Yu Yi, Zhang Hongwei, Sui Long, Chen Limei
Hysteroscopy Centre, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China.
Front Med (Lausanne). 2025 Apr 28;12:1563888. doi: 10.3389/fmed.2025.1563888. eCollection 2025.
This study aimed to explore the feasibility and clinical effects of a novel hysteroscopic levonorgestrel-releasing intrauterine system (LNG-IUS) non-suture fixation at the uterine fundus.
From October 2023 to July 2024, a prospective study involving a novel hysteroscopic LNG-IUS non-suture fixation at the uterine fundus was conducted at Obstetrics and Gynecology Hospital, Fudan University. The patient's clinical symptoms, surgical time, surgical complications, postoperative LNG-IUS expulsion, and other follow-up information were recorded.
A total of 31 patients were included in this study. The average uterine depth is 9.17 ± 0.67 cm. Among them, 10 cases had a history of LNG-IUS expulsion. The average surgical time is 13.0 ± 4.1 min, and the average intraoperative blood loss is 5.3 ± 3.6 mL. All patients did not experience complications such as uterine perforation, massive bleeding, fluid overload, or postoperative infection. The average follow-up time after surgery was 6.0 ± 1.8 months, and no LNG-IUS expulsion occurred. The pain assessment and mean menstrual flow postoperation were less than preoperation, and the endometrial thickness and mean uterine volume postoperation were lower than preoperation, with statistically significant differences. For patients with dysmenorrhea, the postoperative relief rate was 96.3% (26/27), and for those with excessive menstruation, the postoperative effective rate reached 96.2% (25/26). The main adverse reaction was irregular vaginal bleeding, with an incidence rate of 61.3% (19/31).
Hysteroscopic LNG-IUS non-suture fixation at the uterine fundus is a safe and effective technique, particularly suitable for patients with dysmenorrhea, excessive menstruation, or a large uterine cavity who have previously experienced LNG-IUS expulsion. This procedure is simple and minimally invasive, has a short surgical time, has minimal bleeding, and provides rapid recovery; therefore, it is worthy of clinical application.
本研究旨在探讨一种新型宫腔镜下左炔诺孕酮宫内节育系统（LNG-IUS）子宫底部非缝合固定术的可行性及临床效果。
2023年10月至2024年7月，复旦大学附属妇产科医院开展了一项关于新型宫腔镜下LNG-IUS子宫底部非缝合固定术的前瞻性研究。记录患者的临床症状、手术时间、手术并发症、术后LNG-IUS排出情况及其他随访信息。
本研究共纳入31例患者。子宫平均深度为9.17±0.67cm。其中，10例有LNG-IUS排出史。平均手术时间为13.0±4.1分钟，平均术中出血量为5.3±3.6毫升。所有患者均未发生子宫穿孔、大出血、液体超负荷或术后感染等并发症。术后平均随访时间为6.0±1.8个月，未发生LNG-IUS排出。术后疼痛评估及平均月经量均低于术前，术后子宫内膜厚度及平均子宫体积均低于术前，差异有统计学意义。痛经患者术后缓解率为96.3%（26/27），月经过多患者术后有效率达96.2%（25/26）。主要不良反应为不规则阴道出血，发生率为61.3%（19/31）。
宫腔镜下LNG-IUS子宫底部非缝合固定术是一种安全有效的技术，尤其适用于痛经、月经过多或子宫腔较大且既往有LNG-IUS排出史的患者。该手术操作简单、微创，手术时间短，出血少，恢复快，值得临床应用。
