Xin yixue (Nov 2022)

Clinical efficacy of different adjuvant treatment schemes for patients with moderate to severe intrauterine adhesions after hysteroscopic transcervical resection

  • Shi Wen, Wang Maocai, Wang Minyi, Chen Shan, Li Xiao

DOI
https://doi.org/10.3969/j.issn.0253-9802.2022.11.009
Journal volume & issue
Vol. 53, no. 11
pp. 833 – 837

Abstract

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Objective To compare the clinical efficacy of different adjuvant treatment schemes for patients with moderate to severe intrauterine adhesions after hysteroscopic transcervical resection of adhesion (TCRA). Methods Clinical data of 98 patients with moderate to severe intrauterine adhesions were retrospectively analyzed. All patients underwent hysteroscopic TCRA for intrauterine adhesions. According to the adjuvant treatment schemes, all patients were divided into the TCRA group (group A, n =17), TCRA+balloon stenting group (group B, n = 35) and TCRA+balloon stenting+intrauterine injection of sodium hyaluronate group (group C, n=46). Postoperatively, all patients received artificial cycle treatment. At postoperative 1 month, hysteroscopy was performed to evaluate the severity of intrauterine adhesions. The American Fertility Society (AFS) scores of all patients were recorded before and after surgery. The changes of menstrual volume at postoperative 3 months were observed in three groups. Results The differences of pre-TCRA AFS scores in 3 groups were not statistically significant (P > 0.05). Hysteroscopy at postoperative 1 month found statistical significance in the AFS scores among three groups (P < 0.05), and the AFS score in group C was significantly lower than those in groups A and B (both P < 0.05). There was significant difference in the changes of menstrual volume among three groups at postoperative 3 months (all P < 0.05). The effective rates of menstrual volume improvement were 41%(7/17), 63%(22/35) and 91%(42/46) in groups A, B and C, and the differences were statistically significant (all P < 0.05). The effective rate of menstrual volume improvement in group C was significantly higher compared with those in groups A and B (both P < 0.017). Conclusion TCRA combined with intraoperative intrauterine placement of balloon stent, sodium hyaluronate and postoperative artificial cycle treatment yield high clinical efficacy for moderate to severe intrauterine adhesions and accelerate postoperative recovery.

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