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Jing-he Lang

Publications and source records attributed to Jing-he Lang.

At least 19 recordsLinked to original sources
PubMed2006

[Repair of abdominal wall defect after resection of abdominal wall endometriosis].

OBJECTIVE: To study the techniques to repair the fascia layer of abdominal wall after the resection of abdominal wall endometriosis (AWE). METHODS: Fifty-five AWE patients aged 28 approximately 38 underwent resection of the lesion. After the resection a defect fascia in abdominal wall larger than 2 cm(2) was seen in 29 patients (large fascia defect group), and in the other 26 patients the fascia defect was less than 2 cm(2) (small fascia defect group). In the large fascia defect group, 11 cases underwent routine closure of the abdominal wall, 2 underwent abdominal wall reconstruction by applying tension suture, 1 case underwent fascia layer/skin tension-relieving suture, 4 cases abdominal wall reconstruction by PDS-II suture, 4 cases underwent fascia patch grafting, and 7 cases underwent abdominal wall plastic repair plus fascia patch grafting, the different techniques being selected according to the size of the defect. Routine abdominal wall closure was performed on all the 26 patients in the small fascia detect group. The features of the lesion and operation, and the outcomes were compared. RESULTS: Primary healing was achieved in all the patients. In comparison with the small fascia defect group, the mean size of the masses measured by pre-operational ultrasonography of the large fascia defect group was significantly bigger [(3.8 +/- 1.4) cm vs. (2.5 +/- 1.1 cm)], the mean size of the masses resected in operation was significantly larger [(5, 5 +/- 2.0) cm vs. (3.7 +/- 1.9) cm, P = 0.004], the operation time was significantly longer [(66 +/- 42) min vs. (35 +/- 24) min, P = 0.002], and the intra-operational blood loss was significantly more [(52 +/- 50) ml vs. (23 +/- 19) ml, P = 0.006]. Relapse occurred in 1 case in the large fascia defect group. CONCLUSION: Ultrasonography helps estimate the extension of AWE before operation. Fascia layer/skin tension-relieving suture can be used in the fascia defect of abdominal wall larger than 2 cm(2). Abdominal wall plastic repair plus fascia patch grafting is capable of repairing larger fascia layer and skin defects of abdominal wall.

Abdominal Wall↗
PubMed2006

[The study on the prevalence and associated risk factors of female urinary incontinence in Beijing women].

OBJECTIVES: To evaluate the prevalence, the clinical characteristics and associated risk factors of urinary incontinence in Beijing women. METHODS: In the cross-sectional study, 5300 Beijing women aged over 20 years were interviewed through a questionnaire including International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Module (ICIQ-FLUTS). Aged from 20 to 99 years old (mean 46 +/- 17). Divided into 8 groups every 10 years. 4812 cases are married. RESULTS: The overall prevalence of UI was 38.5% (2008/5221), among theses women, 22.9% (1197/5221), had stress incontinence, 2.8% (147/5221) urge incontinence and 12.4% (649/5221) mixed incontinence. In multiple logistic models, age, delivery mode, smoking, hypertension, constipation, body mass index, chronic pelvic pain (CPP) were relation factors for stress incontinence. CONCLUSIONS: The prevalence of urinary incontinence is high (38.5%). Urinary incontinence is major disease that affects female quality of life. 22.9% (1197/5221) of the incontinence women had stress urinary incontinence, 2.8% (147/5221) urge urinary incontinence and 12.4% (649/5221) mixed urinary incontinence. Old, vaginal delivery, smoking, hypertension, constipation, CPP and higher BMI are potential risk factors for stress urinary incontinence. Cesarean section are protective factors for stress urinary incontinence.

Adult↗
PubMed2006

[Cervical carcinoma in situ: a clinical and pathological analysis of 118 cases].

