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  • Title: Effect of the levonorgestrel-releasing intrauterine system on uterine myomas in a renal transplant patient.
    Author: Fong YF, Singh K.
    Journal: Contraception; 1999 Jul; 60(1):51-3. PubMed ID: 10549453.
    Abstract:
    The levonorgestrel-releasing intrauterine system (LNG-IUS) has been used in the treatment of both idiopathic menorrhagia and adenomyosis. An electronic search of the on-line medical literature revealed no reports of its use for menorrhagia secondary to uterine myomas. Presented here is the successful treatment of uterine myomas with menorrhagia in a woman with a renal transplant. There was a significant reduction in menorrhagia, dysmenorrhea, and uterine and myoma size with the use of the LNG-IUS. We believe that this system provides an alternative to conventional hysterectomy and gonadotrophin-releasing hormonal analog medical treatment for uterine myomas, with a possibly inhibitory effect on myoma growth. This case report focuses on the effect of the levonorgestrel-releasing intrauterine system (LNG-IUS) on uterine myomas in a renal transplant patient. The successful treatment of uterine myomas with menorrhagia in a 43-year-old woman with a renal transplant is presented. Preinsertion, the uterine cavity was not distorted and it measured 12 cm. The LNG-IUS was inserted without difficulty. On follow-up, 3 months later, improvement was observed. Her cycles were regular with heavy flow only on the first 2 days. The uterus was 10 weeks¿ size on pelvic examination and her hemoglobin was 9.5 g/dl. One year after the initial insertion, she was asymptomatic with normal menstrual flow. The uterus was 6-8 weeks' size on pelvic examination and the uterine cavity was 6 cm. The largest intramural fibroid measured 10-15 mm. Hemoglobin was 10.8 g/dl without any hematinics. There was a significant reduction in menorrhagia, dysmenorrhea, and uterine and myoma size with the use of the LNG-IUS. Thus, the system provides an alternative to conventional hysterectomy and gonadotrophin-releasing hormonal analog medical treatment for uterine myomas, with a possibly inhibitory effect on myoma growth.
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