CA125 and decyclizing.The differences were statistically significant(P0.01).Adverse reaction in therapy group was manifest in 34 patients with different degrees of coeliac bearing-down pain,5 patients ran a fever(body temperature 37.5-38.8℃) who returned to normal after relevant therapies,3 patients were found with endometrioma 5 cm in diam after operation on necrotic tissue 3 to 4 cm in diam protruding into the uterine cavity during sonographic examination 3 months later and underwent uterine aspiration.Endless abnormal vaginal bleeding occurred in 21 patients of the control group(80.8%) who could not achieve amenorrhea within 6 months.Conclusion Radiofrequency ablation combined with LNG-IUS in treatment of adenomyosis can play a complementary role.It can resolve the problem of irregular bleeding and constant relapses in using only LNG-IUS in a long term.