i3 Waitemata District Health Board, Auckland, New Zealand (Dr. Chowdary); University of Auckland, Auckland, New Zealand (Dr. Chowdary).
Mercy Hospital for Women, Victoria, Australia (Drs. Maher, Ma, Ellett, and Readman).
J Minim Invasive Gynecol. 2019 Nov-Dec;26(7):1297-1302. doi: 10.1016/j.jmig.2018.12.013. Epub 2018 Dec 24.
To study the hypothesis that the levonorgestrel intrauterine device (LNG-IUD) can have a role in the treatment of endometrial polyps confirmed at outpatient hysteroscopy in premenopausal women.
Canadian Task Force classification level II1 (a controlled trial that is not randomised).
Outpatient hysteroscopy.
Premenopausal women who had a polyp diagnosed at outpatient hysteroscopy.
Premenopausal women who had a polyp diagnosed at outpatient hysteroscopy and had a LNG-IUD inserted were booked for general anesthesia hysteroscopy and polypectomy through the standard booking process. A contemporaneous control was taken sequentially from the outpatient hysteroscopy database to match the case.
The presence of a polyp at hysteroscopy under general anesthesia. A total of 39 patients were included in the study, with 19 in the intervention group and 20 in the control group. The mean age was 43.6 (standard deviation = 5.6) and 43.2 (standard deviation = 8.1) years in the 2 groups, respectively. No difference was found in the time interval between the 2 procedures in the intervention and control groups (mean = 92 vs 84 days, p = .73). However, the proportion of polyps present at the second procedure was significantly higher in the control group (80% vs 37%; relative risk = 2.17; 95% confidence interval, 1.16-4.07; p = .0062).
Our case-control study found that the LNG-IUD can have a role in the treatment of polyps for women who have heavy menstrual bleeding. This is the first study to show regression of endometrial polyps after treatment with LNG-IUD by direct visualisation at hysteroscopy.
研究左炔诺孕酮宫内节育器（LNG-IUD）在治疗门诊宫腔镜检查中确诊的绝经前妇女子宫内膜息肉中的作用假说。
加拿大任务组分类 II-1 级（非随机对照试验）。
门诊宫腔镜检查。
在门诊宫腔镜检查中诊断出息肉的绝经前妇女。
在门诊宫腔镜检查中诊断出息肉且已插入 LNG-IUD 的绝经前妇女通过标准预约流程预约全身麻醉宫腔镜检查和息肉切除术。从门诊宫腔镜检查数据库中连续选择一个同期对照病例进行匹配。
全身麻醉下宫腔镜检查中息肉的存在。共有 39 例患者纳入研究，其中干预组 19 例，对照组 20 例。两组的平均年龄分别为 43.6（标准差=5.6）和 43.2（标准差=8.1）岁。干预组和对照组之间两次手术的时间间隔无差异（均值=92 天 vs 84 天，p=0.73）。然而，对照组第二次手术时息肉存在的比例明显更高（80% vs 37%；相对风险=2.17；95%置信区间，1.16-4.07；p=0.0062）。
我们的病例对照研究发现，LNG-IUD 对有月经过多症状的妇女的息肉治疗可能具有作用。这是第一项通过宫腔镜直接观察显示 LNG-IUD 治疗后子宫内膜息肉消退的研究。
