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Postoperative Levonorgestrel-Releasing Intrauterine System Insertion After Gonadotropin-Releasing Hormone Agonist Treatment for Preventing Endometriotic Cyst Recurrence: A Prospective Observational Study

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Abstract

Objective

The aim of this study was to evaluate the effectiveness of postoperative levonorgestrel-releasing intrauterine system (LNG-IUS) insertion after gonadotropin-releasing hormone agonist (GnRH-a) treatment for preventing endometriotic cyst recurrence.

Study Design

The LNG-IUS was applied to 28 women who had undergone surgery for endometriosis followed by 6 cycles of GnRH-a treatment. Clinical characteristics, endometriosis recurrence, and adverse effects were analyzed. Student t test was performed for analysis.

Results

Before surgery, 20 (71.4%) patients had dysmenorrhea, and the mean pain score (visual analog scale [VAS]) was 4.26. The numbers of women diagnosed with stage III endometriosis and stage IV endometriosis were 15 (53.6%) and 13 (46.4%), respectively, according to the revised American Fertility Society scoring system. The mean cancer antigen 125 levels and VAS scores were significantly lower after treatment than before treatment (11.61 vs 75.66 U/mL, P <.0001 and 0.50 vs 4.26 U/mL, P <.0001, respectively). Of the 28 patients, 13 (46.4%) simultaneously had adenomyosis, and 2 (7.1%) underwent LNG-IUS removal because of unresolved vaginal bleeding and dysmenorrhea. Recurrence was noted in 2 (7.1%) women.

Conclusion

Postoperative LNG-IUS insertion after GnRH-a treatment is an effective approach for preventing endometriotic cyst recurrence, especially in women who do not desire to conceive.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University, Gangnam-gu, Seoul, Republic of Korea

    Min Kyoung Kim MD, PhD

  2. Department of Obstetrics and Gynecology, Gil Hospital, Gachon University College of Medicine, Namdong-gu, Incheon, Republic of Korea

    Seung Joo Chon MD, PhD

  3. Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea

    Jae Hoon Lee MD, Bo Hyon Yun MD, MS, Young Sik Choi MD, PhD, Byung Seok Lee MD, PhD & Seok Kyo Seo MD, PhD

  4. Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea

    Jae Hoon Lee MD, Bo Hyon Yun MD, MS, SiHyun Cho MD, PhD, Young Sik Choi MD, PhD, Byung Seok Lee MD, PhD & Seok Kyo Seo MD, PhD

  5. Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Gangnam-gu, Seoul, Republic of Korea

    SiHyun Cho MD, PhD

Authors
  1. Min Kyoung Kim MD, PhD
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  2. Seung Joo Chon MD, PhD
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  3. Jae Hoon Lee MD
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  4. Bo Hyon Yun MD, MS
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  5. SiHyun Cho MD, PhD
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  6. Young Sik Choi MD, PhD
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  7. Byung Seok Lee MD, PhD
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  8. Seok Kyo Seo MD, PhD
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Corresponding author

Correspondence to Seok Kyo Seo MD, PhD.

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Kim, M.K., Chon, S.J., Lee, J.H. et al. Postoperative Levonorgestrel-Releasing Intrauterine System Insertion After Gonadotropin-Releasing Hormone Agonist Treatment for Preventing Endometriotic Cyst Recurrence: A Prospective Observational Study. Reprod. Sci. 25, 39–43 (2018). https://doi.org/10.1177/1933719117718274

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  • DOI: https://doi.org/10.1177/1933719117718274

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