The efficacy of long‐term maintenance therapy with a levonorgestrel‐releasing intrauterine system for prevention of ovarian endometrioma recurrence

Mi-La Kim, Mi‐La Kim, Kim ML, Cho YJ, Yeon Jean Cho, Mi Kyoung Kim, Kim MK, Yong Wook Jung, Yun BS, Bo Seong Yun, Seok Ju Seong, Seong SJ
International Journal of Gynecology & Obstetrics · 2016 · vol. 134(3) , pp. 256–259 · doi:10.1016/j.ijgo.2016.03.017 · PMID:27346551 · W2416074282
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This study found that long-term levonorgestrel-releasing intrauterine system maintenance therapy after conservative surgery was associated with recurrence rates of 4.0% at 24 months and 6.3% at 36 months in premenopausal women.

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Abstract

OBJECTIVE: To evaluate the cumulative recurrence rates of ovarian endometrioma among patients using a levonorgestrel-releasing intrauterine system (LNG-IUS) after conservative laparoscopic surgery. METHODS: A retrospective review was conducted of premenopausal women who underwent conservative laparoscopic surgery for ovarian endometrioma and subsequent treatment with LNG-IUS at two gynecologic surgery centers in South Korea between January 1, 2007, and September 30, 2014. Eligible patients had no residual ovarian lesions before LNG-IUS insertion, underwent insertion within 12 months of primary surgery, and were followed up for at least 6 months afterwards. Recurrence was defined as a cystic mass (≥2 cm in diameter) detected by transvaginal ultrasonography. RESULTS: Overall, 61 patients were included. The mean duration of follow-up was 42.9 ± 22.0 months (range 8-98). Recurrence of ovarian endometrioma was detected among 7 (11%) of the patients. On Kaplan-Meier analysis, the cumulative recurrence rates were 4.0%, 6.3%, and 25.5% at 24, 36, and 60 months after surgery, respectively. In multivariate analysis, nulliparity at surgery was the only risk factor for recurrence (hazard ratio 5.892, 95% confidence interval 1.139-30.484; P=0.034). CONCLUSION: Long-term maintenance therapy with LNG-IUS after conservative surgery might be a treatment option to consider to prevent ovarian endometrioma recurrence among premenopausal women.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Contraceptives, Oral, Combined Endometriosis Levonorgestrel Neoplasm Recurrence, Local Ovarian Neoplasms Adult Combined Modality Therapy Contraceptives, Oral, Combined Drug Administration Schedule Endometriosis Endometriosis Female Humans Levonorgestrel Middle Aged Neoplasm Recurrence, Local Neoplasm Recurrence, Local Ovarian Neoplasms Ovarian Neoplasms Republic of Korea

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