The efficacy of long‐term maintenance therapy with a levonorgestrel‐releasing intrauterine system for prevention of ovarian endometrioma recurrence
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.
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Another retrospective study reported a cumulative postoperative endometrioma recurrence rate of 25% at 5-year follow-up.
“On the contrary, another retrospective study [90] reported a cumulative postoperative endometrioma recurrence rate of 25% at 5-year follow-up.”
From Oral and depot progestin therapy for endometriosis: towards a personalized medicine (2017) · cites this paper as [90]
Cites
Revised American Society for Reproductive Medicine classification of endometriosis: 1996
American Society for Reproductive Medicine (1997) · Fertility and Sterility · doi:10.1016/s0015-0282(97)81391-x · Cited by 3,018 · see citing works
ESHRE guideline: management of women with endometriosis
Dunselman, G. A. J., Vermeulen, N., Becker, C., Calhaz-Jorge, C., D'Hooghe, T., De Bie, B., Heikinheimo, O., Horne, A. W., Kiesel, L., Nap, A., et al. (2014) · Human Reproduction · doi:10.1093/humrep/det457 · Cited by 2,211 · see citing works
Recurrence of endometriosis and its control
Guo, S.-W. (2009) · Human Reproduction Update · doi:10.1093/humupd/dmp007 · Cited by 719 · see citing works
McLaren, J. F., Prentice, A., Jones, D. S., Millican, S. A., Müller, K. H., Sharkey, A., & Smith, S. K. (1996) · Journal of Clinical Investigation · doi:10.1172/jci118815 · Cited by 499 · see citing works
Population-based study of risk of venous thromboembolism associated with various oral contraceptives
Farmer, R., Lawrenson, R., Thompson, C., Kennedy, J., & Hambleton, I. R. (1997) · The Lancet · doi:10.1016/s0140-6736(96)07496-x · Cited by 329 · see citing works
Vercellini, P., Frontino, G., De Giorgi, O., Aimi, G., Zaina, B., & Crosignani, P. G. (2003) · Fertility and Sterility · doi:10.1016/s0015-0282(03)00608-3 · Cited by 263 · see citing works
Recurrence of ovarian endometrioma after laparoscopic excision
Koga, K., Takemura, Y., Osuga, Y., Yoshino, O., Hirota, Y., Hirata, T., Morimoto, C., Harada, M., Yano, T., & Taketani, Y. (2006) · Human Reproduction · doi:10.1093/humrep/del125 · Cited by 203 · see citing works
Postoperative oral contraceptive exposure and risk of endometrioma recurrence
Vercellini, P., Somigliana, E., Daguati, R., Vigano, P., Meroni, F., & Crosignani, P. G. (2008) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2007.11.010 · Cited by 196 · see citing works
The effectiveness of laparoscopic excision of endometriosis
Garry, R. (2004) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/01.gco.0000136496.95075.79 · Cited by 134 · see citing works
Surgical management of endometriosis
Donnez, J., Pirard, C., Smets, M., Jadoul, P., & Squifflet, J. (2004) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2004.03.004 · Cited by 134 · see citing works
Paracrine changes in the peritoneal environment of women with endometriosis
Küpker, W. (1998) · Human Reproduction Update · doi:10.1093/humupd/4.5.719 · Cited by 130 · see citing works
Evaluation and Management of Women With Endometriosis
Winkel, C. A. (2003) · Obstetrics and Gynecology · doi:10.1016/s0029-7844(03)00474-5 · Cited by 129 · see citing works
Vercellini, P., Somigliana, E., Viganò, P., Matteis, S. D., Barbàra, G., & Fedele, L. (2010) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2010.04.018 · Cited by 121 · see citing works
Recurrence rate of endometriomas following a laparoscopic cystectomy
Kikuchi, I., Takeuchi, H., Kitade, M., Shimanuki, H., Kumakiri, J., & Kinoshita, K. (2006) · Acta Obstetricia et Gynecologica Scandinavica · doi:10.1080/00016340600627154 · Cited by 116 · see citing works
Laparoscopic surgery for endometriosis: How often do we need to re-operate?
Cheong, Y., Tay, P., Luk, F., Gan, H. C., Li, T.-C., & Cooke, I. (2008) · Journal of Obstetrics and Gynaecology · doi:10.1080/01443610701811761 · Cited by 110 · see citing works
Maruo, T., Laoag‐Fernandez, J. B., Pakarinen, P. I., Murakoshi, H., Spitz, I. M., & Johansson, E. D. B. (2001) · Human Reproduction · doi:10.1093/humrep/16.10.2103 · Cited by 107 · see citing works
Tanmahasamut, P., Rattanachaiyanont, M., Angsuwathana, S., Techatraisak, K., Indhavivadhana, S., & Leerasiri, P. (2012) · Obstetrics & Gynecology · doi:10.1097/aog.0b013e31824264c3 · Cited by 105 · see citing works
Endometrial Morphology of Women Using A d-Norgestrel-Releasing Intrauterine Device
Nilsson, C. G., Luukkainen, T., & Arko, H. (1978) · Fertility and Sterility · doi:10.1016/s0015-0282(16)43212-7 · Cited by 101 · see citing works
Exacoustós, C., Zupi, E., Carusotti, C., Rinaldo, D., Marconi, D., Lanzi, G., & Arduini, D. (2003) · The Journal of the American Association of Gynecologic Laparoscopists · doi:10.1016/s1074-3804(05)60266-6 · Cited by 76 · see citing works
Endometriosis: What is the risk of hospital admission, readmission, and major surgical intervention?