OBJECTIVE: To analyze the clinical characteristics and treatment of cervical carcinoma in situ. METHODS: The clinical data of 118 patients with cervical carcinoma in situ (CIS), aged 38.8 (24-77), were retrospectively analyzed. RESULTS: Cervical cytology showed that most of the lesions were cervical intraepithelial neoplasm (CINIII), high-grade squamous intraepithelial lesion (HSIL), or CIS. Most of the patients underwent colposcopic examination. All the patients underwent conization. 54% of the patients were given cold knife conization, and 46% of the patients received electric knife conization. 71 of the patients undergoing conization (60%) were followed-up. Another 40% received total hysterectomy and/or bilateral salpingo-oophorectomy. 17 cases were found pregnant after the conization. There were no differences in pathologically thorough resection and operational complication between the two surgery methods: cold knife conization and electric knife conization. Follow up study showed that conization had no effect on the subsequent pregnancy. CONCLUSION: Conization is necessary for the final diagnosis of cervical carcinoma in situ. Both cervical cytology and colposcopic examination are very important for screening of CINIII or CIS. For the young patients conization suffices, however, for the postmenopausal women or those unable to receive follow-up examination total hysterectomy and bilateral salpingo-oophorectomy should be considered.

Adult↗
PubMed2006

Role of laparoscopy in the diagnosis and treatment of adnexal masses.

BACKGROUND: Laparoscopy has been accepted for years as a management of benign ovarian tumors. The aim of this study was to estimate the feasibility and safety of laparoscopy in diagnosis and management of adnexal masses. METHODS: A total of 2083 patients with benign adnexal mass were treated by laparoscopy at Peking Union Medical College Hospital from January 2000 to December 2003. Their clinical data were reviewed retrospectively. All the adnexal masses suspicious of malignancy at the time of laparoscopy were sent for frozen section evaluation intraoperatively. The rates of unexpected intracystic vegetation and low malignant potential (LMP) tumor or malignancy were investigated. The sensitivity, specificity, positive predictive value, and negative predictive value of laparoscopic diagnosis for LMP or ovarian malignancies were calculated. The ratios were compared by Chi-square test and the continuous variables were tested using two-tailed t test. RESULTS: Of the 2083 patients, 16 had LMP or invasive tumors (0.77%), among which 14 were diagnosed histologically intraoperatively and 2 postoperatively. Fifty-five (2.6%) of the 2083 patients had unexpected intracystic vegetations. Their frozen sections showed benign tumors in 41 (74.5%), LMP tumors in 8 (14.5%), and focal invasive ovarian cancers (stage Ic) in 6 (10.9%). The final pathological diagnosis were benign tumors in 41 (74.5%), LMP tumors 7 (12.7%), and focal invasive ovarian cancers (stage Ic) in 7 (12.7%). Laparoscopy achieved a sensitivity of 87.5%, specificity of 98%, positive predictive value of 25.5%, and negative predictive value of 99.9% in the diagnosis of ovarian malignancies. 2067 cases with benign adnexal masses underwent laparoscopy successfully. No conversion to laparotomy, or intra- and postoperative complications in this series. Of the 16 patients with LMP or invasive ovarian cancer, seven underwent laparoscopic surgery including immediate staging laparoscopy in 3. The mean follow-up was 17.3 months for the 16 patients. Among them, 1 developed a recurrent LMP tumor in the contralateral ovary 36 months after laparoscopic salpingo-oophorectomy, and received subsequent laparoscopic cystectomy and pelvic lymph node sampling; the others had no evidence of recurrent tumor during the follow-up. CONCLUSION: Laparoscopy is feasible for diagnosis of adnexal masses, and the surgery is safe for patients with benign ovarian tumors.

Adolescent↗
PubMed2006

Treatment options for patients with recurrent ovarian cancer: a review of 54 cases.

