Department of Obstetrics and Gynaecology, Charles University, First Faculty of Medicine and General Faculty Hospital in Prague, Prague, Czech Republic.
Department of Physiology, Development and Neuroscience, St John's College Teaching Associate, University of Cambridge, Centre for Trophoblast Research, Cambridge, UK.
Minim Invasive Ther Allied Technol. 2022 Apr;31(4):615-619. doi: 10.1080/13645706.2020.1870499. Epub 2021 Jan 11.
This study was designed to evaluate the feasibility and effectiveness of hysteroscopy in the management of symptoms related to endometrial polyps and submucous leiomyomas in women using a levonorgestrel-releasing intrauterine system (LNG-IUS).
Twenty-three LNG-IUS users presenting with endometrial polyps and/or submucous leiomyomas and irregular uterine bleeding were recruited for hysteroscopic examination and surgery. Intrauterine pathology was investigated and treated by hysteroscopic resection with the LNG-IUS , and the effect of the procedure on symptoms was evaluated after three to six months.
Intrauterine pathology was successfully resected by hysteroscopy in 23 (100.0%) out of 23 cases. Following hysteroscopy, 18 (78.3%) women reported amenorrhea, one (4.3%) regular spotting, three (13.0%) irregular spotting and one (4.3%) patient resumed normal menstrual cycle. We conclude that 19 (82.6%) patients were postoperatively asymptomatic. All procedures were uncomplicated and 4 (17.4%) were carried out without general anesthesia as office procedures.
Endometrial polyps and submucous leiomyomas can develop in LNG-IUS users, and this can cause irregular uterine bleeding. Hysteroscopic resection of these pathologies is a feasible method in the clinical management of symptoms.
本研究旨在评估在使用左炔诺孕酮宫内节育系统（LNG-IUS）的妇女中，宫腔镜检查和手术治疗子宫内膜息肉和黏膜下肌瘤相关症状的可行性和有效性。
招募了 23 名 LNG-IUS 使用者，这些患者有子宫内膜息肉和/或黏膜下肌瘤和不规则子宫出血，进行宫腔镜检查和手术。通过宫腔镜切除 LNG-IUS 来研究和治疗宫内病变，并在三到六个月后评估手术对症状的影响。
23 例（100.0%）中的 23 例成功地通过宫腔镜切除了宫内病变。宫腔镜检查后，18 例（78.3%）患者闭经，1 例（4.3%）患者出现规律点状出血，3 例（13.0%）患者出现不规则点状出血，1 例（4.3%）患者恢复正常月经周期。我们得出结论，19 例（82.6%）患者术后无症状。所有手术均无并发症，其中 4 例（17.4%）作为门诊手术在没有全身麻醉的情况下进行。
LNG-IUS 使用者可出现子宫内膜息肉和黏膜下肌瘤，并可引起不规则子宫出血。宫腔镜切除这些病变是治疗症状的一种可行方法。
