{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T13:08:57Z","timestamp":1790860137848,"version":"4.1.0"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to explore the feasibility and clinical effects of a novel hysteroscopic levonorgestrel-releasing intrauterine system (LNG-IUS) non-suture fixation at the uterine fundus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From October 2023 to July 2024, a prospective study involving a novel hysteroscopic LNG-IUS non-suture fixation at the uterine fundus was conducted at Obstetrics and Gynecology Hospital, Fudan University. The patient\u2019s clinical symptoms, surgical time, surgical complications, postoperative LNG-IUS expulsion, and other follow-up information were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 31 patients were included in this study. The average uterine depth is 9.17\u202f\u00b1\u202f0.67\u202fcm. Among them, 10 cases had a history of LNG-IUS expulsion. The average surgical time is 13.0\u202f\u00b1\u202f4.1\u202fmin, and the average intraoperative blood loss is 5.3\u202f\u00b1\u202f3.6\u202fmL. All patients did not experience complications such as uterine perforation, massive bleeding, fluid overload, or postoperative infection. The average follow-up time after surgery was 6.0\u202f\u00b1\u202f1.8\u202fmonths, and no LNG-IUS expulsion occurred. The pain assessment and mean menstrual flow postoperation were less than preoperation, and the endometrial thickness and mean uterine volume postoperation were lower than preoperation, with statistically significant differences. For patients with dysmenorrhea, the postoperative relief rate was 96.3% (26\/27), and for those with excessive menstruation, the postoperative effective rate reached 96.2% (25\/26). The main adverse reaction was irregular vaginal bleeding, with an incidence rate of 61.3% (19\/31).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hysteroscopic LNG-IUS non-suture fixation at the uterine fundus is a safe and effective technique, particularly suitable for patients with dysmenorrhea, excessive menstruation, or a large uterine cavity who have previously experienced LNG-IUS expulsion. This procedure is simple and minimally invasive, has a short surgical time, has minimal bleeding, and provides rapid recovery; therefore, it is worthy of clinical application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1563888","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T01:34:13Z","timestamp":1745804053000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Clinical application of a novel hysteroscopic LNG-IUS non-suture fixation at the uterine fundus"],"prefix":"10.3389","volume":"12","author":[{"given":"Yi","family":"Yu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongwei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Sui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1013921","DOI":"10.3389\/fgwh.2022.1013921","article-title":"Levonorgestrel-releasing intrauterine system vs. systemic medication or blank control for women with dysmenorrhea: systematic review and meta-analysis of randomized controlled trials","volume":"3","author":"Wang","year":"2022","journal-title":"Front Glob Womens Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1111\/aogs.13798","article-title":"The role of levonorgestrel intra-uterine system in the management of adenomyosis: a systematic review and meta-analysis of prospective studies","volume":"99","author":"Am","year":"2020","journal-title":"Acta Obstet Gynecol Scand"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1789","DOI":"10.1016\/j.jogc.2019.03.025","article-title":"Guideline no. 390-classification and management of endometrial hyperplasia","volume":"41","author":"Auclair","year":"2019","journal-title":"J Obstet Gynaecol Can"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1097\/AOG.0000000000005297","article-title":"Management of endometrial intraepithelial neoplasia or atypical endometrial hyperplasia: ACOG clinical consensus no. 5","volume":"142","year":"2023","journal-title":"Obstet Gynecol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e36","DOI":"10.3802\/jgo.2023.34.e36","article-title":"Levonorgestrel-releasing intrauterine system-based therapies for early-stage endometrial cancer: a systematic review and meta-analysis","volume":"34","author":"Wei","year":"2023","journal-title":"J Gynecol Oncol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.1016\/j.jmig.2019.11.023","article-title":"Prevention of benign endometrial polyp recurrence using a Levonorgestrel-releasing intrauterine system in premenopausal patients: a retrospective cohort study","volume":"27","author":"Wang","year":"2020","journal-title":"J Minim Invasive Gynecol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1016\/j.tjog.2014.05.009","article-title":"Clinical experiences of the levonorgestrel-releasing intrauterine system in patients with large symptomatic adenomyosis","volume":"54","author":"Park","year":"2015","journal-title":"Taiwan J Obstet Gynecol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/j.ijgo.2014.02.017","article-title":"Factors affecting the spontaneous expulsion of the levonorgestrel-releasing intrauterine system","volume":"126","author":"Youm","year":"2014","journal-title":"Int J Gynaecol Obstet"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e217","DOI":"10.1111\/hae.12886","article-title":"Pbac score: an easy-to-use tool to predict coagulation disorders in women with idiopathic heavy menstrual bleeding","volume":"22","author":"Halimeh","year":"2016","journal-title":"Haemophilia"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1595","DOI":"10.1007\/s40265-023-01957-7","article-title":"Current medical therapy for Adenomyosis: from bench to bedside","volume":"83","author":"Etrusco","year":"2023","journal-title":"Drugs"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"966","DOI":"10.1007\/s43032-022-01077-9","article-title":"Levonorgestrel-releasing intrauterine system improves menorrhagia-related quality of life in patients with symptomatic Adenomyosis","volume":"30","author":"Ishizawa","year":"2023","journal-title":"Reprod Sci"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1016\/j.fertnstert.2021.05.113","article-title":"The suture fixation of levonorgestrel-releasing intrauterine device using the hysteroscopic cold-knife surgery system: an original method in treatment of adenomyosis","volume":"116","author":"Zhu","year":"2021","journal-title":"Fertil Steril"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"355","DOI":"10.52054\/FVVO.15.4.107","article-title":"Suture-fixation of a levonorgestrel-releasing intrauterine device under hysteroscopic guidance","volume":"15","author":"Pg","year":"2023","journal-title":"Facts Views Vis Obgyn"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"108772","DOI":"10.1016\/j.ijscr.2023.108772","article-title":"The suture fixation of levonorgestrel-releasing intrauterine device in the treatment of adenomyosis: a case report","volume":"110","author":"Cui","year":"2023","journal-title":"Int J Surg Case Rep"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1186\/s12905-022-01932-6","article-title":"An innovative surgical approach: suture fixation of the levonorgestrel-releasing intrauterine system in the treatment of adenomyosis","volume":"22","author":"Zhang","year":"2022","journal-title":"BMC Womens Health"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.jmig.2023.10.012","article-title":"Feasibility and effectiveness of hysteroscopic suture fixation of the levonorgestrel-releasing intrauterine system in the treatment of adenomyosis","volume":"31","author":"Lv","year":"2024","journal-title":"J Minim Invasive Gynecol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"17794","DOI":"10.1038\/s41598-023-44489-6","article-title":"Assessment of key parameters of normal uterus in women of reproductive age","volume":"13","author":"Chen","year":"2023","journal-title":"Sci Rep"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1016\/j.tjog.2022.11.009","article-title":"Comparison of the treatment efficacies of Hifu, Hifu combined with Gnrh-a, and Hifu combined with Gnrh-a and Lng-Ius for adenomyosis: a systematic review and meta-analysis","volume":"62","author":"Otgontuya","year":"2023","journal-title":"Taiwan J Obstet Gynecol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1563888\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T01:34:13Z","timestamp":1745804053000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1563888\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,28]]},"references-count":18,"alternative-id":["10.3389\/fmed.2025.1563888"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1563888","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,28]]},"article-number":"1563888"}}