OBJECTIVE: To evaluate the efficacy of treatment options for patients with recurrent ovarian cancer. METHODS: From 1990 to 2000, 54 patients with recurrent ovarian cancer primarily treated in Peking Union Medical College Hospital were selected and reviewed. All the clinical data related to the recurrent tumor were collected. Two-side P values for differences in survival were calculated by the Cox regression model. RESULTS: The platinum-free interval > 6 months and the surgery followed by salvage chemotherapy prolonged survival time of the patients with recurrent ovarian cancer (95% CI = 0.153-0.987, P = 0.047; 95% CI = 1.611-10.914, P = 0.003, respectively). The increased number of chemotherapy cycles ( > 10 months) offered some benefit on the survival (95% CI = 0.110-1.090, P = 0.070). The initiation of treatment and chemotherapy regiments failed to demonstrate an improvement in survival. CONCLUSION: The treatment options for patients with recurrent ovarian cancer depend on the platinum-free-interval of the patients. A strategy of secondary surgical cytoreduction followed by salvage chemotherapy is suggested for the patients with platinum-sensitive disease.

Adult↗
PubMed2006

Fallopian tube prolapse following hysterectomy.

OBJECTIVE: To investigate the clinical diagnosis, treatment, and prevention of fallopian tube prolapse (FTP) after hysterectomy. METHODS: A total of 7949 patients received hysterectomy from January 1983 to August 2005 in Peking Union Medical College Hospital, and 9 cases (including 1 case from other hospital) of FTP after hysterectomy were involved during this period. All of them were diagnosed according to pathological results and were followed up. The symptoms, diagnosis, and treatment of the FTP patients were analyzed retrospectively. RESULTS: The incidence of FTP after hysterectomy was 0.1% (8/7949), with the incidence of FTP after transabdominal hysterectomy being 0.06% (4/6229), after trans-vaginal hysterectomy being 0.5% (4/780), after laparoscopic assistant vaginal hysterectomy being 0 (0/940). There was no symptom in 3 cases. The pelvic examination revealed the typical prolapsed fimbrial end of a fallopian tube in 3 cases and the other 6 cases revealed red granulation tissue. All of them were excised vaginally and cauterized. The results were proved by pathological examination. No recurrence was reported during follow-up. CONCLUSIONS: FTP is a rare complication after hysterectomy. The prognosis is well after proper diagnosis and treatment Fixation of accessories onto the pelvic wall and complete peritonealization at the time of hysterectomy are the most important methods to prevent FTP after hysterectomy.

Adult↗
PubMed2006

[Expressions of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 mRNA in endometriosis].

OBJECTIVE: To investigate mRNA expression of matrix metalloproteinase (MMP-9) and tissue inhibitor of metalloproteinase (TIMP-1) in ectopic endometriosis tissue and uterine endometrium from women with and without endometriosis. METHODS: Thirty-eight women with endometriosis (Revised American Fertility Society classification, RAFSI-IV) were selected as study group. Thirty-eight specimens of ovarian endometrioma (ovarian chocolate cysts, OCC), 16 red peritoneal endometriotic lesions (RPL), and 35 matched eutopic endometrium (Eu) were collected from them simultaneously at the time of surgery. Twenty specimens of endometrium from reproductive women undergoing laparoscopic surgery without endometriosis were obtained as control group. The mRNA expressions of MMP-9 and TIMP-1 were detected by reverse transcription polymerase chain reaction (RT-PCR). RESULTS: Expression of TIMP-1 mRNA was detected in all samples. The level from endometriosis patients and control group was similar (2.31 +/- 1.21, 2.40 +/- 0.89). However, ectopic endometrium expressed significantly fewer TIMP-1 mRNA (OCC 1.67 +/- 0.79, RPL 1.45 +/- 0.68) compared with eutopic endometrium from both endometriosis and endometriosis-free patients (P < 0.05). The positive expression rate of MMP-9 mRNA was not distinctively different among all samples. The density of MMP-9 mRNA expression in endometrium (0.49 +/- 0.28) from endometriosis patients was similar to that in ectopic endometriosis (OCC 0.46 +/- 0.22, RPL 0.33 +/- 0.12), but was significantly higher compared with endometrium (0.29 +/- 0.12) without endometriosis (P < 0.05). CONCLUSIONS: An increase of MMP-9 mRNA expression of eutopic endometrium with endometriosis might enhance the endometrial implantation ability, thus facilitate the ectopic implantation of endometrium. Ectopic lesions express significantly less TIMP-1 mRNA, indicating they have increased invasive ability, which might facilitate the development of endometriosis.

