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In Endometriosis Treatment of Pain Due Levonorgestrel Releasing Intrauterine Vehicle System (LNG-IUD) to Event and Comparison Naproxen Sodium

Year 2016, Volume: 7 Issue: 28, 37 - 44, 31.12.2016
https://doi.org/10.17944/mkutfd.287836

Abstract

Aim: Although there are many symptoms of endometriosis,
the most frequent symptom is pain. The cause of pain is unknown. In this study,
it is aimed to compare efficiency of LNG-IUD (levonorgestrel releasing
intrauterine vehicle system) and the non-steroidal anti-inflammatory agent,
naproxen sodium which are two current approaches in the management of
endometriosis-related pain.

Material and Methods: After approval of the Ethics
Committee, 60 patients, who were operated with the pathology of endometriosis,
were included in the study.It is divided into three groups and each group
cotained 20 patients.They are named as the control group, the LNG-IUD group,
and the naproxen sodium group. McGill pain questionnaire and pain questionnaire
form were given to patients monthly. Patients were asked to fill out the forms
using a visual analogue scale. Patients were followed-up monthly.

Results: As a result of the statistical tests
applied, there was a significant decrease in the mean VAS score in the LNG- IUD
patient group from 1st to the 6th months of treatment. Reduction of pelvic pain
and dysmenorrhea was detected in the naproxen sodium group, but it did not
differ the decrease in pain severity between months


























Conclusion: A number of medical drugs
are used in the management of endometriosis-related pain. It can be concluded
that LNG-IUD was a more effective due to modality in the management of
endometriosis-related pain, and has both low side effct and no need to be used
continously.

References

  • Mahmood TA, Templeton A, Thomson L, Fraser Cl. Menstrual symtoms in women with pelvic endometriosis. Br J Obstet Gynecol 1991; 98: 555-63.
  • Barry AR, Daniel CM. Endometriosis and chronic pelvic pain. Obstet Gynecol Clin NA 1993; 20: 709-17.
  • Fedele L, Parazzini F, Bianchi S, Arcaini L, Candiani GB. Stage and localization of pelvic endometriosis and pain. Fertil Steril 1990; 53: 155-58.
  • Fedele L, Bianchi S, Bocciolona L, Di Nola G, Parazzini F. Pain symptoms associated with endometriosis. Obstet Gynecol 1992; 75: 767-69.
  • Mishell DR Jr. Intrauterine devices. Curr Ther Endocrinol Metab 1997; 6: 285-92.
  • Eray S , Bakır SA, Hazar Aİ , Güneş J , İzmir M , Ortaylı N , et al. Farma List (1. baskı). 2001, Farmatıp Yayıncılık: Ankara. 388-405.
  • Melzack R. The McGill Pain Questionnaire: Major properties and scoring methods. Pain. 1975; 1: 277-99.
  • Kuğuoğlu S, Aslan FE, Olgun N. McGill Melzack ağrı soru formunun (MASF) Türkçe'ye uyarlanması. Ağrı. 2003; 47-51.
  • Carter JE. Chronic pelvic pain diagnosis and management. http:www.obgyn.net/displayarticle.asp?page=/english/pubs/features/Carter/cpp_car
  • Howard FM, El-Minavi AM. Taking a History. FM. Howard, CP. Perry, JE. Carter ve AM. El-Minavi (Eds.) , Pelvic Pain Diagnosis and Management, in Lippincott Williams & Wilkins. 2000; 7-25.
  • Eti Aslan F. Ağrı Doğası ve Kontrolü (1. Baskı). 2006: Avrupa Tıp Kitabevi, İstanbul.
  • Eskenazi B, Warner ML. Epidemiology of endometriosis. Obstet Gynecol Clin North Am 1997; 24: 235-38.
  • Kerr WJ. Endometriosis involving the urinary tract. Clin Obstet Gynecol 1966; 9; 331-57.
  • Olive DL, Pritts EA. Treatment of endometriosis. N Engl J Med 2001; 345: 266.
  • Prentice A , Deary AJ, Goldbeck-Wood S, Farquhar C, Smith SK.Gonadotropin-releasing hormone analogues for pain associated with endometriosis. Cochrane Database Syst Rev 2000. (2):CD000346.
  • d' Arcangues C. WHO statement on hormonal contraception and bone health. Contraception. 2006; 73: 443-4.
  • Vercellini P, De Giorgi O, Oldani S, Cortesi I, Panazza S, Crosignani PG. Depot medroxyprogesterone acetate versus an oral controceptive combined with very-low-dose danazol for long-term treatment of pelvic pain associated with endometriosis. Am J Obstet Gynecol 1996; 175: 396-401.
  • Lockhat FB, Emembolu JO, Konje JC.The efficacy,side-effects and continuation rates in women with symptomatic endometriosis undergoing teratment with an intra-uterine administered progestogen (levonorgestrel): A 3 year follow-up. Obstet. Gynecol Surv 2005; 60: 443.
  • Luukkainen T, Pakarinen P, Toivonen J. Progestin-releasing intrauterine systems. Semin Reprod Med 2001; 19: 355-63.
  • Katzung BG.In Basic and Clinical Pharmacology, Appleton Lange, Katzung BG(Eds), 1995: Conneticut. 536-560.
  • Marjoribanks J , Proctor M, Farquhar C. Nonsteroidal anti-inflammatory drugs for primary dysmenorrhoea. Cochrane Database Syst Rev, 2003. (4): p. CD001751.
  • Kauppila A, Ronnberg L. Naproxen sodyum in dysmenorrhea secondary to endometriosis. Obstetrics and Gynaecology 1985; 65: 379-83.
  • Vercellini P, Aimi G, Paonazza S, De Giorgi O, Pesole A, Crosignani PG. A levonorgestrel-releasing intrauterine system for the treatment of dysmenorrhea associated with endometroisis: a pilot study. Fertil Steril 1999; 72: 505-8.
  • 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 endometroisis : A pilot study Fertil Steril 2003; 80: 305-9.
  • Fedele L, Bianchi S, Zanconato G, Portuese A, Raffaelli R. Use of a levonorgestrel-releasing intrauterine devive in the teratment of rectovajinal endometriosis. Fertil Steril 2001; 75: 485-88.
  • Lockhat FB, Emembolu JO, Konje JC. The evaluation of the effectiveness of an intrauterine-administered progestogen (levonorgestrel) in the symptomatic teratment of endometriosis and in the staging or the disease. Hum Reprod 2004; 19: 179-84.
  • Petta CA , Ferriani RA, Abrao MS, Hassan D, Rosa E Silva JC, Podgaec S,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: 1993-98.

