The Role of the Mirena Intrauterine Device in the Management of Endometrial Polyps: A Pilot Study |
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| Affiliation: | 1. i3 Waitemata District Health Board, Auckland, New Zealand (Dr. Chowdary);2. University of Auckland, Auckland, New Zealand (Dr. Chowdary);3. Mercy Hospital for Women, Victoria, Australia (Drs. Maher, Ma, Ellett, and Readman);4. Austin Hospital, Victoria, Australia (Dr. Newman).;1. Departments of Obstetrics and Gynecology (Drs. Smith and Hoffman);2. Surgery (Dr. Davenport);3. Division of Gynecologic Subspecialties (Dr. Hoffman), University of Kentucky, Lexington, Kentucky.;1. Department of Biomedical and Human Oncological Science, 2nd Unit of Obstetrics and Gynecology, University of Bari, Bari, Italy (Drs. Cicinelli, Bettocchi, Loizzi, Cormio, Marinaccio, Trojano, Crupano, and Francescato);2. Department of Obstetrics, Gynecology, and Reproductive Medicine, Faculty of Medicine, Foch Hospital, Suresnes, France (Dr. De Ziegler);3. Department of Women and Children''s Health, University of Padua, Padua, Italy (Dr. Vitagliano);4. Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy (Dr. Resta);1. Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA 94305, USA;2. Department of Obstetrics and Gynecology, University of California, Davis, Sacramento, CA 95817, USA;1. Department of Obstetrics and Gynecology, IRCCS Ospedale San Raffaele, Milan, Italy;2. Facoltà di Medicina e Chirurgia, Università Vita-Salute San Raffaele, Milan, Italy;3. Division of Genetics and Cell Biology, Reproductive Sciences Laboratory, IRCCS Ospedale San Raffaele, Milan, Italy |
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| Abstract: | Study ObjectiveTo study the hypothesis that the levonorgestrel intrauterine device (LNG-IUD) can have a role in the treatment of endometrial polyps confirmed at outpatient hysteroscopy in premenopausal women.DesignCanadian Task Force classification level II1 (a controlled trial that is not randomised).SettingOutpatient hysteroscopy.PatientsPremenopausal women who had a polyp diagnosed at outpatient hysteroscopy.InterventionsPremenopausal women who had a polyp diagnosed at outpatient hysteroscopy and had a LNG-IUD inserted were booked for general anesthesia hysteroscopy and polypectomy through the standard booking process. A contemporaneous control was taken sequentially from the outpatient hysteroscopy database to match the case.Measurements and Main ResultsThe presence of a polyp at hysteroscopy under general anesthesia. A total of 39 patients were included in the study, with 19 in the intervention group and 20 in the control group. The mean age was 43.6 (standard deviation = 5.6) and 43.2 (standard deviation = 8.1) years in the 2 groups, respectively. No difference was found in the time interval between the 2 procedures in the intervention and control groups (mean = 92 vs 84 days, p = .73). However, the proportion of polyps present at the second procedure was significantly higher in the control group (80% vs 37%; relative risk = 2.17; 95% confidence interval, 1.16–4.07; p = .0062).ConclusionOur case-control study found that the LNG-IUD can have a role in the treatment of polyps for women who have heavy menstrual bleeding. This is the first study to show regression of endometrial polyps after treatment with LNG-IUD by direct visualisation at hysteroscopy. |
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