Efficacy of levonorgestrel releasing intrauterine system as a postoperative maintenance therapy of endometriosis: A meta-analysis
| Autor: | Mia Park, Ha Kyun Chang, Sang Mi Kwak, Ki Hwan Lee, Soo Youn Song, Heon Jong Yoo, Geon Woo Lee |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
MEDLINE Endometriosis Levonorgestrel law.invention 03 medical and health sciences 0302 clinical medicine Dysmenorrhea Maintenance therapy Randomized controlled trial Recurrence law Internal medicine Secondary Prevention medicine Humans Pain Management Prospective Studies 030212 general & internal medicine Prospective cohort study Randomized Controlled Trials as Topic Retrospective Studies Postoperative Care Danazol 030219 obstetrics & reproductive medicine business.industry Intrauterine Devices Medicated Obstetrics and Gynecology Retrospective cohort study Odds ratio medicine.disease Reproductive Medicine Patient Satisfaction Relative risk Female Uterine Hemorrhage business medicine.drug |
| Zdroj: | European Journal of Obstetrics & Gynecology and Reproductive Biology. 231:85-92 |
| ISSN: | 0301-2115 |
| DOI: | 10.1016/j.ejogrb.2018.10.014 |
| Popis: | Objective To compare the efficacy of levonorgestrel releasing intrauterine system (LNG-IUS) with other treatments as a postoperative maintenance therapy for endometriosis in terms of pain reduction, recurrence prevention, side effects and patients’ satisfaction. Study design We searched MEDLINE, EMBASE, and the Cochrane Library from January 1986 until February 2018. Two evaluators independently extracted and reviewed prospective and retrospective articles based on pre-determined selection criteria. Outcomes were expressed as mean difference (MD), risk ratios (RR) or odds ratios (OR) in a meta-analysis model, using Revman software. Results Among the 962 studies, 7 studies were selected: 7 studies included 4 randomized controlled trials with 212 patients, 1 prospective cohort study with 88 patients, and 2 retrospective studies with 191 patients. A meta-analysis showed that LNG-IUS was significantly effective in reducing pain after surgery (MD = 12.97, 95% confidence interval (CI): 5.55–20.39), with a comparable effect to gonadotropin-releasing hormone analogues (MD = −0.16, 95% CI: −2.02 to 1.70). LNG-IUS was also effective in decreasing the recurrence rate (RR = 0.40, 95% CI: 0.26–0.64), with an effect comparable to OC (OR = 1.00, 95% CI: 0.25–4.02) and danazol (RR = 0.30, 95% CI: 0.03–2.81). Furthermore, patients’ satisfaction with LNG-IUS was significantly higher than that with OC (OR = 8.60, 95% CI: 1.03–71.86). However, vaginal bleeding was significantly higher in the LNG-IUS group than in the gonadotropin-releasing hormone analogue group (RR = 27.0, 95% CI: 1.71–425.36). Conclusion Our meta-analysis found a positive effect of LNG-IUS as a postoperative maintenance therapy for endometriosis on pain relief, prevention of dysmenorrhea recurrence, and patients’ satisfaction. |
| Databáze: | OpenAIRE |
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