ENDOMETRİOZİSE BAĞLI AĞRI TEDAVİSİNDE LEVONORGESTREL SALGILAYAN RAHİM İÇİ ARAÇ SİSTEMİ (LNG-RİA) VE NAPROKSEN SODYUM ETKİNLİĞİ KARŞILAŞTIRILMASI

Year 2016, Volume: 7 Issue: 28, 37 - 44, 31.12.2016
https://doi.org/10.17944/mkutfd.287836

Abstract











Amaç: Endometriozis, birçok semptomu olmasına
rağmen en sık beraber olduğu semptom ağrıdır. Ağrınınsebebi net olarak
bilinmemektedir. Çalışmamızda endometriozise bağlı ağrısı olan hastalarda
güncel tedavi yaklaşımlarından biri olan LNG-RİA (levonorgestrel salgılayan
rahim içi araç sistemi) ve bir nonsteroid antiinflamatuar ajan olan naproksen
sodyumun etkinliğini karşılaştırılmasını amaçladık.



Gereç ve Yöntem: Etik kurul onayı alındıktan
sonra kliniğimizde opere edilip patolojisi endometriozis gelen 60 hasta
çalışmaya dahil edildi. 20 hasta kontrol grubu, 20 hasta LNG-RİA grubu, 20
hasta naproksen sodyum grubu olarak alındı. Hastalara McGill ağrı soru formu ve
aylık ağrı formu verildi.  Visüel analog
skala kullanılarak doldurulması istendi. Hastalar aylık kontrollere çağrıldı.



Bulgular: Yapılan istatistiksel
testler sonucunda LNG-RİA uygulanan hasta grubunda VAS ağrı ortalamasında 1.
aydan 6. aya anlamlı azalma bulundu. Naproksen sodyum grubunda ise pelvik
ağrıda ve dismenorede azalma olduğu; ancak ağrının şiddetindeki azalmanın aylar
arasında farklılık göstermediği görüldü.



Sonuç: Endometriozise bağlı ağrı tedavisinde
birçok medikal ajan kullanılmaktadır. LNG-RİA endometriozise bağlı ağrı
tedavisinde, yan etki profili ve sürekli kullanım gerektirmemesi yönüyle daha
etkin bir tedavidir.



