Palavras-chave
Levonorgestrel
Adenomiose
Como Citar
Copyright © | Todos os direitos reservados.
A revista detém os direitos autorais exclusivos de publicação deste artigo nos termos da lei 9610/98.
Reprodução parcial
É livre o uso de partes do texto, figuras e questionário do artigo, sendo obrigatória a citação dos autores e revista.
Reprodução total
É expressamente proibida, devendo ser autorizada pela revista.
Resumo
Objetivo: Investigar na literatura cientifica o tratamento para adenomiose com o Dispositivo Intrauterino de Levonorgestrel (DIU-LNG). Métodos: Trata-se de uma revisão integrativa da literatura, com artigos publicados entre 2019 e 2024, nos idiomas português e inglês. A busca pelos artigos foi executada considerando os descritores “Intrauterine Devices”, “Levonorgestrel” e “Adenomyosis”, utilizando o operador booleano “AND”, nas bases de dados National Library of Medicine (PubMed), Science Direct e Google Acadêmico. Resultados: Foram selecionados 13 artigos de 5.002 encontrados inicialmente. Destes, 11 confirmaram a eficácia do DIU-LNG no tratamento de adenomiose, com melhora dos sintomas e redução do volume uterino. Quatro estudos relataram expulsão do dispositivo em úteros grandes, mas modificações na inserção, como fixação por sutura, reduziram esse problema e melhoraram os resultados. Apenas um estudo demonstrou maior eficácia do Dienogeste em comparação ao DIU-LNG. Considerações finais: Conclui-se que O DIU de levonorgestrel é eficaz na redução da dor pélvica e da metrorragia, sintomas comuns da adenomiose e na diminuição do volume uterino com poucos efeitos hormonais. É uma alternativa eficiente e menos invasiva para controlar os sintomas sem recorrer à histerectomia.
Referências
ARKHIGBE RE, et al. Comparison of the effectiveness of levonorgestrel intrauterine system and dienogest in the management of adenomyosis: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2024; 300: 230-239.
BANU J, et al. Clinical Efficacy of Levonorgestrel Releasing Intrauterine System versus Dienogest for Women having Symptomatic Adenomyosis. Sch Int J Obstet Gynec 2023; 6(1): 34-40.
CHEN S, et al. Efficacy of the levonorgestrel-releasing intrauterine device is associated with different subtypes of adenomyosis: a retrospective study. Ann Transl Med. 2020; 8(21): 1356.
COSTANZI F, et al. The treatment with Levonorgestrel Releasing Intrauterine System (LNG-IUS) in patients affected by menometrorrhagia, dysmenorrhea and adenomyosis: clinical and ultrasonographic reports. Eur Rev Med Pharmacol Sci. 2021; 25(9): 3432-3439.
GUO W, et al. Compare the Efficacy of Dienogest and the Levonorgestrel Intrauterine System in Women with Adenomyosis 2023; 45(10): 973-976.
ISHIZAWAC, et al. Levonorgestrel-Releasing Intrauterine System Improves Menorrhagia-Related Quality of Life in Patients with Symptomatic Adenomyosis. Reprod Sci. 2023; 30(3): 966-973.
JAISWAL A, et al. Effectiveness and Safety of Levonorgestrel Intrauterine Device in Abnormal Uterine Bleeding, Adenomyosis and Perimenopausal Bleeding Patients. Int. J. Pharm. Investigation, 2024; 14(1):186-190.
KHAN KN, et al. Biological differences between focal and diffuse adenomyosis and response to hormonal treatment. Reprod Biomed Online 2019; 38: 634-46.
KISHI Y, et al. Four subtypes of adenomyosis assessed by magnetic resonance imaging and their specification. Am J Obstet Gynecol 2012; 207: 114.e1-7.
KITAWAKI J, et al. Bleeding patterns of women with heavy menstrual bleeding or dysmenorrhoea using the levonorgestrel-releasing intrauterine system: results from a real-world observational study in Japan (J-MIRAI). Eur J Contracept Reprod Health Care. 2022; 27(4): 300-307.
LEE KH, et al. Relationship between uterine volume and discontinuation of treatment with levonorgestrel-releasing intrauterine devices in patients with adenomyosis. Arch Gynecol Obstet. 2016; 294(3): 561-6.
LI L, et al. Treatment of symptomatic adenomyosis with the levonorgestrel-releasing intrauterine system. Int J Gynaecol Obstet. 2019; 146(3): 357-363.
LV N, et al. Feasibility and Effectiveness of Hysteroscopic Suture Fixation of the Levonorgestrel-Releasing Intrauterine System in the Treatment of Adenomyosis. J Minim Invasive Gynecol. 2024; 31(1): 57-63.
MAO M, et al. The suture fixation of the levonorgestrel-releasing intrauterine device with hysteroscope for the treatment of adenomyosis in patients at high risk of device expulsion-a prospective observational study. BMC Womens Health. 2024; 24(1): 556.
MAGALHAES J, et al. Uterine volume, menstrual patterns, and contraceptive outcomes in users of the levonorgestrel-releasing intrauterine system: A cohort study with a five-year follow-up. Eur J Obstet Gynecol Reprod Biol. 2022; 276: 56-62.
MOAWAD G, et al. The Present and the Future of Medical Therapies for Adenomyosis: A Narrative Review. J Clin Med. 2023; 12(19): 6130.
PARK DS, et al. Clinical experiences of the levonorgestrel-releasing intrauterine system in patients with large symptomatic adenomyosis. Taiwan J Obstet Gynecol. 2015; 54(4): 412-5.
RATHINAM KK, et al. Evaluation of pharmacological interventions in the management of adenomyosis: a systematic review. Eur J Clin Pharmacol. 2022; 78(4): 531-545.
SCHRAGER S, et al. Adenomyosis: Diagnosis and Management. Am Fam Physician, 2022; 105(1): 33-38.
SHENG J, et al. The LNG-IUS study on adenomyosis: a 3-year follow-up study on the efficacy and side effects of the use of levonorgestrel intrauterine system for the treatment of dysmenorrhea associated with adenomyosis. Contraception. 2009; 79(3): 189-93.
SONG SY, et al. Long-term efficacy and feasibility of levonorgestrel-releasing intrauterine device use in patients with adenomyosis. Medicine (Baltimore). 2020; 99(22): e20421.
YANG H, et al. Effect of modified levonorgestrel-releasing intrauterine system in human adenomyosis with heavy menstrual bleeding. J Obstet Gynaecol Res. 2022; 48(1): 161-168.
ZHANG H, et al. An innovative surgical approach: suture fixation of the levonorgestrel-releasing intrauterine system in the treatment of adenomyosis. BMC Womens Health. 2022; 22(1): 451.
ZHANG L, et al. Efficacy and adverse effects of levonorgestrel-releasing intrauterine system in treatment of adenomyosis. Medical Sciences. 2019; 48(2): 130-135
ZHU GG, et al. CT imaging of intrauterine devices (IUD): expected findings, unexpected findings, and complications. Abdom Radiol (NY). 2024; 49(1): 237-248.