Department of Gynecology, Chengdu First People's Hospital, Sichuan Province, Chengdu, 610000, China.
Surgical center, Chengdu First People's Hospital, Chengdu, Sichuan Province, China.
BMC Womens Health. 2024 Oct 9;24(1):556. doi: 10.1186/s12905-024-03390-8.
This study aimed to investigate the safety and efficacy of suture fixation of the levonorgestrel-releasing intrauterine device (LNG-IUD) by hysteroscope for the treatment of adenomyosis in patients at high risk of device expulsion, to provide a viable treatment option for these patients.
Twenty-one patients with large symptomatic adenomyosis were sewed and fixed with the LNG-IUD in the uterus by hysteroscopy to prevent the device expulsion.
In this prospective case series, all 21 patients were successfully sewed and fixed with the LNG-IUD in the uterus by hysteroscopy. The amount of menstruation was significantly decreased and dysmenorrhea was significantly relieved in 3, 6, and 12 months after surgery compared with before surgery. Only one patient underwent a laparoscopic hysterectomy due to dysmenorrhea which was not alleviated one month later. Serious IUD complications including expulsion and perforation were not observed. There was no development of new side effects than LNG-IUD insertion.
Our findings indicate that suture fixation of the LNG-IUD by hysteroscope is a safe, effective, and minimally invasive surgical procedure to prevent the device expulsion. It is a good solution for the treatment of large symptomatic adenomyosis and has shown to be effective in managing symptoms related to adenomyosis.
本研究旨在探讨宫腔镜下缝合固定左炔诺孕酮宫内节育器（LNG-IUD）治疗有节育器脱落高风险的患者的安全性和有效性，为这些患者提供一种可行的治疗选择。
对 21 例大的有症状的子宫腺肌病患者进行宫腔镜下缝合固定 LNG-IUD，以防止节育器脱落。
在这项前瞻性病例系列研究中，所有 21 例患者均成功地在宫腔镜下缝合固定了 LNG-IUD。与术前相比，术后 3、6 和 12 个月的月经量明显减少，痛经明显缓解。仅 1 例患者因痛经未缓解 1 个月后行腹腔镜子宫切除术。未观察到严重的 IUD 并发症，包括脱落和穿孔。与 LNG-IUD 插入相比，没有出现新的副作用。
我们的研究结果表明，宫腔镜下缝合固定 LNG-IUD 是一种安全、有效、微创的手术方法，可以防止节育器脱落。对于治疗大的有症状的子宫腺肌病是一种很好的解决方案，并且已经证明在治疗与子宫腺肌病相关的症状方面是有效的。
