Effectiveness of Intrauterine Levonorgesterel-Releasing Device in the Treatment of Endometrial Hyperplasia in Obese Patients

Year 2025, Volume: 9 Issue: 1, 36 - 41, 01.04.2025

Sezin Ateş , Işıl Çiçekdağı

Abstract

Aim: Endometrial hyperplasia (EH) is a precursor lesion of endometrial adenocarcinoma, the most common gynecological malignancy in women. Endometrial hyperplasias divided in two groups: non-atypical hyperplasia and atypical hyperplasia. The most commonly used treatment approach is progestin therapy for non-atypical hyperplasias. In this study, we aimed to compare the regression outcomes in control biopsies between obese and non obese patients diagnosed with non-atypical endometrial hyperplasia who were treated with an LNG-IUD and followed up in our clinic.

Methods: This study conducted was patients were diagnosed with non-atypical endometrial hyperplasia via endometrial biopsy and treated with intrauterine levonorgestrel. Patient data were reviewed retrospectively. Patients were divided into two groups based on BMI: obese and non-obese. İn regression and treatment success were assessed between control endometrial biopsies taken at 6 and 12 months in the obese and non-obese groups.

Results: A total of 110 patients were included in the study who were categorized into two groups according to BMI as obese and non-obese. Data of 32 patients in the obese patient group and 78 patients in the non-obese patient group were examined. In obese patients, the regression rate at the 6th month was 62.5%, and the regression rate at the 12th month was 90.6%. In non-obese patients, the regression rate at the 6th month was 96%, and the regression rate at the 12th month was 97.4%. In the obese patient group, both the 6th-month regression rate and the 12th-month regression rate were statistically significantly lower compared to the non-obese patient group. (p < 0.05).

Conclusions: Obesity negatively affects the response to progesterone treatment and that regression rates decrease as BMI increases.

Keywords

Endometrial hyperplasia, Obesity, Progestin, Levo-norgestrel

Ethical Statement

Etik Kurul Onayı Alkü Tıp Fakültesi Klinik Araştırmalar Etik Kurulundan Alınmış Olup; 11/09/2024 Tarihli 20-05 Karar nolu'dur. Yazarlar arasında çıkar çatışması yoktur.

Supporting Institution

yok

Thanks

Çalışmanın parçası olmayı kabul eden tüm hastalarımıza teşekür ederiz

Endometrial Hiperplazi Tedavisinde İntrauterin Levo-Norgestrel Salgılayan Cihazların Obez Hastalarda Etkinliğinin Araştırılması

Abstract

Amaç: Endometrial hiperplazi; en sık görülen jinekolojik kanser olan endometrium adenokarsinomunun öncül lezyonudur. Bu çalışmada kliniğmizde atipisiz endometrial hiperplazi tanıyla levo-norgestrel salgılayan intrauterine cihaz ile tedavi edilen obez ve obez olmayan hastaların kontrol biyopsileri ile regresyon oranlarını karşılaştırmayı amaçladık.

Yöntemler: Çalışma endometrial biyopsi ile atipisiz endometrial hiperplazi tanısı alan ve intrauterine levonorgestrel ile tedavi edilen hastalar üzerinde yapıldı. Hastalara ait veriler retrospektif olarak incelendi.Hastalar vücut kitle indeksine göre obez ve obez olmayan olarak iki gruba ayrıldı.Obez ve obez olmayan hasta gruplarında 6. ve 12. ayda alınan kontrol endometrial biyopsileri incelenerek regresyon oranı ve tedavi başarısı araştırıldı.

Bulgular: Vücut kitle indeksine göre obez ve obez olmayan olarak iki grubu ayrılan toplam 110 hasta çalışmaya dahil edildi. Obez hasta grubunda 32 hasta, obez olmayan hasta grubunda 78 hasta verileri incelendi. Obez hasta grubunda 6. ayda regresyon oranı %62.5 ve 12. ayda regresyon oranı %90.6 olarak saptandı. Obez olmayan hasta grubunda 6. ayda regresyon oranı %96 ve 12. ayda regresyon oranı %97.4 olarak saptandı. Obez hasta grubunda hem 6. hem 12. ay regresyon oranı normal kilolu hasta grubuna göre istatistiksel olarak anlamlı düzeyde düşük saptandı.(p < 0.05).

Sonuç: Obezite progesteron tedavisine cevabı olumsuz etkiler ve vücut kitle indeksi arttıkça regresyon oranı azalır.

Keywords

Endometrial hiperplazi, Obezite, Progestin, Levo-norgestrel

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