Insertion of the Mirena intrauterine system for treatment of adenomyosis-associated menorrhagia: a novel method
Peng, F.-S.; Wu, M.-Y.; Yang, J.-H.; Chen, S.-U.; Ho, H.-N.; Yang, Y.-S.
Taiwanese Journal of Obstetrics and Gynecology 49(2): 160-164
2010
ISSN/ISBN: 1875-6263 PMID: 20708521 DOI: 10.1016/s1028-4559(10)60034-4Document Number: 215410
Insertion of the levonorgestrel-releasing intrauterine system Mirena is difficult in women with adenomyosis, and the device is often subsequently expelled. We used a novel insertion technique (Yang's method) to overcome this problem. This retrospective study enrolled 273 patients with adenomyosis who were receiving Mirena for treatment of menorrhagia and/or dysmenorrhea between 2001 and 2008. Clinical outcomes and expulsion rates were compared between patients treated using conventional insertion and those treated using Yang's insertion methods. Expulsion occurred in 25.3% of patients with the conventional method, compared with 10.2% of patients with Yang's method. Hemoglobin levels and dysmenorrhea improved greatly in both groups after Mirena insertion. Yang's insertion method for levonorgestrel-releasing intrauterine system is more reliable in some difficult cases, such as patients with severe adenomyosis. This method ensures correct positioning, thus reducing the risks of uterine perforation and/or expulsion.