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In comparison to gonadotropin-releasing hormone
analogues the levonorgestrel releasing intrauterine system found to exhibit
comparable efficacy with improved patient satisfaction as postoperative maintenance
therapy for endometriosis.
A recent study issued in the 'European Journal of Obstetrics & Gynecology and Reproductive Health' stated that there is a positive effect of the levonorgestrel-releasing intrauterine system (LNG-IUS) as postoperative maintenance therapy for endometriosis on pain relief, prevention of dysmenorrhea recurrence, and on patients' satisfaction.
This
meta-analysis was performed to distinguish the efficacy of LNG-IUS with other
treatments as postoperative maintenance therapy for endometriosis for pain
reduction, recurrence prevention, side effects and patients' satisfaction. Soo
Youn Song and the team searched MEDLINE, EMBASE, and the Cochrane Library from
January 1986 until February 2018. The predetermined selection criteria were
used by two evaluators to extract and review the prospective and retrospective
articles. The outcomes were portrayed as mean difference (MD), risk ratios (RR)
or odds ratios (OR) in a meta-analysis model, using Revman software. Out of a
total of 962 studies, 7 studies were selected. These 7 studies included 4
randomized controlled trials comprising 212 patients, 1 prospective cohort
study involving 88 patients, and 2 retrospective studies involving 191
patients. It was revealed that LNG-IUS
was significantly effective in reducing pain after surgery with a comparable
effect to gonadotropin-releasing hormone analogues. The LNG-IUS was also
effective in reducing the recurrence rate (RR = 0.40, 95% CI: 0.26–0.64), with
an effect corresponding to OC and danazol. Also, the patients' satisfaction
with LNG-IUS was significantly more than that with OC (OR = 8.60, 95% CI:
1.03–71.86). But, the vaginal bleeding was significantly higher in the LNG-IUS
group than in the gonadotropin-releasing hormone analogue group.
EJOG
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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