Analysis on the clinical efficacy of hysteroscopic LNG-IUS non-suture fixation in treatment of adenomyosis
ZHANG Luping
ZHANG Shengpeng
LI Jinghua
FENG Limin
Abstract：Objective To explore the feasibility and clinical efficacy of a novel hysteroscopic levonorgestrel-releasing intrauterine system(LNG-IUS)non-suture fixation in treatment of adenomyosis.Methods Forty-four patients with adenomyosis who were admitted to Beijing Tiantan Hospital,Capital Medical University from January 2024 to March 2025 and were treated with hysteroscopic LNG-IUS non-suture fixation for adenomyosis were selected.The patients'general data,clinical manifestations,operative duration,operative complications,postoperative LNG-IUS expulsion and other follow-up data were collected.The operation effects were assessed by using a one way ANOVA paired T test.Results A total of 44 patients were included,with average age of(40.16±4.54)years,average number of pregnancy of(2.30±1.62),average number of delivery of(1.14±0.80),average uterine cavity depth of(10.58±1.03)cm,average uterine volume of 130.31(90.60,174.04)mL,average operative duration of(14.54±5.01)min,and intraoperative blood loss of(4.59±3.34)mL.Among them,there were 36 cases(81.82％)of dysmenorrhea,44 cases(100.00％)of menorrhagia,23 cases(52.27％)of anemia,17 cases(38.64％)with a history of LNG-IUS expulsion,and 7 cases(15.91％)with a history of LNG-IUS dislodgement.Among the 44 patients,13 patients underwent hysteroscopic electroresection of endometrial polyps simultaneously,and 3 patients underwent electroresection of submucosal myoma of the uterus simultaneously,and 24 patients underwent aspiration of uterine lining to thin the endometrium at the same time.None of the patients presented with complications such as uterine perforation,massive hemorrhage,fluid overload and postoperative infection.The average postoperative follow-up time was(7.01±1.20)months,and no postoperative LNG-IUS expulsion occurred in all the patients.The follow-up results at 6 months after the operation showed that the effective rate of dysmenorrhea was 91.67％(33/36),and the effective rate of menorrhagia was 95.45％(42/44).At 1 month after the operation,the hemoglobin content of the patients was 124.00(114.50,130.00)g/L,which was significantly increased compared with that before the operation[108.00(96.25,118.75)g/L](Z=5.661,P＜0.001).At 1 month and 6 months after the operation,the patients'menstrual Pictorial Blood Loss Assessment Chart(PBLAC)scores,Visual Analogue Scale(VAS)scores for dysmenorrhea,and uterine volume were decreased compared with those before the operation,and the differences were statistically significant(P＜0.05).Conclusion The hysteroscopic LNG-IUS non-suture fixation is a safe and effective technique,especially suitable for adenomyosis patients with a history of LNC-IUS expulsion or a history of LNG-IUS dislodgement.This surgical method is simple to operate,minimally invasive,with a short operation time,less hemorrhage and a quick postoperative recovery in the patients,and thus is worthy of clinical application.
Keywords：Levonorgestrel-releasing intrauterine system(LNG-IUS)Non-suture fixationHysteroscopeAdenomyosis
Publication Date：2025-11-30
Online Publishing Date：2025-12-25(First online date of this platform, not the publication date of the document)
Pages：5( 1218-1222 )