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Levonorgestrel intra-uterine system as a treatment option for complex endometrial hyperplasia.

AbstractOBJECTIVE:
The objective of this study was to evaluate the potential treatment of atypical and non-atypical endometrial hyperplasia with the levonorgestrel intrauterine system (LNG-IUS).
STUDY DESIGN:
A prospective observational study was undertaken at Queen's Medical Centre's menstrual disorder clinic between 2001 and 2008. Women presenting with abnormal perimenopausal and postmenopausal bleeding, underwent an endometrial biopsy followed by the insertion of a levonorgestrel intrauterine system (LNG-IUS). The study population comprised of 51 patients. The histology of 32 patients (Group A) showed complex hyperplasia without atypia, and in 19 patients (Group B), biopsy revealed atypical endometrial hyperplasia. These patients chose to be managed conservatively with repeat sampling of the endometrium.
RESULTS:
Group A: 28 (87.5%) patients out of 32 had regression of their endometrial hyperplasia within the first 12 months of follow-up. Three of the patients achieved regression by 24 months increasing regression rate to 96.8% and the remaining one had a hysterectomy due to a rare side effect. Group B: 16 (84.2%) of 19 patients had regression of the atypical hyperplasia after treatment with the intrauterine system within 12 months of treatment. One patient achieved regression of the hyperplasia by 24 months and two patients went on to have surgical management due to persistent atypia and severe atypia respectively.
CONCLUSION:
This study contribute further evidence that illustrates that levonorgestrel intrauterine systems have a potential role in patients requiring non-operative management although close follow-up is essential.
AuthorsZeina J Haoula, Kate F Walker, Martin C Powell
JournalEuropean journal of obstetrics, gynecology, and reproductive biology (Eur J Obstet Gynecol Reprod Biol) Vol. 159 Issue 1 Pg. 176-9 (Nov 2011) ISSN: 1872-7654 [Electronic] Ireland
PMID21741152 (Publication Type: Clinical Trial, Journal Article)
CopyrightCopyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Chemical References
  • Anticarcinogenic Agents
  • Progestins
  • Levonorgestrel
Topics
  • Aged
  • Anticarcinogenic Agents (administration & dosage, adverse effects, therapeutic use)
  • Biopsy
  • Drug Delivery Systems
  • Drug Monitoring
  • Endometrial Hyperplasia (drug therapy, pathology, physiopathology, surgery)
  • Endometrial Neoplasms (etiology, prevention & control)
  • Endometrium (drug effects, pathology)
  • Female
  • Humans
  • Intrauterine Devices, Medicated (adverse effects)
  • Levonorgestrel (administration & dosage, adverse effects, therapeutic use)
  • Menstruation Disturbances (etiology)
  • Middle Aged
  • Progestins (administration & dosage, adverse effects, therapeutic use)
  • Remission Induction

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