将 Mirena 宫内节育系统插入治疗与子宫腺肌病相关的月经过多：一种新方法。

Insertion of the Mirena intrauterine system for treatment of adenomyosis-associated menorrhagia: a novel method.

机构信息

Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Taipei, Taiwan.

出版信息

Taiwan J Obstet Gynecol. 2010 Jun;49(2):160-4. doi: 10.1016/S1028-4559(10)60034-4.

DOI:10.1016/S1028-4559(10)60034-4

PMID:20708521

Abstract

OBJECTIVE

Insertion of the levonorgestrel-releasing intrauterine system Mirena is difficult in women with adenomyosis, and the device is often subsequently expelled. We used a novel insertion technique (Yang's method) to overcome this problem.

MATERIALS AND METHODS

This retrospective study enrolled 273 patients with adenomyosis who were receiving Mirena for treatment of menorrhagia and/or dysmenorrhea between 2001 and 2008. Clinical outcomes and expulsion rates were compared between patients treated using conventional insertion and those treated using Yang's insertion methods.

RESULTS

Expulsion occurred in 25.3% of patients with the conventional method, compared with 10.2% of patients with Yang's method. Hemoglobin levels and dysmenorrhea improved greatly in both groups after Mirena insertion.

CONCLUSION

Yang's insertion method for levonorgestrel-releasing intrauterine system is more reliable in some difficult cases, such as patients with severe adenomyosis. This method ensures correct positioning, thus reducing the risks of uterine perforation and/or expulsion.

摘要