2026-10-07T04:51:37Z https://api.figshare.com/v2/oai

oai:figshare.com:article/34004100 2026-09-27T01:20:39Z category_25072 item_type_3 month_year_09_2026

Hysteroscopic Suture Fixation of a Levonorgestrel-Releasing Intrauterine System for Symptomatic Adenomyosis Yufei Zeng (15415103) Analytical spectrometry Adenomyosis levonorgestrel-releasing intrauterine system LNG-IUS <p dir="ltr">Adenomyosis commonly causes dysmenorrhea, heavy menstrual bleeding, anemia, uterine enlargement, and impaired quality of life. Although the levonorgestrel-releasing intrauterine system (LNG-IUS) provides sustained local hormonal treatment, displacement and expulsion may limit continued drug exposure in women with enlarged or anatomically unfavorable uterine cavities. This prospective, non-randomized comparative cohort study consecutively enrolled 180 women with symptomatic adenomyosis between January 2022 and December 2024. Ninety participants underwent hysteroscopic fundal suture fixation and 90 underwent conventional placement. The primary outcome was partial or complete expulsion within 12 months; secondary assessments included device position, dysmenorrhea, menstrual blood loss, hemoglobin concentration, uterine volume, WHOQOL-BREF scores, adverse events, and reinterventions. Partial or complete expulsion occurred in 4.4% of the fixation group and 15.6% of the conventional-placement group, an absolute risk difference of 11.1 percentage points. Both groups showed substantial improvement in pain, bleeding, hemoglobin concentration, uterine volume, and quality of life, consistent with the pharmacological action of the LNG-IUS rather than a direct therapeutic effect of the suture. Fixation required a longer procedure and modestly greater blood loss. Three early postoperative pelvic infections occurred after fixation; all resolved with medical treatment without hospitalization or serious sequelae. Because treatment allocation was non-randomized and the fixation group had more baseline expulsion risk factors, the comparative effect estimates should be interpreted cautiously. The principal potential benefit of fixation is mechanical device retention, not enhancement of LNG-IUS pharmacological efficacy.</p> 2026-09-27T01:20:39Z Dataset Dataset 10.6084/m9.figshare.34004100.v1 https://figshare.com/articles/dataset/Hysteroscopic_Suture_Fixation_of_a_Levonorgestrel-Releasing_Intrauterine_System_for_Symptomatic_Adenomyosis/34004100 CC BY 4.0