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Valdés G, Patricio; Sánchez G, Raúl (2004)
Publisher: Sociedad Chilena de Obstetricia y Ginecología
Languages: Spanish
Types: Article
Subjects: uterine myoma, Metrorragia, dispositivos intrauterino con levonorgestrel, mioma uterino, Abnormal uterine bleeding, levonorgestrel intra-uterine devices
El uso de dispositivos intrauterinos con levonorgestrel (DIU-LNG) además de su efecto anticonceptivo, disminuye significativamente el sangrado uterino. Esto hace que los DIU-LNG expresen beneficios tales como el control del sangrado uterino, especialmente en metrorragias o menometrorragias por enfermedades orgánicas como miomatosis uterina. Sin embargo, en nuestro medio existen dudas sobre los beneficios reales de estos métodos y la posibilidad de plantear su uso como alternativa quirúrgica del sangrado uterino anormal. Se presenta una serie de 8 pacientes que han completado un seguimiento de un año desde la inserción de DIU-LNG como alternativa para el tratamiento de sangrados uterino anormales. Todos estos casos tenían indicación quirúrgica de acuerdo a los criterios tradicionales de resolución de patología orgánica. En 7 pacientes el sangrado disminuyó, con buena aceptabilidad y continuidad del tratamiento. En una paciente se detectó un crecimiento rápido de un mioma intramural con posterior expulsión del DIU-LNG, y se efectuó una miomectomía múltiple. Estos resultados permiten postular que el uso de los DIU-LNG para el tratamiento de sangrados uterinos anormales de origen orgánico no neoplásico maligno, asociado o no a la anticoncepción, es una alternativa a los procedimientos quirúrgicos u otras técnica invasivas Levonorgestrel - releasing intrauterine system (LNG-IUS) besides their contraception effect, it diminishes the uterine bleeding. The purpose of this study was to investigate the effect of LNG-IUS in decreasing menstrual blood loss in cases of benign uterine pathologies. A total of 8 women are presented that have completed one year from the insertion of LNG-IUS for abnormal uterine bleeding. All these cases had initially a surgical indication according to traditional approaches of resolution for a benign pathology. At the end of the study period, the pattern of bleeding, the acceptability of the treatment as well as the presence of surgical decision criteria were evaluated. In one out of eight there was a quick growth of an intramural myoma and expulsion of the intrauterine device. A multiple myomectomy was performed in this case. In conclusion the use of LNG-IUS for treatment of abnormal uterine bleeding, associate or not to the contraception, it should be an alternative treatment in cases of benign pathologies
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