Evaluation of Intrauterine Devices With Levonorgestrel in Patients With Heavy Menstrual Bleeding According to the Palm-Coein Classification System

AVŞAR YAVUZ, Ayşe Filiz; YEĞİN, Gülin Feykan; KESKİN, Hüseyin Levent; Tas, Emre Erdem

Evaluation of Intrauterine Devices With Levonorgestrel in Patients With Heavy Menstrual Bleeding According to the Palm-Coein Classification System

Emre Erdem TAŞ, (Antalya Eğitim ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum Kliniği, Antalya, Türkiye)

Hüseyin Levent KESKİN, (Sağlık Bakanlığı, Atatürk Eğitim ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum Kliniği, Ankara, Türkiye)

Gülin Feykan YEĞİN, (Sağlık Bakanlığı, Atatürk Eğitim ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum Kliniği, Ankara, Türkiye)

Ayşe Filiz AVŞAR YAVUZ (Atatürk Eğitim ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum Kliniği, Ankara, Türkiye)

Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi

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Yıl: 2015 Cilt: 12 Sayı: 1 Sayfa Aralığı: 23 - 27 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Evaluation of Intrauterine Devices With Levonorgestrel in Patients With Heavy Menstrual Bleeding According to the Palm-Coein Classification System

Öz:

Amaç: Ağır menstruel kanamalı olguların tedavisinde levonorgestrel salgılayan intrauterin araç etkinliğinin PALM-COEİN (polip; adenomiyozis; leiomyoma; malignensi; koagülopati; endometrial hiperplazi; ovulatuar disfonksiyon; iatrojenik; henüz sınıflandırılmamış) sistemine göre etkinliğini belirlemek. Gereç ve Yöntemler: Yapısal anomalisi bulunup bulunmamasına göre PALM-COEİN sınıflama sistemi ile gruplandırılan 110 olgu retrospektif olarak incelendi. Oniki aylık tedaviyi tamamlayan 84 olgunun menstruel paternleri, pictorial blood assessment chart (PBAC) skorları, hemoglobin (Hb) değerleri ve endometrial kalınlıklarındaki 1, 6 ve 12. aydaki değişikleri incelendi. İstatistiksel değerlendirmede Independent sample t-tests, repeated-measures ANOVA, post-hoc Bonferroni düzeltmesi ve ki-kare testleri kullanıldı. Bulgular: Tedaviye başlangıçtan 12 ay sonra olguların % 73.8i normal menstruel paterne kavuştu. PBAC skoru COEIN grubunda % 80.6, PALM grubunda ise % 83.9 azaldı. Tedaviye başladıktan 12 ay sonra her iki grupta PBAC skoru ve endometrial kalınlık azalırken (p<0.001), Hb değerleri artmıştı (p<0.001). Gruplar arasında ise farklılık yoktu (p>0.05). PBAC skoru tedavinin 1. ayında PALM grubunde COEİN grubuna göre daha yüksek olsa da, bu farklılık tedavinin 6. aynından itibaren kaybolmuştu (p >0.05). Sonuç: Levonorgestrel salgılayan intrauterin araçlar yapısal uterin anomalisi olsun olmasın yüksek oranda etkinlik göstermektedir.

Anahtar Kelime:

Konular: Cerrahi

Ağır Menstrüel Kanamalı Olgularda Levonorgestrelli İntrauterin Araç Etkinliğinin PalmCoein Sınıflama Sistemine Göre Değerlendirilmesi

Öz:

Aim: To evalute the efficacy of a levonorgestrel-releasing intrauterine device for the treatment of patients with heavy menstrual bleeding based on the PALM-COEIN (polyp; adenomyosis; leiomyoma; malignancy; hyperplasia-coagulopathy; ovulatory dysfunction; endometrial; iatrogenic; not yet classified) system. Material and Methods: A retrospective study was performed of 110 cases that were grouped according to the PALM-COEIN classification system as those with or without structural abnormalities. For the 84 cases who completed 12 months of treatment, menstrual patterns, pictorial blood assessment chart (PBAC) scores, hemoglobin (Hb) values, and endometrial thickness changes were examined after 1,6 and 12 months. Independent sample t-tests,repeated-measures ANOVA, post-hoc Bonferroni adjustment and chi-squared tests were used for statistical evaluation. Results: After 12 months of treatment, 73.8% of cases achieved a normal menstrual pattern. The PBAC score decreased by 80.6% in the COEIN group and 83.9% in the PALM group. The PBAC scores and endometrial thicknesses were decreased (p<0.001) and the Hb values were increased (p<0.001) after 12 months of treatment, with no intergroup differences (p>0.05). The PBAC score was higher in the PALM group compared to the COEIN group at 1 month, but this difference disappeared by 6 months of treatment (p >0.05). Conclusion: The levonorgestrel-releasing intrauterine device has high levels of effectiveness in cases with or without structural uterine abnormalities.