Actins↗
PubMed2006

[Primary study on fusions of ovarian carcinoma cells to dendritic cell transfected with interleukin-12 gene in vitro].

OBJECTIVE: To investigate the immune response of the fusions of ovarian carcinoma cells to dendritic cell (DC) transfected with interleukin (IL)-12 gene in vitro. METHODS: Recombinant human granulocyte macrophage colony stimulating factor and recombinant human tumor necrosis factor alpha were used to generate DC from cord blood in vitro. IL-12 fusion gene was cloned into a eukaryotic vector-pcDNA3.1 (+). DC were transfected with IL-12-pcDNA3.1 (+) using lipofectamine transfection method and electric transfection method respectively. Then polyethylene glycol mediated the fusion of transfected DC and ovarian carcinoma cells, and 3-(4, 5-dimethylthiazol-2-yl) 2, 5-diphenyl tetrazolium bromide (MTT) test was carried out to observe the immune response. RESULTS: DC were generated in vitro from cord blood and expressed high levels of costimulatory (50%) and MHC II molecules (99%). RT-PCR showed that IL-12-pcDNA3.1 (+) had been successfully transfected into DC. RT-PCR and immunofluorescence analysis showed that DC were fused with ovarian carcinoma cells successfully. Then the fusion cells of ovarian carcinoma cells to transfected DC, and the fusions of ovarian carcinoma cells to DC were cocultured with peripheral blood mononuclear cell respectively. MTT test showed that both fusions could induce cytolytic T cell activity and lysis of ovarian carcinoma cells, and the former effect was stronger. CONCLUSION: The cytolytic T cell activity induced by the fusions of ovarian carcinoma cells to transfected DC is enhanced.

Cell Fusion↗
PubMed2006

[Visual and histologic analysis of laparoscopic diagnosis of endometriosis].

OBJECTIVE: To determine the characteristics of anatomical distribution of pelvic endometriosis and the correlation between visual and histologic findings of endometriosis at laparoscopy. METHODS: A prospective study of 62 patients undergoing laparoscopy for the pelvic pain, infertility and/or pelvic masses was carried out. All lesions with the diagnosis of endometriosis laparoscopically were excised and examined pathologically. Normal-appearing peritoneal biopsies were obtained randomly. All lesions were identified by anatomical site and color of the foci. The positive predictive value (PPV), sensitivity, negative predictive value (NPV), and specificity were determined for visually identified endometriosis versus the histologic findings. RESULTS: Totally, 219 peritoneal endometriotic lesions, 54 normal peritoneal biopsies, and 71 ovarian endometriotic cysts were obtained. Peritoneal lesions tended to locate in posterior part of the pelvis (80.8%, 177/219) and in left (58.0%, 127/219) with most in black (39.2%). The PPV was 67.6%; sensitivity, 93.7%; NPV, 81.4%; and specificity, 38.3% for visual versus histologic diagnosis of peritoneal endometriosis. Lesions in black or from sacral ligaments were confirmed histologically in 94.2% and 84.7% respectively, and 80.3% (57/71) of ovarian endometriotic cysts diagnosed by laparoscopy were confirmed histologically with 43.6% in the left, 27.3% in the right; and 29.1% (16/55) in both sides of the ovary. In addition, 18.5% (10/54) of normal-appearing peritoneal biopsy were identified as endometriosis by pathological examination. Laparoscopy was confirmed to be in 100% diagnostic accordance with pathology for patients with endometriosis. CONCLUSIONS: Our study showed asymmetrical distribution of pelvic endometriosis. Peritoneal lesions in black or from sacral ligament are more likely to be histologically confirmed, and microscopic lesions are not a rare phenomenon of endometriosis.

