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KMID : 0358420080510030324
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Korean Journal of Obstetrics and Gynecology
2008 Volume.51 No. 3 p.324 ~ p.329
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The usefulness of combined treatment of GnRH agonist and Levonorgestrel-releasing intrauterine system (Mirena(R)) for chronic pelvic pain of endometriosis
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Cho Moon-Kyoung
Kim Cheol-Hong
Cho Hye-Yon
Oh Sung-Taek
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Abstract
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Objective : The purpose of this study was to evaluate the effects of levonorgestrel-releasing intrauterine system (Mirena ) combination to GnRH (gonadotropin releasing hormone) agonist treatment on chronic pelvic pain of endometriosis, hypoestrogenic symptoms.
Methods : One hundred twenty eight patients who were diagnosed as endometriosis, were divided into endometriosis without adenomyosis group (n=88) and endometriosis with adenomyosis group (n=40). In 57 of 88 patients who had only endometriosis without adenomyosis, only GnRH agonist for 6 months was injected monthly (Group A). In the other 31 of 88 patients, Mirena was inserted and GnRH agonist for 6 months was injected monthly (Group B). In 12 of 40 patients who had endometriosis and adenomyosis, only GnRH agonist for 6 months was injected monthly (Group C). In the other 28 of 40 patients, Mirena was inserted and GnRH agonist for 6 months was injected monthly (Group D). The degree of pelvic pain, dysmenorrhe, and hypoestrogenic symptoms of each groups were observed and compared.
Results : The decreased pain rates of Group B and D were significantly higher than Group A and C (p<0.01), and decreased pain rates of Group D were significantly higher than Group B (p<0.05). The incidence of hot flush, depression and insomnia of 4 groups were not significantly different.
Conclusion : Although Mirena combination to GnRH agonist treatment cannot prevent the hypoestrogeic symptoms, Mirena combination increases the treatment effect for pain of endometriosis. Especially, this effect is the more if adenomyosis is combined to endometriosis.
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KEYWORD
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Endometriosis, Adenomyosis, Levonorgestrel-releasing intrauterine system (Mirena(R)), GnRH agonist, Pelvic pain
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