{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T20:35:40Z","timestamp":1793565340911,"version":"4.5.0"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T00:00:00Z","timestamp":1741219200000},"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. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Hysteroscopic polypectomy is a common method for treating endometrial polyps, but postoperative recurrence remains a key concern. Recently, the levonorgestrel intrauterine system (LNG-IUS) has been suggested to reduce the recurrence rate of polyps. This study aims to investigate the differences in recurrence rates and recurrence-free survival times between hysteroscopic polypectomy alone and hysteroscopic polypectomy combined with LNG-IUS, and to assess their impact on recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study retrospectively included clinical data from 1,160 patients with endometrial polyps from 2020 to 2021, the follow-up period was 1 year. Patients were divided into two groups based on whether LNG-IUS was used after surgery: the Hysteroscopic Polypectomy group (<jats:italic>n<\/jats:italic>\u2009=\u2009812) and the Hysteroscopic Polypectomy Combined with LNG-IUS group (<jats:italic>n<\/jats:italic>\u2009=\u2009348). Based on the analysis, two multivariate logistic regression models were constructed: the first model included only the factors with significant differences from the statistical analysis, while the second model additionally included the treatment method. The predictive abilities of the two models for polyp recurrence were compared. The recurrence-free survival time differences between the two treatment methods were also analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Univariate logistic regression analysis showed that birth history, menstrual symptoms, quality of life, and treatment method were significantly associated with polyp recurrence. In multivariate logistic regression models, the second model, which included the treatment method, had a higher AUC (0.703) compared to the first model (AUC\u2009=\u20090.676), which included only significant factors. The recurrence-free survival rate in the group that received hysteroscopic polypectomy combined with LNG-IUS was significantly higher than in the hysteroscopic polypectomy group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Hysteroscopic polypectomy combined with LNG-IUS significantly reduces polyp recurrence and extends recurrence-free survival time. Multivariate logistic regression analysis indicates that including the treatment method improves the predictive ability of the model, suggesting that combined treatment plays an important role in reducing polyp recurrence and is worthy of further clinical promotion and application.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2025.1557877","type":"journal-article","created":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T05:11:07Z","timestamp":1741237867000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["The effect of hysteroscopic endometrial polypectomy combined with LNG-IUS treatment on polyp recurrence: a multicenter retrospective study"],"prefix":"10.3389","volume":"12","author":[{"given":"Cheng","family":"Peng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongmei","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Duan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zichang","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.ejogrb.2021.03.017","article-title":"Endometrial polyps. An evidence-based diagnosis and management guide","volume":"260","author":"Vitale","year":"2021","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1016\/j.ajog.2021.11.013","article-title":"Endometrial polyps","volume":"226","author":"Jiang","year":"2022","journal-title":"Am J Obstet Gynecol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1016\/j.fertnstert.2019.02.008","article-title":"Uterine polyps, adenomyosis, leiomyomas, and endometrial receptivity","volume":"111","author":"Munro","year":"2019","journal-title":"Fertil Steril"},{"key":"B4","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1097\/GCO.0000000000000277","article-title":"Hysteroscopic polypectomy for women undergoing IVF treatment: when is it necessary?","volume":"28","author":"Kodaman","year":"2016","journal-title":"Curr Opin Obstet Gynecol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.ejogrb.2017.04.025","article-title":"Hysteroscopic polypectomy prior to infertility treatment: a cost analysis and systematic review","volume":"213","author":"Mouhayar","year":"2017","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"2084","DOI":"10.1111\/jog.14400","article-title":"Comparison of endometrial polyp recurrence in fertile women after office hysteroscopic endometrial polypectomy using two widely spread techniques","volume":"46","author":"Ceci","year":"2020","journal-title":"J Obstet Gynaecol Res"},{"key":"B7","doi-asserted-by":"publisher","first-page":"209","DOI":"10.4103\/GMIT.GMIT_102_19","article-title":"Retrospective