References

  • Mahmood TA, Templeton A, Thomson L, Fraser Cl. Menstrual symtoms in women with pelvic endometriosis. Br J Obstet Gynecol 1991; 98: 555-63.
  • Barry AR, Daniel CM. Endometriosis and chronic pelvic pain. Obstet Gynecol Clin NA 1993; 20: 709-17.
  • Fedele L, Parazzini F, Bianchi S, Arcaini L, Candiani GB. Stage and localization of pelvic endometriosis and pain. Fertil Steril 1990; 53: 155-58.
  • Fedele L, Bianchi S, Bocciolona L, Di Nola G, Parazzini F. Pain symptoms associated with endometriosis. Obstet Gynecol 1992; 75: 767-69.
  • Mishell DR Jr. Intrauterine devices. Curr Ther Endocrinol Metab 1997; 6: 285-92.
  • Eray S , Bakır SA, Hazar Aİ , Güneş J , İzmir M , Ortaylı N , et al. Farma List (1. baskı). 2001, Farmatıp Yayıncılık: Ankara. 388-405.
  • Melzack R. The McGill Pain Questionnaire: Major properties and scoring methods. Pain. 1975; 1: 277-99.
  • Kuğuoğlu S, Aslan FE, Olgun N. McGill Melzack ağrı soru formunun (MASF) Türkçe'ye uyarlanması. Ağrı. 2003; 47-51.
  • Carter JE. Chronic pelvic pain diagnosis and management. http:www.obgyn.net/displayarticle.asp?page=/english/pubs/features/Carter/cpp_car
  • Howard FM, El-Minavi AM. Taking a History. FM. Howard, CP. Perry, JE. Carter ve AM. El-Minavi (Eds.) , Pelvic Pain Diagnosis and Management, in Lippincott Williams & Wilkins. 2000; 7-25.
  • Eti Aslan F. Ağrı Doğası ve Kontrolü (1. Baskı). 2006: Avrupa Tıp Kitabevi, İstanbul.
  • Eskenazi B, Warner ML. Epidemiology of endometriosis. Obstet Gynecol Clin North Am 1997; 24: 235-38.
  • Kerr WJ. Endometriosis involving the urinary tract. Clin Obstet Gynecol 1966; 9; 331-57.
  • Olive DL, Pritts EA. Treatment of endometriosis. N Engl J Med 2001; 345: 266.
  • Prentice A , Deary AJ, Goldbeck-Wood S, Farquhar C, Smith SK.Gonadotropin-releasing hormone analogues for pain associated with endometriosis. Cochrane Database Syst Rev 2000. (2):CD000346.
  • d' Arcangues C. WHO statement on hormonal contraception and bone health. Contraception. 2006; 73: 443-4.
  • Vercellini P, De Giorgi O, Oldani S, Cortesi I, Panazza S, Crosignani PG. Depot medroxyprogesterone acetate versus an oral controceptive combined with very-low-dose danazol for long-term treatment of pelvic pain associated with endometriosis. Am J Obstet Gynecol 1996; 175: 396-401.
  • Lockhat FB, Emembolu JO, Konje JC.The efficacy,side-effects and continuation rates in women with symptomatic endometriosis undergoing teratment with an intra-uterine administered progestogen (levonorgestrel): A 3 year follow-up. Obstet. Gynecol Surv 2005; 60: 443.
  • Luukkainen T, Pakarinen P, Toivonen J. Progestin-releasing intrauterine systems. Semin Reprod Med 2001; 19: 355-63.
  • Katzung BG.In Basic and Clinical Pharmacology, Appleton Lange, Katzung BG(Eds), 1995: Conneticut. 536-560.
  • Marjoribanks J , Proctor M, Farquhar C. Nonsteroidal anti-inflammatory drugs for primary dysmenorrhoea. Cochrane Database Syst Rev, 2003. (4): p. CD001751.
  • Kauppila A, Ronnberg L. Naproxen sodyum in dysmenorrhea secondary to endometriosis. Obstetrics and Gynaecology 1985; 65: 379-83.
  • Vercellini P, Aimi G, Paonazza S, De Giorgi O, Pesole A, Crosignani PG. A levonorgestrel-releasing intrauterine system for the treatment of dysmenorrhea associated with endometroisis: a pilot study. Fertil Steril 1999; 72: 505-8.
  • 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 endometroisis : A pilot study Fertil Steril 2003; 80: 305-9.
  • Fedele L, Bianchi S, Zanconato G, Portuese A, Raffaelli R. Use of a levonorgestrel-releasing intrauterine devive in the teratment of rectovajinal endometriosis. Fertil Steril 2001; 75: 485-88.
  • Lockhat FB, Emembolu JO, Konje JC. The evaluation of the effectiveness of an intrauterine-administered progestogen (levonorgestrel) in the symptomatic teratment of endometriosis and in the staging or the disease. Hum Reprod 2004; 19: 179-84.
  • Petta CA , Ferriani RA, Abrao MS, Hassan D, Rosa E Silva JC, Podgaec S,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: 1993-98.
There are 27 citations in total.

Details

Journal Section Original Articles
Authors

Şengül Talar Arslan This is me

Bünyamin Börekçi This is me

Emsal Pınar Topdağı

Publication Date December 31, 2016
Submission Date January 24, 2017
Acceptance Date November 6, 2016
Published in Issue Year 2016 Volume: 7 Issue: 28

Cite

Vancouver Arslan ŞT, Börekçi B, Topdağı EP. In Endometriosis Treatment of Pain Due Levonorgestrel Releasing Intrauterine Vehicle System (LNG-IUD) to Event and Comparison Naproxen Sodium. mkutfd. 2016;7(28):37-44.