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| Curative effect and recurrence rate of levonorgestrel intrauterine system inserted after hysteroscopic surgery for treating patients with endometrial polyps |
| 1. Taikang Xianlin Branch, Affiliated Hospital of Medical School of Nanjing University, Jiangsu Province, 210000; 2. Xiangtan Maternal and Child Health Care Hospital, Hunan Province; 3. Loudi Central Hospital, Hunan Province |
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Abstract To explore the curative effect of levonorgestrel intrauterine system inserted combined with hysteroscopic surgery of endometrial polyps of patients, and to study its influence on the recurrence rate of endometrial polyps of these patients. Methods: A total of 96 patients with endometrial polyps were enrolled and were randomly divided into observation group and control group (48 cases in each group) between October 2017 and November 2020. The patients in both groups had given hysteroscopic endometrial polypectomy, and the patients in the observation group were given levonorgestrel intrauterine system inserted for treatment after the surgery. The endometrial thickness, the menstrual blood loss, the levels of hemoglobin (Hb) and vascular endothelial growth factor(VEGF), uterine hemodynamic indexes, the incidence of adverse reactions, and the recurrence rate of endometrial polyps at different time within 12 months after surgery of the patients were compared between the two groups. Results: At 3 months, 6 months and 12 months after surgery, the endometrial thickness of the patients in the observation group was significantly lower than that of the patients in the control group (P＜0.05). The PBAC score of menstrual blood loss of the patients in the observation group was significantly lower than that of the patients in the control group (P＜0.05). The Hb level of the patients in the observation group was significantly higher than that of the patients in control group, while the level of VEGF was significantly lower than that of the patients in the control group (P＜0.05). At 12 months after surgery, the values of pulsatility index (PI) and resistance index (RI) of the patients in the observation group were significantly
lower than those of the patients in the control group (P＜0.05). After 1 year of follow-up, the recurrence rate (2.1%) of the patients in observation group was significantly lower than that (16.7%) of the patients in the control group (P＜0.05). Conclusion：Hysteroscopy combined with levonorgestrel intrauterine system for treating the patients with endometrial polyps is beneficial to reducing their endometrial thickness and VEGF level, increasing their Hb level, and which also improves the uterine hemodynamics and reduces the postoperative recurrence rate of these patients.
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