Adult↗
PubMed2006

[Analysis of 16 patients with early cervical cancer treated by laparoscopic vaginal radical trachelectomy].

OBJECTIVE: To evaluate the therapeutic efficacies of preserving fertility treatment in patients with early cervical cancer. METHODS: Sixteen patients with early cervical cancer treated by laparoscopic vaginal radical trachelectomy and pre- or postoperative chemotherapy were analyzed retrospectively, focusing on the treatment indication and management of high risk patients. RESULTS: The median age was 29 years (range 26 to 34 years). Eleven were nulligravida and 4 multipara. All patients had a desire to maintain fertility. For clinical stage, 2 were stage Ia2, 13 stage Ib1 and 1 stage Ib2. Fifteen patients had squamous cell carcinoma and 1 had adenosquamous cell carcinoma. Mean operative time was 3 hours and 12 minutes, and mean blood loss was 320 ml. There were no intra- or postoperative complications. With mean follow-up time of 13 months, one patient had recurrence (6%), and no one became pregnant. CONCLUSIONS: It is possible to preserve fertility in the treatment of patients with early cervical cancer, but treatment indication should be considered carefully. The management of high risk patients should be investigated extensively.

Adult↗
PubMed2006

[Outcome analysis of conservative treatment of well-differentiated endometrial adenocarcinoma and severe atypical hyperplasia in young women].

OBJECTIVE: To evaluate the effect of hormonal therapy on well-differentiated endometrial adenocarcinoma and severe atypical hyperplasia in young women aged 35 years and younger. METHODS: We retrospectively studied the clinical characteristics of 25 patients under 35 years of age (average: 28.6) diagnosed with well-differentiated endometrial adenocarcinoma or severe atypical hyperplasia, who were treated with progestin in Peking Union Medical College Hospital from 1991 to 2005. According to pathologic results, 25 patients were divided into two groups: 8 cases of endometrial carcinoma and 17 cases of severe atypical hyperplasia. In the endometrial carcinoma group, pelvic ultrasound, MRI, chest X-ray and serum CA(125) were used in pretreatment evaluation. Progesterone receptors were examined with immunohistochemical method. All patients received dilation and curettage of endometrium every 1-6 months as an assessment of treatment results. For chemotherapy, most of them were treated with medroxyprogesterone acetate. RESULTS: Six cases (6/7) in endometrial carcinoma group, and 17 cases (100%) in severe atypical hyperplasia group responded to treatment respectively; among them, 5 cases (5/7) and 14 cases (82%) had complete response, which was defined as the absence of any carcinoma or hyperplasia on endometrial samplings; one case (1/5) and 3 cases (21%) recurred within 6 to 30 months after their complete response. Follow-up on 14 patients with complete response, and the desire for childbearing showed that none of the 4 cases of endometrial carcinoma had conceived a pregnancy and 4 (40%) patients had pregnancy for totally 7 times of 10 cases of severe atypical hyperplasia. Three patients delivered full-term fetuses with induced ovulation, one of whom had artificial abortion 3 times after her delivery. One patient was lost to follow up after her spontaneous pregnancy. CONCLUSIONS: Progestin therapy is a good choice for young women having fertility desires diagnosed with well-differentiated endometrial adenocarcinoma or severe atypical hyperplasia. Endometrial carcinoma patients should be selected carefully before therapy. Pregnant rate is not satisfactory after conservative treatment. Assistant reproductive technology is potentially helpful to improve pregnant rate of patients responded to progestin therapy.

Adult↗
PubMed2006

[Study of sexual function in women after surgery for stress urinary incontinence].

