Management of patients with non-atypical and atypical endometrial hyperplasia with a levonorgestrel-releasing intrauterine system: Long-term follow-up
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This study reports on the long-term outcomes of managing patients with both non-atypical and atypical endometrial hyperplasia using a levonorgestrel-releasing intrauterine system.
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Abstract
ObjectivesLevonorgestrel (LNG), delivered locally into the uterine cavity has a profound effect on the endometrium. The aim of the study was to use a LNG intrauterine system to treat non-atypical and atypical endometrial hyperplasia in women and to evaluate the long-term cure (remission) rate.MethodsEach of the 20 women in the study, of whom eight were diagnosed with atypical hyperplasia, received a LNG-IUS, releasing 20 microg LNG/day. The study is a non-comparative study with long-term follow-up (range 14-90 months).ResultsAll women developed a normal endometrium, except one asymptomatic woman with atypical hyperplasia who still had focal residual non-atypical hyperplasia at 3 years follow-up in the presence of a thin (< 4 mm) endometrium.ConclusionContinuous intrauterine delivery of LNG appears to be a promising alternative to hysterectomy for the treatment of endometrial hyperplasia and could enhance the success rate when compared with other routes of progestagen administration as well as intrauterine progesterone delivery. The significant reduction of the PR expression observed during treatment with the LNG-IUS appears to be a marker for the strong antiproliferative effect of the hormone at a cellular level resulting in an inhibition of estrogen bioactivity and endometrial suppression.
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Cited by (16)
- The efficacy of levonorgestrel intrauterine device, medroxyprogesterone acetate, and norethisterone acetate in the treatment of endometrial hyperplasia without atypia 2024
- Comparison of the effect of levonorgestrel-intrauterine system with or without oral megestrol acetate on fertility-preserving treatment in patients with atypical endometrial hyperplasia: A prospective, open-label, randomized controlled phase II study 2023
- Effect of the Levonorgestrel-Releasing Intrauterine System on the Uterine Artery, Uterine Volume, and Endometrium in Endometrial Hyperplasia without Atypia 2019
- Erratum: HE4 is a novel tissue marker for therapy response and progestin resistance in medium- and low-risk endometrial hyperplasia 2016
- HE4 is a novel tissue marker for therapy response and progestin resistance in medium- and low-risk endometrial hyperplasia 2016
- Response to “A new approach to the management of ovarian endometrioma to prevent tissue damage and recurrence” 2016
- Efficacy of the Levonorgestrel-Releasing Intrauterine Device as an Alternative to Oral Progesterone in the Management of Endometrial Hyperplasia without Atypia 2014
- Levonorgestrel-Releasing Intrauterine Device Versus Dydrogesterone for Management of Endometrial Hyperplasia Without Atypia 2014
- Clinical applications of levonorgestrel-releasing intrauterine system to gynecologic diseases 2013
- Levonorgestrel intra-uterine system as a treatment option for complex endometrial hyperplasia 2011
- The effectiveness of levonorgestrel releasing intrauterine system in the treatment of endometrial hyperplasia in Korean women 2010
- Non-contraceptive applications of the levonorgestrel intrauterine system 2010
- Best Practice & Research Clinical Obstetrics and Gynaecology 2009
- Intrauterine progestins, progesterone antagonists, and receptor modulators: a review of gynecologic applications 2009
- Review of the safety, efficacy and patient acceptability of the levonorgestrel-releasing intrauterine system 2008
- Bleeding with menopausal hormone therapy 2008
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