Clinical study of bipolar radiofrequency impedance-controlled system combined with levonorgestrel intrauterine system in women with abnormal uterine bleeding

doi:10.3877/cma.j.issn.1674-6899.2023.02.008

Abstract

Abstract:

Objective

This study aims to evaluate the clinical efficacy of the combination of bipolar radiofrequency impedance-controlled endometrial ablation (Novasure) and levonorgestrel intrauterine system (LNG-IUS, Mirena) placement in comparison with Novasure endometrial ablation alone in women with abnormal uterine bleeding (AUB).

Methods

This study is a retrospective cohort study. A total of 373 patients with abnormal uterine bleeding underwent Novasure endometrial ablation at the Department of Gynaecology of Beijing Tiantan Hospital from Jan. 2011 to Dec. 2018. 243 women meeting the criteria were selected, and 86 of them offered Mirena simultaneously with Novasure were separated as combined therapy group, and the 157 women treated with Novasure alone as control group. The postoperative situation was recorded through the telephone follow-up. The situation on amenorrhea, dysmenorrhea, quality of life, satisfaction and re-intervention were compared beetween the two group.

Results

The combined therapy group had higher rates of amenorrhoea, pain relief, improvement of life′s quality and satisfaction than the control group after 1 months, 12 months, 48 months. However, the rate of re-intervention in the combined treatment group was lower than that in the control group (all P<0.05).

Conclusions

For women with AUB, the combination of Novasure combined with Levonorgestrel intrauterine system is more effective than Novasure alone in achieving amenorrhea, alleviating dysmenorrhea and reducing re-interventions.

Key words: Abnormal uterine bleeding, Bipolar radiofrequency impedance-controlled system, Novasure, Endometrial ablation, Levonorgestrel intrauterine system, Mirena

Shengpeng Zhang, Hongyu Shang, Ruyuan Li, Luping Zhang, Baojun Yang, Limin Feng. Clinical study of bipolar radiofrequency impedance-controlled system combined with levonorgestrel intrauterine system in women with abnormal uterine bleeding[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2023, 16(02): 101-105.

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URL: https://zhqjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6899.2023.02.008

https://zhqjwkzz.cma-cmc.com.cn/EN/Y2023/V16/I02/101

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References 24

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变量	联合治疗组(78例)	双极射频阻抗控制系统组(78例)	χ²/t值	P值
年龄(岁)	46.0±4.9	45.4±4.7	0.890	0.375
体质量指数(kg/m²)	25.4±3.0	25.2±2.6	0.229	0.819
孕(次)	3.0±1.4	2.8±1.3	0.418	0.676
产(次)	1.6±0.9	1.5±0.7	0.548	0.585
月经失血图评分(分)	378.3±245.7	312.9±247.3	1.651	0.101
疼痛视觉模拟评分(分)	3.6±3.3	3.1±2.9	0.895	0.372
血红蛋白(g/L)	102.0±24.9	101.6±25.1	0.097	0.923
子宫深度(cm)	8.9±0.8	8.9±1.0	0.649	0.518

变量	联合治疗组(78例)	双极射频阻抗控制系统组(78例)	χ²/t值	P值
年龄(岁)	46.0±4.9	45.4±4.7	0.890	0.375
体质量指数(kg/m²)	25.4±3.0	25.2±2.6	0.229	0.819
孕(次)	3.0±1.4	2.8±1.3	0.418	0.676
产(次)	1.6±0.9	1.5±0.7	0.548	0.585
月经失血图评分(分)	378.3±245.7	312.9±247.3	1.651	0.101
疼痛视觉模拟评分(分)	3.6±3.3	3.1±2.9	0.895	0.372
血红蛋白(g/L)	102.0±24.9	101.6±25.1	0.097	0.923
子宫深度(cm)	8.9±0.8	8.9±1.0	0.649	0.518

组别	例数	闭经	痛经改善	生活质量改善	患者满意	子宫切除	再次干预
联合治疗组	78
术后1个月		47(60.2)	46(59.0)	65(83.3)	70(89.7)	0(0.0)	3(3.8)
术后12个月		55(70.5)	47(60.2)	68(87.2)	69(88.5)	1(1.3)	9(11.6)
术后48个月		61(78.2)	47(60.2)	74(94.9)	74(94.9)	3(3.8)	18(23.1)
双极射频阻抗控制系统组	78
术后1个月		40(51.3)	37(47.4)	65(83.3)	70(89.7)	0(0.0)	3(3.8)
术后12个月		44(56.4)	35(44.9)	64(82.1)	66(84.6)	1(1.3)	17(21.8)
术后48个月		48(61.6)	29(37.2)	60(76.9)	60(76.9)	7(9.0)	29(37.2)
P值¹		0.105	0.038	>0.999	>0.999	－	>0.999
P值²		0.006	0.005	0.309	0.287	>0.999	0.004
P值³		<0.001	<0.001	<0.001	<0.001	0.191	0.003

组别	例数	闭经	痛经改善	生活质量改善	患者满意	子宫切除	再次干预
联合治疗组	78
术后1个月		47(60.2)	46(59.0)	65(83.3)	70(89.7)	0(0.0)	3(3.8)
术后12个月		55(70.5)	47(60.2)	68(87.2)	69(88.5)	1(1.3)	9(11.6)
术后48个月		61(78.2)	47(60.2)	74(94.9)	74(94.9)	3(3.8)	18(23.1)
双极射频阻抗控制系统组	78
术后1个月		40(51.3)	37(47.4)	65(83.3)	70(89.7)	0(0.0)	3(3.8)
术后12个月		44(56.4)	35(44.9)	64(82.1)	66(84.6)	1(1.3)	17(21.8)
术后48个月		48(61.6)	29(37.2)	60(76.9)	60(76.9)	7(9.0)	29(37.2)
P值¹		0.105	0.038	>0.999	>0.999	－	>0.999
P值²		0.006	0.005	0.309	0.287	>0.999	0.004
P值³		<0.001	<0.001	<0.001	<0.001	0.191	0.003

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