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To compare the efficacy of the
levonorgestrel-releasing intrauterine system (LNG-IUS) with other treatments as
postoperative maintenance therapy for endometriosis concerning pain reduction,
recurrence prevention, side effects and patients’ satisfaction.
This analysis portrayed that the
levonorgestrel-releasing intrauterine system (LNG-IUS) provides higher
satisfaction rate of patients without systemic adverse drug reaction than other
treatments and significantly prevents the recurrence of dysmenorrhea. Hence,
LNG-IUS might be a treatment option as maintenance therapy after the surgical
management for endometriosis.
To compare the efficacy of the
levonorgestrel-releasing intrauterine system (LNG-IUS) with other treatments as
postoperative maintenance therapy for endometriosis concerning pain reduction,
recurrence prevention, side effects and patients’ satisfaction.
The investigators
searched MEDLINE, EMBASE, and the Cochrane Library from January 1986 to
February 2018. Two evaluators independently extracted and reviewed the
prospective and retrospective articles as per the predetermined selection
criteria. Outcomes were determined as mean difference (MD), risk ratios (RR) or
odds ratios (OR) in a meta-analysis model, using the Revman software.
From a total of 962 studies, 7 studies were
selected. These 7 studies comprised of four randomized controlled trials with
212 patients, one prospective cohort study with 88 patients, and two
retrospective studies with 191 patients. According to the meta-analysis,
LNG-IUS significantly reduced the pain
after surgery (MD = 12.97, 95% CI: 5.55–20.39), with a comparable effect to
gonadotropin-releasing hormone analogues (MD = −0.16, 95% CI: −2.02 to 1.70).
LNG-IUS was also effective in reducing the recurrence rate (RR = 0.40, 95% CI:
0.26–0.64), with an effect comparable to OC (OR = 1.00, 95% CI: 0.25–4.02) and
danazol (RR = 0.30, 95% CI: 0.03–2.81). Also, patients' satisfaction with
LNG-IUS was significantly higher than that with OC (OR = 8.60, 95% CI:
1.03–71.86). Vaginal bleeding was significantly higher in the LNG-IUS group as
compared to the gonadotropin-releasing hormone analogue group (RR = 27.0, 95%
CI: 1.71–425.36).
This meta-analysis portrayed a positive effect of LNG-IUS as
postoperative maintenance therapy for endometriosis on pain relief, prevention
of dysmenorrhea recurrence, and the patient's satisfaction.
European Journal of Obstetrics and Gynecology
Efficacy of levonorgestrel releasing intrauterine system as a postoperative maintenance therapy of endometriosis: A meta-analysis
Soo Youn Song et al.
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