Evaluation of Levonorgestrel-Releasing Intrauterine System (LNG) in The Management of Uterine Adenomyosis: An Update Systematic Review and Meta- Analysis

Chun Kit, Khor; Sin Ee, Christine Na; Kee Hung, Jackie Wong; A/P Tambi Selvam, Aiswaryaa Devi; Sue Vern, Chan; Lionel, Lee; Akl, Hussein; Nagandla, Kavitha

doi:10.30699/jogcr.8.2.105

Document Type : Meta-Analysis Article

Authors

Department of Obstetrics and Gynaecology, International Medical University, Seremban, Malaysia

https://doi.org/10.30699/jogcr.8.2.105

Abstract

Background & Objective: Adenomyosis is a common benign endometrial disease which causes abnormal uterine bleeding in premenopausal women and affects the quality of life. The definitive treatment is hysterectomy; however, medical treatment is an option for those who wish to preserve fertility. This systematic review aims to assess the efficacy of levonorgestrel-releasing intrauterine device as medical management in women who have adenomyosis.
Materials & Methods: We searched PubMed, Cochrane and Scopus databases from January 2000 to November 2019 for relevant studies containing the use of levonorgestrel-releasing intrauterine device (LNG-IUD) in managing patients with ultrasonographic diagnosis of adenomyosis. Main outcome measures in the study are menstrual blood loss (milliliters), pain score measured in 10 cm-visual analogue scale, and uterine volume.
Results: Pooled results from meta-analysis showed that after LNG-IUD treatment for adenomyosis, there is significant reduction in dysmenorrhoea, measured using Visual Analogue Scale after 6 months (Standardized Mean Difference (SMD): 3.68; Cl: 2.11-5.25) , 12 months (SMD: 4.23; CI: 2.99-5.48), 24 months (SMD: 4.69; CI: 3.40-5.97) and 36 months (SMD: 4.01; CI: 3.57-4.45); significant reduction in menstrual bleeding after 6 months (SMD: 2.52; CI: 1.15-3.89), 12 months (SMD: 3.43; CI: 1.64-5.22) and 24 months (SMD: 3.57; CI: 1.88-5.26); significant reduction in uterine volume after 6 months (SMD: 0.49; CI: 0.04-0.93), 12 months (SMD: 0.80; CI: 0.11-1.48) and 24 months (SMD: 0.86; CI: 0.15-1.58).
Conclusion: LNG-IUS is an effective method in alleviating the symptoms of adenomyosis. It is a valuable long-term alternative for the treatment of adenomyosis for young and perimenopausal women in terms of dysmenorrhoea and heavy menstrual bleeding.

Keywords

Main Subjects

Obstetrics and Gynecology

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Journal of Obstetrics, Gynecology and Cancer Research

Evaluation of Levonorgestrel-Releasing Intrauterine System (LNG) in The Management of Uterine Adenomyosis: An Update Systematic Review and Meta- Analysis

References

References

Volume 8, Issue 2 - Serial Number 31
March and April 2023
Pages 105-112

Evaluation of Levonorgestrel-Releasing Intrauterine System (LNG) in The Management of Uterine Adenomyosis: An Update Systematic Review and Meta- Analysis

References

References

Volume 8, Issue 2 - Serial Number 31March and April 2023Pages 105-112

Volume 8, Issue 2 - Serial Number 31
March and April 2023
Pages 105-112