Objective: To determine whether the frequency and severity of dysmenorrhea are reduced in women with symptomatic endometriosis in whom a levonorgestrel-releasing intrauterine device (Lng-IUD) is inserted after operative laparoscopy compared with those treated with surgery only. Design: Open-label, parallel-group, randomized, controlled trial. Setting: A tertiary care and referral center for patients with endometriosis. Patient(s): Parous women with moderate or severe dysmenorrhea undergoing first-line operative laparoscopy for symptomatic endometriosis. Intervention(s): Randomization to immediate Lng-IUD insertion or expectant management after laparoscopic treatment of endometriotic lesions. Main Outcome Measure(s): Proportions of women with recurrence of moderate or severe dysmenorrhea in the two study groups 1 year after surgery and overall degree of satisfaction with treatment. Result(s): Moderate or severe dysmenorrhea recurred in 2 of 20 (10%) subjects in the postoperative Lng-IUD group and 9/20 (45%) in the surgery-only group. Thus, a medicated device inserted postoperatively will prevent the recurrence of moderate or severe dysmenorrhea in one out of three patients 1 year after surgery. A total of 15/20 (75%) women in the Lng-IUD group and 10/20 (50%) in the expectant management group were satisfied or very satisfied with the treatment received. Conclusion(s): Insertion of an Lng-IUD after laparoscopic surgery for symptomatic endometriosis significantly reduced the medium-term risk of recurrence of moderate or severe dysmenorrhea.
Comparison of a levonorgestrel-releasing intrauterine device versus expectant management after conservative surgery for symptomatic endometriosis: a pilot study / P.Vercellini, G.Frontino, O.De Giorgi, G.Aimi, B.Zaina, P.G.Crosignani. - In: FERTILITY AND STERILITY. - ISSN 0015-0282. - 80:2(2003 Aug), pp. 305-309.
|Titolo:||Comparison of a levonorgestrel-releasing intrauterine device versus expectant management after conservative surgery for symptomatic endometriosis: a pilot study|
VERCELLINI, PAOLO PIETRO (Primo)
FRONTINO, GIADA (Secondo)
CROSIGNANI, PIERGIORGIO (Ultimo)
|Parole Chiave:||Dysmenorrhea; Endometriosis; IUD; Pelvic pain; Progestins|
|Settore Scientifico Disciplinare:||Settore MED/40 - Ginecologia e Ostetricia|
|Data di pubblicazione:||ago-2003|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/S0015-0282(03)00608-3|
|Appare nelle tipologie:||01 - Articolo su periodico|