Peng F.-SMING-YIH WUJEHN-HSIAHN YANGSHEE-UAN CHENHONG-NERNG HOYU-SHIH YANG2020-02-172020-02-1720101028-4559https://scholars.lib.ntu.edu.tw/handle/123456789/460284Objective: Insertion of the levonorgestrel-releasing intrauterine system Mirena is difficult in women with adenomyosis, and the device is often subsequently expelled. We used a novel insertion technique (Yang's method) to overcome this problem. Materials and Methods: This retrospective study enrolled 273 patients with adenomyosis who were receiving Mirena for treatment of menorrhagia and/or dysmenorrhea between 2001 and 2008. Clinical outcomes and expulsion rates were compared between patients treated using conventional insertion and those treated using Yang's insertion methods. Results: Expulsion occurred in 25.3% of patients with the conventional method, compared with 10.2% of patients with Yang's method. Hemoglobin levels and dysmenorrhea improved greatly in both groups after Mirena insertion. Conclusion: Yang's insertion method for levonorgestrel-releasing intrauterine system is more reliable in some difficult cases, such as patients with severe adenomyosis. This method ensures correct positioning, thus reducing the risks of uterine perforation and/or expulsion. ? 2010 Taiwan Association of Obstetrics and Gynecology.[SDGs]SDG3diane; hemoglobin; levonorgestrel; adenomyosis; adult; article; clinical assessment; controlled study; dysmenorrhea; female; hemoglobin blood level; human; intermethod comparison; major clinical study; menorrhagia; menstruation; myometrium; outcome assessment; retrospective study; risk reduction; spotting; uterine bleeding pattern; uterus bleeding; uterus disease; uterus expulsion; uterus perforation; Adult; Anemia; Contraceptive Agents, Female; Dysmenorrhea; Endometriosis; Female; Humans; Intrauterine Device Expulsion; Intrauterine Devices, Medicated; Levonorgestrel; Menorrhagia; Middle Aged; Retrospective Studies; Uterine Diseasesjournal article10.1016/S1028-4559(10)60034-4207085212-s2.0-77955568815