cohort study on the symptomatic recurrence pattern after hysteroscopic polypectomy","volume":"9","author":"Cea Garc\u00eda","year":"2020","journal-title":"Gynecol Minim Invasive Ther"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e0144857","DOI":"10.1371\/journal.pone.0144857","article-title":"Factors influencing the recurrence potential of benign endometrial polyps after hysteroscopic polypectomy","volume":"10","author":"Yang","year":"2015","journal-title":"PLoS One"},{"key":"B9","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/j.jmig.2012.10.013","article-title":"Long-term outcomes after intrauterine morcellation vs hysteroscopic resection of endometrial polyps","volume":"20","author":"AlHilli","year":"2013","journal-title":"J Minim Invasive Gynecol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"100732","DOI":"10.1016\/j.gore.2021.100732","article-title":"Efficacy of the LNG-IUS for treatment of endometrial hyperplasia and early stage endometrial cancer: can biomarkers predict response?","volume":"36","author":"Dore","year":"2021","journal-title":"Gynecol Oncol Rep"},{"key":"B11","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":"B12","doi-asserted-by":"publisher","first-page":"948709","DOI":"10.3389\/fmed.2022.948709","article-title":"LNG-IUS vs. medical treatments for women with heavy menstrual bleeding: a systematic review and meta-analysis","volume":"9","author":"Chen","year":"2022","journal-title":"Front Med"},{"key":"B13","doi-asserted-by":"publisher","first-page":"2050312116671725","DOI":"10.1177\/2050312116671725","article-title":"SF-36 total score as a single measure of health-related quality of life: scoping review","volume":"4","author":"Lins","year":"2016","journal-title":"SAGE Open Med"},{"key":"B14","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1016\/j.otohns.2010.05.007","article-title":"A practical guide to understanding Kaplan\u2013Meier curves","volume":"143","author":"Rich","year":"2010","journal-title":"Otolaryngol Head Neck Surg"},{"key":"B15","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1093\/humupd\/dmv039","article-title":"What we know about primary dysmenorrhea today: a critical review","volume":"21","author":"Iacovides","year":"2015","journal-title":"Hum Reprod Update"},{"key":"B16","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1136\/bmj.305.6846.160","article-title":"Validating the SF-36 health survey questionnaire: new outcome measure for primary care","volume":"305","author":"Brazier","year":"1992","journal-title":"Br Med J"},{"key":"B17","doi-asserted-by":"publisher","first-page":"3168","DOI":"10.1007\/s00464-014-3577-8","article-title":"Validation of the SF-36 as a measure of postoperative recovery after colorectal surgery","volume":"28","author":"Antonescu","year":"2014","journal-title":"Surg Endosc"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1382","DOI":"10.1016\/j.jacc.2018.07.042","article-title":"Positive psychological well-being and cardiovascular disease: JACC health promotion series","volume":"72","author":"Kubzansky","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1007\/s00404-022-06720-z","article-title":"Efficacy of high-intensity focused ultrasound combined with LNG-IUS for adenomyosis: a systematic review and meta-analysis","volume":"308","author":"Zhao","year":"2023","journal-title":"Arch Gynecol Obstet"},{"key":"B20","first-page":"5412","article-title":"LNG-IUS combined with progesterone ameliorates endometrial thickness and pregnancy outcomes of patients with early-stage endometrial cancer or atypical hyperplasia","volume":"13","author":"Fang","year":"2021","journal-title":"Am J Transl Res"},{"key":"B21","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1080\/09513590.2018.1491028","article-title":"Malignant endometrial polyp in woman with the levonorgestrel intrauterine system\u2014a case report","volume":"35","author":"Kuzel","year":"2019","journal-title":"Gynecol Endocrinol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/j.1600-0412.2011.01303.x","article-title":"Emerging indications for the levonorgestrel-releasing intrauterine system (LNG-IUS)","volume":"91","author":"Heikinheimo","year":"2012","journal-title":"Acta Obstet Gynecol Scand"},{"key":"B23","doi-asserted-by":"publisher","first-page":"S72","DOI":"10.1016\/j.chest.2020.03.014","article-title":"Cohort studies: design, analysis, and reporting","volume":"158","author":"Wang","year":"2020","journal-title":"Chest"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1557877\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T05:11:09Z","timestamp":1741237869000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1557877\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,6]]},"references-count":23,"alternative-id":["10.3389\/fsurg.2025.1557877"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2025.1557877","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,6]]},"article-number":"1557877"}}