Department of Ambulatory Surgery, Women's Hospital, Zhejiang University School of Medicine (Dr. Wang).
Department of Reproductive Endocrinology, Zhejiang University School of Medicine (Dr. Yang).
J Minim Invasive Gynecol. 2020 Sep-Oct;27(6):1281-1286. doi: 10.1016/j.jmig.2019.11.023. Epub 2020 May 21.
To evaluate the levonorgestrel-releasing intrauterine system (LNG-IUS) to prevent the recurrence of endometrial polyps (EPs) after hysteroscopic polypectomies in premenopausal female patients.
A retrospective cohort study.
A tertiary-care women's hospital.
A total of 451 premenopausal female patients underwent hysteroscopic polypectomies between January 1, 2016, and December 31, 2017.
Treatment with LNG-IUS after hysteroscopic polypectomies.
After the hysteroscopic polypectomies and placement of LNG-IUS, transvaginal ultrasounds were performed every 6 months to measure the recurrence of EPs. Overall, 5 (3.47%) of 144 patients in the LNG-IUS cohort and 49 (15.96%) of 307 patients in the control cohort experienced EP recurrence within the follow-up period of up to 3 years. The recurrence exhibited a strongly negative correlation when LNG-IUS was inserted (relative risk, 0.218; 95% confidence interval, 0.089-0.535; p <.05), but this did not significantly correlate with age, polyp size, number of polyps, previous history of polypectomy, and abnormal uterine bleeding. For the LNG-IUS and control cohorts, the recurrence in the first postoperative year was 1.39% and 6.19%, respectively, and 5.41% and 19.23% in the second postoperative year, respectively.
LNG-IUS reduces the recurrence of postoperative EPs in premenopausal patients.
评估左炔诺孕酮释放宫内节育系统（LNG-IUS）在预防绝经前女性宫腔镜息肉切除术（EP）后子宫内膜息肉（EP）复发的作用。
回顾性队列研究。
一家三级妇女医院。
共有 451 名绝经前女性患者于 2016 年 1 月 1 日至 2017 年 12 月 31 日接受宫腔镜息肉切除术。
宫腔镜息肉切除术后放置 LNG-IUS。
宫腔镜息肉切除术后及放置 LNG-IUS 后，每 6 个月进行经阴道超声检查，以测量 EP 的复发情况。在 LNG-IUS 组的 144 例患者和对照组的 307 例患者中，在最长 3 年的随访期间，共有 5（3.47%）例和 49（15.96%）例患者出现 EP 复发。当插入 LNG-IUS 时，复发呈现出强烈的负相关（相对风险，0.218；95%置信区间，0.089-0.535；p<0.05），但这与年龄、息肉大小、息肉数量、既往息肉切除术史和异常子宫出血无关。在 LNG-IUS 组和对照组中，术后第 1 年的复发率分别为 1.39%和 6.19%，第 2 年的复发率分别为 5.41%和 19.23%。
LNG-IUS 降低了绝经前患者宫腔镜息肉切除术后 EP 的复发率。
