Laparoscopic adenomyomectomy combined with levonorgestrel-releasing intrauterine system is effective for long management of adenomyosis

Abstract Background: Laparoscopic adenomyomectomy combined with intraoperative placement of levonorgestrel-releasing intrauterine device (LNG-IUS) is a novel conservative surgical procedure for adenomyosis. Our study aimed to compare the efficacy of surgery with or without intraoperative placement of LNG-IUStreatment in adenomyosis. Methods: We retrospectively studyed the medical records of adenomyosis patients who received laparoscopic adenomyomectomy from January 2017 to December 2018, including 50 patients surgery-LNG-IUS as group A and 48 patients undegoing surgery alone as group B. Demographic data, surgery-related conditions, and symptom replapse 3 years after surgery were analyzed and compared. Results: Visual analog scale and Mansfield-Voda-Jorgensen Menstrual Bleeding Scale scores of group A at 6, 12, 24, and 36 months were significantly lower than those of group B at the corresponding points (P < .001 for both scales). Individuals in both groups showed statistically significant symptom relief. The recurrence rate in group A was significantly lower than that in group B (6.0% vs. 22.9%,P = .017). Conclusions: Conservative surgery with intraoperative placement of LNG-IUS is more effective for adenomyosis long-term therapy and has a lower recurrence rate of adenomyosis compared to surgery alone.