Levonorgestrel intrauterine system versus oral progestin for preventing the recurrence of endometrial polyps after hysteroscopic resection: A meta­analysis of 19 randomized controlled trials

Abstract

Levonorgestrel intrauterine system versus oral progestin for preventing the recurrence of endometrial polyps after hysteroscopic resection: A meta­analysis of 19 randomized controlled trials Y. Sun1 , X. Chen1 , X. Yuan1 , L. Xu1 , Y.C. Jin1 , T.H. Ji1 , X.L. Wang1 , H.H. Dai1,∗ , W.J. Cheng1,∗ 1Department of Gynecology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029 (P.R. China) Summary Background: The aim of this meta­analysis was to compare levonorgestrel intrauterine system (LNG­IUS) with oral progestin for preventing the recurrence of endometrial polyps after hysteroscopic resection. Materials and Methods: Computerized literature search was performed in PubMed and several Chinese databases to screen for relevant trials. Quality assessment and meta­analysis were performed for the included trials. Results: A total of 19 randomized controlled trials were identified. Meta­analysis indicated that the LNG­IUS group was associated with lower recurrence rate of endometrial polyps than the oral progestin group (p < 0.0001), while there was no significant difference in the incidence of abnormal uterine bleeding between groups (p > 0.05). In terms of adverse effects related to progestin, the LNG­IUS group had significantly fewer adverse effects than the oral progestin group (p < 0.0001). Additionally, the LNG­IUS group had thinner endometrium and higher hemoglobin levels than the oral progestin group (p < 0.00001). Conclusion: The LNG­IUS was more effective and safer in preventing the recurrence of endometrial polyps after hysteroscopic resection than oral progestin. Key words: Endometrial polyps; Levonorgestrel intrauterine system; LNG­IUS; Oral progestin; Meta­analysis