Efficacy of the levonorgestrel-releasing intrauterine device in the treatment of recurrent pelvic pain in multitreated endometriosis
Matorras, R.; Ballesteros, A.; Prieto, B.ña.; Ocerin, I.; Expósito, A.; Pijoan, J.é I.; Crisol, L.
Journal of Reproductive Medicine 56(11-12): 497-503
2011
ISSN/ISBN: 0024-7758 PMID: 22195333 Document Number: 226460
To assess the value of the levonorgestrel-releasing intrauterine device (LNG-IUD) in the treatment of pelvic pain in patients with endometriosis in which previous medical and surgical treatments have failed. This prospective study evaluated pelvic pain by means of both a visual analog grading scale and a verbal descriptive grading scale. Pain was evaluated before insertion of the LNG-IUD and afterwards, at 3-month intervals. Adverse effects and reasons for removal were recorded. Me dian follow-up was 22 months (range, 3-36 months). Response rates were expressed as a percentage of the initial cohort in whom the LNG-IUD was inserted, including cases in which the LNG-IUD was extracted. Three months after LNG-IUD insertion, almost 50% of patients reported an improvement in pain symptoms, with this figure rising to 60% after 6 months and almost 70% by the end of follow-up. A trend of better responses was observed when endometriosis was diagnosed <10 years before, as well as in stage I-II endometriosis, but these differences were not statistically significant. In endometriosis patients with recurrent pelvic pain in whom previous medical and surgical treatments have failed, LNG-IUD insertion should be considered before radical surgery is performed.