Postoperative levonorgestrel‐releasing intrauterine system versus oral contraceptives after gonadotropin‐releasing hormone agonist treatment for preventing endometrioma recurrence
Open accessAbstract
Objective: Although the levonorgestrel‐releasing intrauterine system (LNG‐IUS) is effective in reducing the recurrence of endometriosis‐associated pain, its efficacy in preventing endometrioma recurrence is questionable. We compared the efficacy of postoperative use of LNG‐IUS with oral contraceptives (OC) for preventing endometrioma recurrence. Design: A retrospective cohort study. Setting: Medical university hospital. Population: Ninety‐nine women with endometriomas. Methods: A chart review was performed of women of reproductive age who had undergone laparoscopic surgery for endometrioma followed by three cycles of gonadotropin‐releasing hormone agonist (leuprolide acetate) treatment. Women were categorized into two groups: a group that had postoperative LNG‐IUS placement (n = 42) and a group that received postoperative, cyclic, low‐dose, monophasic,OC s (n = 57). Main outcome measures: Endometrioma recurrence was analyzed according to several clinical variables and postoperative treatment modalities. Results: During the follow‐up period (median 17 months), recurrent endometriomas were detected in eight women (8.1%). Patients with LNG‐IUS had a recurrence rate of 4.8% (2/42), whereas women receiving OC had a recurrence rate of 10.5% (6/57). Cumulative recurrence‐free survival assessment revealed that mean disease‐free survival times for both groups were similar, but that for LNG‐IUS was slightly longer than that for OC, with statistical significance (34.4 ± 1.0 months, 95% confidence interval 32.3–36.5, vs. 33.4 ± 1.3 months, 95% confidence interval 30.8–36.0,p = 0.045). Univariate analysis revealed a hazard ratio of 0.178 (95% confidence interval 0.029–1.075) (p = 0.060) for postoperative LNG‐IUS use and endometrioma recurrence. However, for the multivariate regression analysis, only postoperative serum CA 125 levels were significantly associated with endometrioma recurrence (hazard ratio 1.012,p = 0.010). Conclusions: Postoperative LNG‐IUS use seemed to be comparable to the use of cyclic OC in preventing endometrioma recurrence.
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Two retrospective studies found that postoperative LNG-IUS use seems comparable to COC in preventing endometrioma recurrence.
“Two retrospective studies [88,89] compared the efficacy of postoperative use LNG-IUS with COC for preventing endometrioma recurrence. In both cases, postoperative LNG-IUS use seems comparable to that of COC in preventing endometrioma recurrence.”
From Oral and depot progestin therapy for endometriosis: towards a personalized medicine (2017) · cites this paper as [89]
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- Authors
- Cho, S., Jung, J. A., Lee, Y., Kim, H. Y., Seo, S. K., Choi, Y. S., Lee, J. S., & Lee, B. S.
- Affiliations
- Yonsei University (KR)
- Gachon University (KR)
- Corresponding author
- Lee, Byung Seok
- Venue
- Acta Obstetricia et Gynecologica Scandinavica
- Publisher
- Wiley
- Published
- 2013-12-17
- Volume
- 93
- Issue
- 1
- Pages
- 38-44
- ISSN
- 0001-6349 (ISSN-L)
- 1600-0412
- OpenAlex
- W2021451858
- Cited by
- 39
- References
- 37
- Citations by year
- 2026: 3 · 2023: 3 · 2022: 3 · 2021: 1 · 2020: 7 · 2019: 4 · 2018: 5 · 2017: 6 · 2016: 4 · 2015: 3
- FWCI
- 2.82
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Acta Obstetricia Et Gynecologica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- YUHSpace (Yonsei University Medical Library) (submittedVersion, cc-by-nc-nd)
- Funders
- Yonsei University
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Keywords
- endometrioma recurrence, levonorgestrel-releasing intrauterine system, oral contraceptives, GnRH agonist, leuprolide, postoperative hormonal therapy, CA125, endometriosis-associated pain, disease-free survival, endometriosis surgery, recurrence prevention, levonorgestrel
- MeSH terms
- Adult, Contraceptives, Oral, Hormonal, Endometriosis, Female, Humans, Intrauterine Devices, Medicated, Gonadotropin-Releasing Hormone, Middle Aged, Retrospective Studies, Leuprolide, Levonorgestrel, Disease-Free Survival, Secondary Prevention
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