Abstract
Objective
This study is to evaluate the relationship between the uterine volume and the failure of levonorgestrel-releasing intrauterine device (LNG-IUD) in patients with adenomyosis.
Methods
A total of 171 women with adenomysis were treated with LNG-IUD from November 2009 to December 2011. The amount of menorrhagia, degree of dysmenorrhea, and the uterine volume were compared before and after insertion of LNG-IUD, and the treatment failure of LNG-IUD was observed.
Results
The mean age of the participants was 42.5 years (range 29–53 years). The mean uterine volume was 158 mL (range 46–769 mL). Among the total participants, 37 (21.6 %) discontinued the treatment prematurely. There were no different characteristics between the ongoing treatment group and treatment failure group with LNG-IUD. However, there was significant difference of uterine volume between two groups (178 ± 14 and 141 ± 7 mL, P = 0.010). Based on the receiver operator characteristic analysis, the optimum cutoff value of uterine volume more than 150 mL was significantly associated with failure of LNG-IUD (area under curve: 0.763, 95 % CI 0.669–0.856). In univariate analysis, the uterine volume more than 150 mL was the only independent factor for the failure of LNG-IUD (odds ratio 6.76, 95 % CI 1.20–38.02, P = 0.030).
Conclusion
The rate of treatment failure after LNG-IUD insertion for the patients with adenomyosis was related to the uterine volume. Specifically, the treatment failure rate of large volume uterus (>150 mL) with LNG-IUD was significantly higher than that of small volume uterus.
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While preparing this manuscript, we have strictly followed not only the instructions for authors as specified by Archives of Gynecology and obstetrics, but also the guidelines of the Ethic Committee of the Chungnam National University Hospital, Korea and the provisions of the Declaration of Helsinki. This study was approved by the Institutional Review Board of the Chungnam National University Hospital, Korea (2013-08-038). Patient anonymity was completely preserved and the unique nature of identifying patients was not included in this manuscript.
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This is retrospective study. Informed consent was not needed to obtain from all individual participants included in the study.
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Lee, K.H., Kim, J.K., Lee, M.A. et al. Relationship between uterine volume and discontinuation of treatment with levonorgestrel-releasing intrauterine devices in patients with adenomyosis. Arch Gynecol Obstet 294, 561–566 (2016). https://doi.org/10.1007/s00404-016-4105-y
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DOI: https://doi.org/10.1007/s00404-016-4105-y