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Efficacy of a polyethylene oxide-sodium carboxymethylcellulose gel in prevention of intrauterine adhesions after hysteroscopic surgery.
J Minim Invasive Gynecol. 2011 Jul-Aug; 18(4):462-9.JM

Abstract

STUDY OBJECTIVES

To assess the efficacy of a polyethylene oxide-sodium carboxymethylcellulose gel (Intercoat; Gynecare, division of Ethicon, Inc., Somerville, NJ) in preventing the development of de novo intrauterine adhesions (IUAs) after hysteroscopic surgery and to rate the patency of the internal uterine ostium at 1-month follow-up diagnostic hysteroscopy.

DESIGN

Randomized controlled study (Canadian Task Force classification I).

SETTING

University hospital.

PATIENTS

One hundred ten patients diagnosed during office hysteroscopy as having single or multiple lesions suitable for surgical treatment or resistant dysfunctional uterine bleeding requiring endometrial ablation.

INTERVENTIONS

Patients were randomized to 2 groups. Group 1 underwent hysteroscopic surgery plus intrauterine application of Intercoat gel, and group 2 underwent hysteroscopic surgery only (control group). Follow-up office hysteroscopy was performed at 1 month after surgery to assess the rate and severity of IUA formation and to rate the patency of the internal uterine ostium after the surgical intervention.

MEASUREMENTS AND MAIN RESULTS

Compared with the group 2, group 1 demonstrated a significant reduction in the incidence (6% vs 22%; p <.05) of de-novo IUAs. Application of the gel seemed to reduce the severity of IUAs, with fewer moderate and severe IUAs at follow-up in group 1 in comparison with group 2 (33% vs 92%). Furthermore, group 1 demonstrated significant improvement in the degree of patency of the internal uterine ostium (41.9% of cases) in comparison with diagnostic office hysteroscopy performed at enrollment (p <.05). In contrast, in group 2, worsening of patency of the internal uterine ostium was recorded in 18.2% of cases (p <.05).

CONCLUSIONS

Intercoat gel seems to prevent de novo formation of IUAs and to improve the patency of the internal uterine ostium at follow-up hysteroscopy. However, larger studies are needed to confirm these findings.

Authors+Show Affiliations

Department of Gynaecology and Obstetrics, and Pathophysiology of Human Reproduction, University of Naples Federico II, Naples, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

21777835

Citation

Di Spiezio Sardo, Attilio, et al. "Efficacy of a Polyethylene Oxide-sodium Carboxymethylcellulose Gel in Prevention of Intrauterine Adhesions After Hysteroscopic Surgery." Journal of Minimally Invasive Gynecology, vol. 18, no. 4, 2011, pp. 462-9.
Di Spiezio Sardo A, Spinelli M, Bramante S, et al. Efficacy of a polyethylene oxide-sodium carboxymethylcellulose gel in prevention of intrauterine adhesions after hysteroscopic surgery. J Minim Invasive Gynecol. 2011;18(4):462-9.
Di Spiezio Sardo, A., Spinelli, M., Bramante, S., Scognamiglio, M., Greco, E., Guida, M., Cela, V., & Nappi, C. (2011). Efficacy of a polyethylene oxide-sodium carboxymethylcellulose gel in prevention of intrauterine adhesions after hysteroscopic surgery. Journal of Minimally Invasive Gynecology, 18(4), 462-9. https://doi.org/10.1016/j.jmig.2011.04.007
Di Spiezio Sardo A, et al. Efficacy of a Polyethylene Oxide-sodium Carboxymethylcellulose Gel in Prevention of Intrauterine Adhesions After Hysteroscopic Surgery. J Minim Invasive Gynecol. 2011 Jul-Aug;18(4):462-9. PubMed PMID: 21777835.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of a polyethylene oxide-sodium carboxymethylcellulose gel in prevention of intrauterine adhesions after hysteroscopic surgery. AU - Di Spiezio Sardo,Attilio, AU - Spinelli,Marialuigia, AU - Bramante,Silvia, AU - Scognamiglio,Marianna, AU - Greco,Elena, AU - Guida,Maurizio, AU - Cela,Vito, AU - Nappi,Carmine, PY - 2011/02/05/received PY - 2011/04/20/revised PY - 2011/04/22/accepted PY - 2011/7/23/entrez PY - 2011/7/23/pubmed PY - 2011/12/13/medline SP - 462 EP - 9 JF - Journal of minimally invasive gynecology JO - J Minim Invasive Gynecol VL - 18 IS - 4 N2 - STUDY OBJECTIVES: To assess the efficacy of a polyethylene oxide-sodium carboxymethylcellulose gel (Intercoat; Gynecare, division of Ethicon, Inc., Somerville, NJ) in preventing the development of de novo intrauterine adhesions (IUAs) after hysteroscopic surgery and to rate the patency of the internal uterine ostium at 1-month follow-up diagnostic hysteroscopy. DESIGN: Randomized controlled study (Canadian Task Force classification I). SETTING: University hospital. PATIENTS: One hundred ten patients diagnosed during office hysteroscopy as having single or multiple lesions suitable for surgical treatment or resistant dysfunctional uterine bleeding requiring endometrial ablation. INTERVENTIONS: Patients were randomized to 2 groups. Group 1 underwent hysteroscopic surgery plus intrauterine application of Intercoat gel, and group 2 underwent hysteroscopic surgery only (control group). Follow-up office hysteroscopy was performed at 1 month after surgery to assess the rate and severity of IUA formation and to rate the patency of the internal uterine ostium after the surgical intervention. MEASUREMENTS AND MAIN RESULTS: Compared with the group 2, group 1 demonstrated a significant reduction in the incidence (6% vs 22%; p <.05) of de-novo IUAs. Application of the gel seemed to reduce the severity of IUAs, with fewer moderate and severe IUAs at follow-up in group 1 in comparison with group 2 (33% vs 92%). Furthermore, group 1 demonstrated significant improvement in the degree of patency of the internal uterine ostium (41.9% of cases) in comparison with diagnostic office hysteroscopy performed at enrollment (p <.05). In contrast, in group 2, worsening of patency of the internal uterine ostium was recorded in 18.2% of cases (p <.05). CONCLUSIONS: Intercoat gel seems to prevent de novo formation of IUAs and to improve the patency of the internal uterine ostium at follow-up hysteroscopy. However, larger studies are needed to confirm these findings. SN - 1553-4669 UR - https://www.unboundmedicine.com/medline/citation/21777835/Efficacy_of_a_polyethylene_oxide_sodium_carboxymethylcellulose_gel_in_prevention_of_intrauterine_adhesions_after_hysteroscopic_surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1553-4650(11)00233-0 DB - PRIME DP - Unbound Medicine ER -