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The efficacy of long‐term maintenance therapy with a levonorgestrel‐releasing intrauterine system for prevention of ovarian endometrioma recurrence
Author(s) -
Kim MiLa,
Cho Yeon Jean,
Kim Mi Kyoung,
Jung Yong Wook,
Yun Bo Seong,
Seong Seok Ju
Publication year - 2016
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2016.03.017
Subject(s) - medicine , levonorgestrel , hazard ratio , endometriosis , retrospective cohort study , surgery , confidence interval , laparoscopy , gynecology , population , family planning , environmental health , research methodology
Abstract Objective To evaluate the cumulative recurrence rates of ovarian endometrioma among patients using a levonorgestrel‐releasing intrauterine system (LNG‐IUS) after conservative laparoscopic surgery. Methods A retrospective review was conducted of premenopausal women who underwent conservative laparoscopic surgery for ovarian endometrioma and subsequent treatment with LNG‐IUS at two gynecologic surgery centers in South Korea between January 1, 2007, and September 30, 2014. Eligible patients had no residual ovarian lesions before LNG‐IUS insertion, underwent insertion within 12 months of primary surgery, and were followed up for at least 6 months afterwards. Recurrence was defined as a cystic mass (≥ 2 cm in diameter) detected by transvaginal ultrasonography. Results Overall, 61 patients were included. The mean duration of follow‐up was 42.9 ± 22.0 months (range 8–98). Recurrence of ovarian endometrioma was detected among 7 (11%) of the patients. On Kaplan–Meier analysis, the cumulative recurrence rates were 4.0%, 6.3%, and 25.5% at 24, 36, and 60 months after surgery, respectively. In multivariate analysis, nulliparity at surgery was the only risk factor for recurrence (hazard ratio 5.892, 95% confidence interval 1.139–30.484; P = 0.034). Conclusion Long‐term maintenance therapy with LNG‐IUS after conservative surgery might be a treatment option to consider to prevent ovarian endometrioma recurrence among premenopausal women.