Comparison of safety and efficacy of hysteroscopic LNG-IUS fixation surgery and conventional LNG-IUS placement in the treatment of adenomyosis: A retrospective cohort study

Shanshan Li, Wenwen Li, Wen Li, Qi Ye, X. Xu, Xiaojiu Xu, An Zhang, Chongyi Yang, Xuan Liu, F. Hu, Fangjing Hu, Jie Liu
Medicine · 2025 · vol. 104(44) , pp. e44941 · doi:10.1097/md.0000000000044941 · PMID:41261701 · W4416365056
article OA: gold CC0
🔓 Open OA copy View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Hysteroscopic LNG-IUS fixation surgery significantly reduced device displacement or expulsion compared to conventional placement, with both methods improving adenomyosis symptoms but fixation offering superior pain and blood loss reduction.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

The Levonorgestrel-releasing Intrauterine System (LNG-IUS) is extensively utilized in the treatment of adenomyosis. However, the displacement and expulsion of the LNG-IUS bring significant challenges. This was a retrospective analysis comparing displacement or expulsion risk and the efficacy of hysteroscopic LNG-IUS fixation surgery with conventional LNG-IUS placement. Patients who received LNG-IUS treatment were followed up. We measured dysmenorrhea severity (the visual analog pain scale, VAS score), menstrual blood loss (the pictorial blood loss assessment chart, PBAC score), uterine volume, endometrial thickness, and the laboratory marker carbohydrate antigen 125 (CA125) on the day of insertion, and at 3-, 6-, 12-, 18- and 24-months post-insertion. A total of 38 patients underwent the hysteroscopic LNG-IUS fixation surgery and 45 received the conventional placement. Only 2 patients experienced LNG-IUS displacement or expulsion in the hysteroscopic LNG-IUS fixation surgery group (incidence 5.3%), as opposed to 14 events in the conventional placement group (incidence 31.1%). Hysteroscopic fixation surgery significantly decreased the risk (HR 0.13, 95% CI 0.03-0.61) of displacement or expulsion compared with the conventional placement. Both methods led to a marked decrease in uterine volume, endometrial thickness and CA125, as well as improvement in VAS and PBAC scores. Patients who received hysteroscopic LNG-IUS fixation surgery reported significant lower VAS score and PBAC score during the follow-up. Hysteroscopic LNG-IUS fixation surgery has low risk of LNG-IUS displacement and expulsion and it may offer superior outcomes in terms of reducing menstrual blood loss and alleviating dysmenorrhea, potentially making it a more favorable treatment option for certain patients.

My notes (saved in your browser only)

Outcome instruments

VAS-pain

Condition tags

mesh:D004412adenomyosisdysmenorrhea

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Hysteroscopy Hysteroscopy Hysteroscopy Hysteroscopy Hysteroscopy Hysteroscopy Hysteroscopy Hysteroscopy Intrauterine Devices, Medicated Intrauterine Devices, Medicated Intrauterine Devices, Medicated Intrauterine Devices, Medicated

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (22)

Source provenance

europepmc
last seen: 2026-06-04T01:30:01.192114+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pmc
last seen: 2026-05-13T20:22:03.195721+00:00
pubmed
last seen: 2026-05-16T00:30:41.751120+00:00
License: CC0 · commercial use OK