Weir, E. L., Mustard, C., Cohen, M. M., & Kung, R. (2005) · Journal of Minimally Invasive Gynecology · doi:10.1016/j.jmig.2005.09.001 · Cited by 54 · see citing works
Lee, D.-Y., Bae, D.-S., Yoon, B.-K., & Choi, D. (2010) · Human Reproduction · doi:10.1093/humrep/deq279 · Cited by 54 · see citing works
Morelli, M., Sacchinelli, A., Venturella, R., Mocciaro, R., & Zullo, F. (2013) · Journal of Obstetrics and Gynaecology Research · doi:10.1111/jog.12030 · Cited by 52 · see citing works
Clinical applications of levonorgestrel-releasing intrauterine system to gynecologic diseases
Kim, M., & Seong, S. J. (2013) · Obstetrics & Gynecology Science · doi:10.5468/ogs.2013.56.2.67 · Cited by 45 · see citing works
Self-citationCho, S., Jung, J. A., Lee, Y., Kim, H. Y., Seo, S. K., Choi, Y. S., Lee, J. S., & Lee, B. S. (2014) · Acta Obstetricia et Gynecologica Scandinavica · doi:10.1111/aogs.12294 · Cited by 39 · see citing works
Recurrence of ovarian endometrioma after second-line, conservative, laparoscopic cyst enucleation
Kim, M., Kim, J. M., Seong, S. J., Lee, S. Y., Han, M. S., & Cho, Y. J. (2013) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2013.11.007 · Cited by 38 · see citing works
Self-citationEngemise, S. L., Willets, J. M., Taylor, A. H., Emembolu, J. O., & Konje, J. C. (2011) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2011.02.013 · Cited by 35 · see citing works
Hurskainen, R. (2000) · Molecular Human Reproduction · doi:10.1093/molehr/6.11.1013 · Cited by 34 · see citing works
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Estrogen-progestins and progestins for the management of endometriosis
Vercellini, P., Buggio, L., Berlanda, N., Barbara, G., Somigliana, E., & Bosari, S. (2016) · Fertility and Sterility · doi:10.1016/j.fertnstert.2016.10.022 · Cited by 243 · see citing works
Barra, F., Scala, C., & Ferrero, S. (2018) · Expert Opinion on Drug Metabolism & Toxicology · doi:10.1080/17425255.2018.1461840 · Cited by 100 · see citing works
Wattanayingcharoenchai, R., Rattanasiri, S., Charakorn, C., Attia, J., & Thakkinstian, A. (2021) · BJOG: An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.16366 · Cited by 58 · see citing works
Oral and depot progestin therapy for endometriosis: towards a personalized medicine
Buggio, L., Somigliana, E., Barbara, G., Frattaruolo, M. P., & Vercellini, P. (2017) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2017.1381086 · Cited by 58 · see citing works
Acién, P., Velasco, I., & Acién, M. (2021) · BMC Women s Health · doi:10.1186/s12905-021-01347-9 · Cited by 15 · see citing works
Krakhotkin, D. V., Silkina, M. N., Chernylovskyi, V. A., & Gayvoronskaya, S. A. (2022) · Journal of Obstetrics and Gynaecology · doi:10.1080/01443615.2022.2081492 · Cited by 9 · see citing works
Acién, P., Velasco, I., & Acién, M. (2019) · Preprints.org · doi:10.20944/preprints201911.0010.v1 · Cited by 2 · see citing works
El tratamiento hormonal es imperativo para todas las pacientes: lo antes posible y siempre
Martínez‐Zamora, M. Á. (2023) · Clínica e Investigación en Ginecología y Obstetricia · doi:10.1016/j.gine.2023.100856
Acién, P., Velasco, I., & Acién, M. (2021) · Figshare · doi:10.6084/m9.figshare.14633981
Youssef, Y., Cherouveim, P., Pintar, V., & Moawad, G. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-27757-3.00010-9
The role of dienogest and other progestogens in the management of endometriosis-related pain
Perrone, U., Ferrero, S., Antonelli, A., Izzotti, A., Anatrà, M., & Barra, F. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-27757-3.00009-2
- Authors
- Kim, M., Cho, Y. J., Kim, M. K., Jung, Y. W., Yun, B. S., & Seong, S. J.
- Affiliations
- CHA University (KR)
- Dong-A University Hospital (KR)
- Corresponding author
- Seong, Seok Ju
- Venue
- International Journal of Gynecology & Obstetrics
- Publisher
- Wiley
- Published
- 2016-09
- Volume
- 134
- Issue
- 3
- Pages
- 256-259
- ISSN
- 0020-6695 (ISSN-L)
- 0020-7292
- 1879-3479
- OpenAlex
- W2416074282
- Cited by
- 11
- References
- 27
- Citations by year
- 2026: 2 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 1 · 2018: 1 · 2017: 1 · 2016: 1
- FWCI
- 1.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- International Journal of Gynecology & Obstetrics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Keywords
- endometrioma, levonorgestrel-releasing intrauterine system, recurrence prevention, maintenance therapy, laparoscopic conservative surgery, nulliparity, premenopausal women, endometriosis
- MeSH terms
- Adult, Combined Modality Therapy, Contraceptives, Oral, Combined, Drug Administration Schedule, Endometriosis, Female, Humans, Middle Aged, Neoplasm Recurrence, Local, Ovarian Neoplasms, Retrospective Studies, Treatment Outcome, Levonorgestrel, Young Adult, Republic of Korea
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