Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: Endometrioid adenocarcinoma is a common endometrial cancer, linked to excess oestrogen exposure. Obesity, a major risk factor, can lead to unopposed oestrogen and endometrial cancer. Surgery is the standard treatment for early-stage disease. However, obese patients with a high body mass index (BMI) may be unsuitable due to surgical risks.
Objectives: We present a novel completely endoscopic technique for placing a levonorgestrel-releasing intrauterine system (LNG-IUS) in an obese patient with early-stage endometrioid adenocarcinoma (FIGO 2009 stage IA, grade 1) who was not a surgical candidate due to multiple comorbidities.
Participant: An 82-year-old obese woman (BMI: 48.9 kg/m) with abnormal uterine bleeding was referred to our gynaecological department. Endometrial thickening, without spread beyond the uterus, was observed by transvaginal ultrasound and magnetic resonance imaging, and final diagnosis of early stage endometrioid adenocarcinoma was confirmed by hysteroscopic endometrial biopsy. Due to her high-risk status and anatomical challenges, initial management involved oral medication and regular biopsies. After a year of presence of a stable disease, a new technique for LNG-IUS placement was attempted.
Intervention: The LNG-IUS was successfully placed within the uterine cavity using a 5 mm XL Bettocchi hysteroscope and a 5 Fr grasping forceps, without needing vaginal speculum or cervical grasping. The patient tolerated the procedure well. Follow-up at six months was negative, without signs of recurrence.
Conclusions: This case demonstrates the feasibility and safety of a total endoscopic LNG-IUS placement as an alternative for obese patients with early-stage endometrioid adenocarcinoma who are not surgical candidates.
What Is New?: This is the first description of a total endoscopic technique for LNG-IUS placement performed without speculum or anesthesia.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233119 | PMC |
| http://dx.doi.org/10.52054/FVVO.2025.11 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Clinical efficacy analysis of LNG-IUS tail anchoring to the superficial myometrium under hysteroscopic direct vision.
BMC Surg
August 2025
Department of Obstetrics and Gynecology, Third Xiangya Hospital, Central South University, No. 138 Tongzipo Road, Yuelu District, Changsha, Hunan, China.
Objective: To investigate the clinical efficacy of levonorgestrel-releasing intrauterine system (LNG-IUS) tail anchoring to the superficial myometrium under hysteroscopic direct vision.
Methods: From March 1, 2017, to March 1, 2022, 206 patients at the Third Xiangya Hospital of Central South University who had a history of at least one LNG-IUS expulsion and who required replacement of the LNG-IUS were retrospectively analyzed. Patients were divided into a common placement group and an anchoring group according to the placement method used for the LNG-IUS.
Study: This multi-institutional, retrospective study explores the risks of laparoscopy for diagnosis and treatment of endometriosis to facilitate shared medical decision-making in patients age < 22 years old with chronic pain considering surgery.
Methods: A retrospective review of patients less than 22 years old who had surgically proven endometriosis at eight pediatric hospitals was completed. Patient demographics, operative interventions, concurrent procedures, and complications were evaluated.
A total endoscopic levonorgestrel-releasing intrauterine system (LNG-IUS) placement: a novel approach for obese patients with early-stage endometrial cancer.
Facts Views Vis Obgyn
June 2025
Fondazione Policlinico Universitario A. Gemelli, Department of Woman and Child Health and Public Health, Rome, Italy.
Background: Endometrioid adenocarcinoma is a common endometrial cancer, linked to excess oestrogen exposure. Obesity, a major risk factor, can lead to unopposed oestrogen and endometrial cancer. Surgery is the standard treatment for early-stage disease.
View Article and Find Full Text PDFEffects of levonorgestrel-releasing intrauterine system on recurrence and fertility outcomes during assisted reproduction after complete remission of early endometrioid endometrial cancer and precancerous lesions: A retrospective cohort study.
Int J Cancer
September 2025
Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
To investigate the efficacy of the levonorgestrel-releasing intrauterine system (LNG-IUS) on recurrence and fertility outcomes during controlled ovarian stimulation (COS) in patients with early stage endometrioid endometrial carcinoma (EEC) and endometrial atypical hyperplasia (EAH) following successful fertility-preserving treatment. We reviewed the patients with Grade 1 presumed Stage IA EEC or EAH who underwent in vitro fertilization and embryo transfer after successful fertility-sparing treatment. A total of 176 women were enrolled in this study, undergoing 318 cycles of COS and 290 cycles of embryo transfer (ET).
View Article and Find Full Text PDFSuture Fixation of Levonorgestrel-Releasing Device Using the Hysteroscopic Surgery System.
JSLS
April 2025
The First People's Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China.
Background: The levonorgestrel-releasing intrauterine system (LNG-IUS) is a widely recognized method for contraception and the management of various gynecological conditions. However, the placement of LNG-IUS can be particularly challenging in patients with large or anatomically irregular uteri. The objective of this study was to evaluate the efficacy and safety of hysteroscopic cold-knife-assisted suture fixation of the LNG-IUS in the uteri of patients diagnosed with adenomyosis.
View Article and Find Full Text PDF