OBJECTIVE: To investigate the change of the patients' sexual function after the surgeries for stress urinary incontinence (SUI). METHODS: Pelvic organ prolapse-urinary incontinence sexual function questionnaire (PISQ) was sent to 62 sexually active patients who underwent laparoscopic Burch colposuspension or had a tension free vaginal tape (TVT) inserted at least 6 months after the operation, to a maximum of 3 years. The patient was divided into two groups according to different operations, different follow-up intervals and whether there was concomitant coital incontinence before the operations respectively. The changes of PISQ scores before and after the operation were compared between two groups. For the groups not having significant difference in PISQ score, we compared the rate of PISQ score improvement and the rate of satisfaction postoperatively. Multivariate logistic regression analyses were performed to determine whether age, parity, body mass index, menstrual status, surgical history, medical illness, severity of SUI, concomitant hysterectomy and intraoperative or postoperative complications affected the change of sexual function. RESULTS: Fifty-six patients answered the questionnaire giving a follow-up rate of 90%. The average score of PISQ was 85.2 +/- 10.7 and 82.4 +/- 17.7 before and after the surgery, and there was no significant difference (P > 0.05); however behavioral emotional domain scores worsened (30.5 +/- 6.6 vs 26.8 +/- 10.7, P < 0.05). The PISQ scores of the patients who underwent the operation within a year declined significantly (86.0 +/- 10.7 vs 77.7 +/- 18.6, P < 0.05), especially in behavioral emotional domain (31.0 +/- 7.2 vs 23.7 +/- 11.3, P < 0.01); however after a year, there was no significant change (84.4 +/- 10.8 vs 86.5 +/- 16.1, P > 0.05) and even an improvement in the physical domain (34.5 +/- 5.6 vs 36.9 +/- 4.3, P < 0.05). Regarding the sexual function improvement ratio, the patients who had the TVT operations (54% vs 12%) or had concomitant coital incontinence before the operations (62% vs 23%) were better (P < 0.01). The change of PISQ scores was independent of clinical features. CONCLUSIONS: The operations of SUI have an adverse effect on the patients' sexual life within a year, which may recover after that period. TVT operation has a better effect on the patients sexual function compared with laparoscopic Burch colposuspension; the patients who have concomitant coital incontinence before the operations have a better sexual function improvement.

Adult↗
PubMed2006

[Clinical analysis of fallopian tube prolapse after hysterectomy].

OBJECTIVE: To investigate the clinical diagnosis, treatment and prevention of fallopian tube prolapse (FTP) after hysterectomy. METHODS: A total of 7949 patients received hysterectomy from 1983 to Aug 2005 in Peking Union Medical College Hospital, including 6229 cases of trans-abdominal hysterectomy (TAH), 780 cases of transvaginal hysterectomy (TVH), and 940 cases of laparoscopic assisted vaginal hysterectomy (LAVH). Nine cases (including 1 case from other hospital) of FTP after hysterectomy were analyzed retrospectively for their symptoms, diagnosis and treatment. All of them were diagnosed according to the results of histology and follow-up. RESULTS: The overall incidence of FTP after hysterectomy was 0.11% (9/7949). Incidence of FTP after trans-abdominal hysterectomy was 0.08% (5/6229), after vaginal hysterectomy 0.51% (4/780), and after laparoscopic assisted vaginal hysterectomy 0 (0/940). There were no symptoms in 3 cases, but the other 6 cases had symptoms. The pelvic examination revealed the typical prolapsed fimbrial end of a fallopian tube in 3 cases and red granulation tissue in the other 6 cases. All of them were excised vaginally and cauterized. The results were confirmed by histological examination. No recurrent cases were reported in follow up. CONCLUSIONS: FTP is a rare complication after hysterectomy. The prognosis is well after proper diagnosis and treatment. Salpingectomy or fixation of accessories into the pelvic wall and complete peritonealisation at the time of hysterectomy are important methods to prevent FTP after hysterectomy.

Adult↗
PubMed2006

[A prospective control study on treatment of stress urinary incontinence with alpha-adrenoceptor agonists and pelvic floor muscle exercises].

