TỈ LỆ THÁO DỤNG CỤ TỬ CUNG PHÓNG THÍCH LEVONORGESTREL TRƯỚC THỜI HẠN VÀ CÁC YẾU TỐ LIÊN QUAN TRONG BỆNH LÝ TỬ CUNG TẠI BỆNH VIỆN TỪ DŨ

Abstract

Objective: The objective of this study was to evaluate the premature removal rate of Levonorgestrel-releasing intrauterine system and risk factors of premature removal in the treament of benign uterine diseases at Tu Du Hospital. Methods: A cross-sectional study on one hundred eighty seven (n=187) patients with benign uterine diseases such as: adenomyosis, uterine leiomyoma, endometrial hyperplasia being treated by LNG-IUS were included between October 2018 and May 2019 at Tu Du Hospital. Results: The patient^,s mean age was 41,7 ± 6 years. Fourteen (7,5%) patients underwent premature LNG-IUS removal, which mostly occurred during the first 3 months and improved as time passed. Risk factor of premature LNG-IUS removal was associated with prolonged vaginal bleeding over 8 days (PR = 7,94; CI 95% 1,88-33,46; p=0,005). The most common side-effects were vaginal spotting (n=152; 81,3%), amenorrhea (n=39; 20,9%), heavy vaginal bleeding (n=29; 15,5%), prolonged vaginal spotting (n=25; 13,4%), expulsion (n=24; 12,8%). Risk factors for expulsion included heavy menstrual bleeding, large uterine volume. LNG-IUS improved significantly in dysmenorrhea (94,7%) and heavy bleeding (84,5%). Satisfactive rate was 79,7%. Conclusion: The data suggest that premature LNG-IUS removal rate and side effects is low. LNG-IUS is a suitable alternative option for treament of benign uterine diseases prior to hysterectomy.