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Tas E, KESKİN H, YEĞİN G, AVŞAR YAVUZ A (2015). Evaluation of Intrauterine Devices With Levonorgestrel in Patients With Heavy Menstrual Bleeding According to the Palm-Coein Classification System. , 23 - 27.
Chicago	Tas Emre Erdem,KESKİN Hüseyin Levent,YEĞİN Gülin Feykan,AVŞAR YAVUZ Ayşe Filiz Evaluation of Intrauterine Devices With Levonorgestrel in Patients With Heavy Menstrual Bleeding According to the Palm-Coein Classification System. (2015): 23 - 27.
MLA	Tas Emre Erdem,KESKİN Hüseyin Levent,YEĞİN Gülin Feykan,AVŞAR YAVUZ Ayşe Filiz Evaluation of Intrauterine Devices With Levonorgestrel in Patients With Heavy Menstrual Bleeding According to the Palm-Coein Classification System. , 2015, ss.23 - 27.
AMA	Tas E,KESKİN H,YEĞİN G,AVŞAR YAVUZ A Evaluation of Intrauterine Devices With Levonorgestrel in Patients With Heavy Menstrual Bleeding According to the Palm-Coein Classification System. . 2015; 23 - 27.
Vancouver	Tas E,KESKİN H,YEĞİN G,AVŞAR YAVUZ A Evaluation of Intrauterine Devices With Levonorgestrel in Patients With Heavy Menstrual Bleeding According to the Palm-Coein Classification System. . 2015; 23 - 27.
IEEE	Tas E,KESKİN H,YEĞİN G,AVŞAR YAVUZ A "Evaluation of Intrauterine Devices With Levonorgestrel in Patients With Heavy Menstrual Bleeding According to the Palm-Coein Classification System." , ss.23 - 27, 2015.
ISNAD	Tas, Emre Erdem vd. "Evaluation of Intrauterine Devices With Levonorgestrel in Patients With Heavy Menstrual Bleeding According to the Palm-Coein Classification System". (2015), 23-27.

APA	Tas E, KESKİN H, YEĞİN G, AVŞAR YAVUZ A (2015). Evaluation of Intrauterine Devices With Levonorgestrel in Patients With Heavy Menstrual Bleeding According to the Palm-Coein Classification System. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi, 12(1), 23 - 27.
Chicago	Tas Emre Erdem,KESKİN Hüseyin Levent,YEĞİN Gülin Feykan,AVŞAR YAVUZ Ayşe Filiz Evaluation of Intrauterine Devices With Levonorgestrel in Patients With Heavy Menstrual Bleeding According to the Palm-Coein Classification System. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi 12, no.1 (2015): 23 - 27.
MLA	Tas Emre Erdem,KESKİN Hüseyin Levent,YEĞİN Gülin Feykan,AVŞAR YAVUZ Ayşe Filiz Evaluation of Intrauterine Devices With Levonorgestrel in Patients With Heavy Menstrual Bleeding According to the Palm-Coein Classification System. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi, vol.12, no.1, 2015, ss.23 - 27.
AMA	Tas E,KESKİN H,YEĞİN G,AVŞAR YAVUZ A Evaluation of Intrauterine Devices With Levonorgestrel in Patients With Heavy Menstrual Bleeding According to the Palm-Coein Classification System. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi. 2015; 12(1): 23 - 27.
Vancouver	Tas E,KESKİN H,YEĞİN G,AVŞAR YAVUZ A Evaluation of Intrauterine Devices With Levonorgestrel in Patients With Heavy Menstrual Bleeding According to the Palm-Coein Classification System. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi. 2015; 12(1): 23 - 27.
IEEE	Tas E,KESKİN H,YEĞİN G,AVŞAR YAVUZ A "Evaluation of Intrauterine Devices With Levonorgestrel in Patients With Heavy Menstrual Bleeding According to the Palm-Coein Classification System." Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi, 12, ss.23 - 27, 2015.
ISNAD	Tas, Emre Erdem vd. "Evaluation of Intrauterine Devices With Levonorgestrel in Patients With Heavy Menstrual Bleeding According to the Palm-Coein Classification System". Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi 12/1 (2015), 23-27.