Managing endometriosis pain symptoms with a levonorgestrel intrauterine device in a patient suffering from frozen pelvis: a case report

Authors

  • José Fernando De los Ríos
  • Erika Molina

DOI:

https://doi.org/10.18597/rcog.495

Keywords:

severe endometriosis, frozen pelvis, levonorgestrel intrauterine device, Mirena®, medical treatment

Abstract

Medical management of pain in patient’s suffering endometriosis is a controversial topic in gynaecology. Most regimens offer patients different degrees of improvement whilst they are on them but they are accompanied by many adverse effects and there will probably be a recurrence of pain after they have been discontinued. Most treatment is expensive and should not be taken for long periods of time due to concomitant adverse effects. Some patients, having no further wish to bear children, will benefit from hysterectomy with bilateral salpingo-oophorectomy. Such surgery can improve their quality of life after suffering from pain throughout their reproductive years. Surgery can be very difficult in advanced endometriosis and can become dangerous for other pelvic organs. The case of a patient in which surgery was impossible due to a frozen pelvis is described here. Successful symptom control was finally achieved by choosing to manage her pain by applying a levonorgestrel intrauterine device (Mirena).

Author Biographies

José Fernando De los Ríos

Ginecólogo Endoscopista, Hospital Pablo Tobón Uribe, Profesor adscrito de Ginecología Universidad Pontificia Bolivariana, Medellín, Colombia Correo electrónico: cristidelos@epm.net.co 

Erika Molina

Residente II de Ginecología y Obstetricia Universidad Pontificia Bolivariana, Medellín, Colombia.

References

Winkel CA. Evaluation and management of women with endometriosis. Obstet Gynecol 2003;102:397-408.

Luciano DE, Luciano AA. Pain associated with endometriosis: therapeutic options. Women´s Health 2006;2:617-26.

Hornstein MD, Surrey ES, Wesberg GW, Casino LA. Leuprolide acetate depot and hormonal add-back in endometriosis: a 12-month study. Lupron Add-Back Study Group. Obstet Gynecol 1998;91:16-24.

Vercellini P, Cortesi I, Crosignani PG. Progestins for symptomatic endometriosis: a critical analysis of the evidence. Fertil Steril 1997;68:393-491.

Namnoum AB, Hickman TN, Goodman SB, Gegkbach DL, Rock JA. Incidence of symptom recurrence after hysterectomy for endometriosis. Fertil Steril 1995;64:898-902.

Fedele L, Bianchi S, Raffaelli R, Portuese A, Dorta M. Treatment of adenomyosis-associated menorrhagia with levonorgestrel-releasing intrauterine device. Fertil Steril 1997;68:426-9.

Vercellini P, Aimi G, Panazza S, De Giorgi O, Pesole A, Crosignani PG. A levonorgestrel-releasing intrauterine system for the treatment of dysmenorrhoea associated with endometriosis: a pilot study. Fertil Steril 1999;72:505-8.

Fedele L, Bianchi S, Zanconato G, Portuese A, Rafaelli R. Use of a levonorgestrel-releasing intrauterine device in the treatment of rectovaginal endometriosis. Fertil Steril 2001;75:485-8.

Lockhat FB, Emembolu JO, Konje JC. The evaluation of the effectiveness of an intrauterine administered progestogen (levonorgestrel) in the symptomatic treatment of endometriosis and in the staging of the disease. Hum Reprod 2004;19:179-84.

Vercellini P, Frontino G, De Giorgi O, Aimi G, Zaina B, Crosignani PG. Comparison of a levonorgestrel-releasing intrauterine device versus expectant management after conservative surgery for symptomatic endometriosis: a pilot study. Fertil Steril 2003;80:305-9.

Lockhat FB, Emembolu JO, Konje JC. The efficacy, side-effects and continuation rates in women with symptomatic endometriosis undergoing treatment with an intrauterine administered progestogen (levonorgestrel): a 3 year follow-up. Hum Reprod 2005:20:789-93.

Petta CA, Ferriani RA, Abrao MS, Hassan D, Rosa E, Silva JC, et al. Randomized clinical trial of a levonorgestrel-releasing intrauterine system and a depot GnRH analogue for the treatment of chronic pelvic pain in women with endometriosis. Hum Reprod 2005;20:1993-8.

Lockhat FB, Emembolu JO, Konje JC. Serum and peritoneal fl uid levels of levonorgestrel in women with endometriosis who were treated with an intrauterine contraceptive device containing levonorgestrel. Fertil Steril 2005;83:398-404.

How to Cite

1.
De los Ríos JF, Molina E. Managing endometriosis pain symptoms with a levonorgestrel intrauterine device in a patient suffering from frozen pelvis: a case report. Rev. colomb. obstet. ginecol. [Internet]. 2006 Sep. 30 [cited 2024 May 12];57(3):211-5. Available from: https://revista.fecolsog.org/index.php/rcog/article/view/495

Downloads

Download data is not yet available.

Published

2006-09-30
QR Code

Altmetric

Article metrics
Abstract views
Galley vies
PDF Views
HTML views
Other views
Crossref Cited-by logo