The effectiveness of pharmacological treatment for adenomyosis with GnRH and LNG-IUS post adenomyomectomy  at Shaikh Zaid Woman Hospital Larkana Pakistan

Saeedunisa Sangi; Shabnum Naz Shaikh; Ahmed Bux Shaikh; Sumera Brohi; Shazia Shaikh; Shaista Hifaz Abro

Abstract
Objective: To compare effectiveness of pharmacological treatment for adenomyosis with GnRH and LNG-IUS post adenomyomectomy.
Methodology: This randomized controlled trial was conducted at Chandka Medical College Larkana from May 2018 to May 2020. The enrollment criteria included all women between the ages of 18 and 45 years; symptomatic patients with Visual Analog Scale (VAS) scores >3 points; diagnosed with focal or diffuse adenomyosis; and post-operative histopathological confirmation of adenomyosis. We divided 150 patients in three groups having 50 patients in each group. In-group A GnRH was given, in-group B LNG-IUS was given and in Group C, no pharmacological treatment given postoperatively. All patients had regular three follow-up at two weekly intervals and VAS pain scores were recorded postoperatively and at each follow-up visit.
Results: VAS scores of all patients decreased from 7.0 (0.6) to 4 (0.3) at the 6 months, postoperatively. The postoperative VAS was significantly higher in-group C (no medical treatment) compared to group A and B, (p<0.05). Dysmenorrhea was noted in 24 (48.00%), 23 (46.00%), and 17 (34.00%) in Group A, B, and C, respectively which was significantly higher in group C.
Conclusion: The current study highlighted the significance of medical treatment with GnRH and LNG-IUS treatment following adenomyomectomy and recommend all patients be administered this to produce better patient outcome.

Key words: Adenomyosis, GnRH, LNG-IUS and Post adenomyomectomy.

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