OBJECTIVE: To evaluate the therapeutic results of alpha-adrenoceptor agonists and pelvic floor muscle exercises (PFME) for stress urinary incontinence. METHODS: A prospective, single-center, random control study was carried out in 46 patients with stress urinary incontinence (SUI). The patients were divided into two groups, 22 in alpha-adrenoceptor agonists group vs 24 in PFME group. Clinical outcomes and the scores of quality of life were evaluated and compared between the two groups. RESULTS: Two patients in alpha-adrenoceptor agonists group and four patients in PFME group were failed to complete the study. According to patient's subjective scores, excellent effective rate was 15% (3/20) and effective rate was 85% (17/20) in alpha-adrenoceptor agonists group versus effective rate of 55% (11/20) and no-effective rate of 45% (9/20) in PFME group. According to objective 1 h pad test criteria, the efficacy was significantly better in alpha-adrenoceptor agonists group (P < 0.01). The scores of quality of life were improved in all patients of two groups after treatment, and were significantly better in alpha-adrenoceptor agonists group (P < 0.05). There was no difference in sexual life score in PFME group and alpha-adrenoceptor agonists group. CONCLUSIONS: Both alpha-adrenoceptor agonists and PFME are effective non-surgical treatments for stress urinary incontinence. However, alpha-adrenoceptor agonists have better effect than PFME.

Adrenergic alpha-Agonists↗
PubMed2006

[Clinical features and treatment options for aggressive angiomyxoma].

OBJECTIVE: To discuss the clinical features and treatment options for aggressive angiomyxoma (AAM). METHODS: We retrospectively analyzed the clinical data of 4 patients with AAM treated at PUMC Hospital from January 1990 to December 2004. RESULTS: There were 1 man and 3 women with an average age of 34 years. The average age of the female patients were 27 years. Two patients (50%) had urinary or enteric compressive complaints, while another 2 patients had no clinical symptoms. Two patients underwent transvaginal surgeries, 1 patient underwent transabdomenal surgery, and 1 patient underwent subcurtaneouly local excision. Three patients (75%) experienced recurrences after operation and the median relapse time was 2.5 years. CONCLUSIONS: AAM usually occurs in female pelvic cavity and the soft tissues of female perineum. AAM is huge in capacity, and easy to infiltrate or recur locally.

Adolescent↗
PubMed2006

[Effects of levonorgestrel-releasing intrauterine system on pain and recurrence associated with endometriosis and adenomyosis].

OBJECTIVE: To observe the effects of levonorgestrel-releasing intrauterine system (LNG-IUS) in treatment of pain associated with endometriosis (EM) and adenomyosis (AM), and in prevention of disease recurrence. METHODS: Thirty-three cases of moderate to severe EM or AM patients received insertion of LNG-IUS immediately after conservative operation, or after recurrence of simple pain, and were self controlled respectively before and after insertion of LNG-IUS. The visual analogue scale (VAS) was compared, and the change of the lesion and the uterine size, as well as the serum steroid and CA(125) were observed. The side-effects, such as bleeding pattern were recorded. The bleeding period was compared between the cases injected with or without gonadotropin-releasing hormone agonist (GnRHa) before insertion of LNG-IUS. RESULTS: Baseline and follow-up VASs of EM were 8.09 +/- 0.21 and 1.64 +/- 1.12 (P = 0.042), of AM were 8.41 +/- 1.59 and 3.99 +/- 3.87 (P = 0.068), respectively. During nearly 2 years' follow-up, moderate dysmenorrhea recurred in only 1 case who was hyper-estrogenism at that time. Generally, irregular bleeding and spotting period were longer in this LNG-IUS treated group than those reported in literatures in which LNG-IUS was used for contraception. Persistent prolonged spotting was seen in most of the patients during 1 year follow-up. Average bleeding days in one month during the first 6 months after insertion of LNG-IUS were both around 18 days, whether using GnRHa or not. CONCLUSIONS: LNG-IUS greatly reduces pain associated with EM and AM, and delays disease recurrence. Irregular bleeding and spotting is the main side effects. Administration of GnRHa in advance does not improve the bleeding symptoms.

Adult↗