• Ki Hwan Lee, Jang Kew Kim, Min A Lee, Young Bok Ko, Jung Bo Yang, Byung Hun Kang, and Heon Jong Yoo.
• Department of Obstetrics and Gynecology, Chungnam National University, 33, Munhwa-ro, Jung-gu, Deajeon, 301-721, Republic of Korea.
• Arch. Gynecol. Obstet. 2016 Sep 1; 294 (3): 561-6.

ObjectiveThis study is to evaluate the relationship between the uterine volume and the failure of levonorgestrel-releasing intrauterine device (LNG-IUD) in patients with adenomyosis.MethodsA total of 171 women with adenomysis were treated with LNG-IUD from November 2009 to December 2011. The amount of menorrhagia, degree of dysmenorrhea, and the uterine volume were compared before and after insertion of LNG-IUD, and the treatment failure of LNG-IUD was observed.ResultsThe mean age of the participants was 42.5 years (range 29-53 years). The mean uterine volume was 158 mL (range 46-769 mL). Among the total participants, 37 (21.6 %) discontinued the treatment prematurely. There were no different characteristics between the ongoing treatment group and treatment failure group with LNG-IUD. However, there was significant difference of uterine volume between two groups (178 ± 14 and 141 ± 7 mL, P = 0.010). Based on the receiver operator characteristic analysis, the optimum cutoff value of uterine volume more than 150 mL was significantly associated with failure of LNG-IUD (area under curve: 0.763, 95 % CI 0.669-0.856). In univariate analysis, the uterine volume more than 150 mL was the only independent factor for the failure of LNG-IUD (odds ratio 6.76, 95 % CI 1.20-38.02, P = 0.030).ConclusionThe rate of treatment failure after LNG-IUD insertion for the patients with adenomyosis was related to the uterine volume. Specifically, the treatment failure rate of large volume uterus (>150 mL) with LNG-IUD was significantly higher than that of small volume uterus.

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