| The effectiveness of a levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of endometrial hyperplasia--a long-term follow-up study. | |
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MedLine Citation:
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PMID: 18440693 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Medical treatment of non-atypical endometrial hyperplasia with oral progestogens has limited efficacy and poor compliance. A levonorgestrel-releasing intrauterine system (LNG-IUS) has been shown to successfully treat hyperplasia in small-sized studies. Our aim was to examine the effectiveness of LNG-IUS in a larger study with long-term follow up. STUDY DESIGN: Prospective observational study of 105 women diagnosed with endometrial hyperplasia and treated with LNG-IUS between 1999 and 2004 at a University Teaching hospital. Baseline characteristics and outpatient endometrial Pipelle sampling were undertaken at 3 and 6 months post LNG-IUS insertion and 6-monthly intervals thereafter in all cases. Outcome included histological data derived from both Pipelle and uterine histologies at 1 and 2 years LNG-IUS therapy. RESULTS: LNG-IUS achieved endometrial regression in 90% (94/105) of cases by 2 years, with a significant proportion (96%, 90/94) achieving this within 1 year. Regression occurred in 88/96 (92%) of non-atypical and 6/9 (67%) of atypical hyperplasias, and in all 22 cases of endometrial hyperplasia associated with HRT. Regression rates did not differ between histological types of hyperplasia. Twenty-three women (22%) underwent hysterectomy of which 13 were indicated and 10 were performed at patient request despite regressed endometrium. Two cases of cancer (one uterine and one ovarian) were identified. CONCLUSION: LNG-IUS is highly effective in treating endometrial hyperplasia. Beneficial effects are observed by the majority within 1 year. Treatment can be reliably monitored through regular 6-montly outpatient endometrial Pipelle surveillance. LNG-IUS treatment of non-atypical hyperplasias is likely to reduce the number of hysterectomies performed in this subgroup. |
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Authors:
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Rajesh Varma; Hemi Soneja; Kalsang Bhatia; Raji Ganesan; Terence Rollason; T Justin Clark; Janesh K Gupta |
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Publication Detail:
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Type: Journal Article Date: 2008-04-28 |
Journal Detail:
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Title: European journal of obstetrics, gynecology, and reproductive biology Volume: 139 ISSN: 0301-2115 ISO Abbreviation: Eur. J. Obstet. Gynecol. Reprod. Biol. Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-08-01 Completed Date: 2008-10-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375672 Medline TA: Eur J Obstet Gynecol Reprod Biol Country: Ireland |
Other Details:
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Languages: eng Pagination: 169-75 Citation Subset: IM |
Affiliation:
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Academic Department of Obstetrics and Gynaecology, Birmingham Women's Hospital, Birmingham B15 2TG, UK. r.varma@bham.ac.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Oral Adult Aged Aged, 80 and over Contraceptive Agents, Female / administration & dosage* Endometrial Hyperplasia / drug therapy* Female Follow-Up Studies Humans Hysterectomy Intrauterine Devices, Medicated* Levonorgestrel / administration & dosage* Longitudinal Studies Middle Aged Progestins / administration & dosage, therapeutic use Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Contraceptive Agents, Female; 0/Progestins; 797-63-7/Levonorgestrel |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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