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Oxidized, Regenerated Cellulose Adhesion Barrier Plus Intrauterine Device Prevents Recurrence After Adhesiolysis for Moderate to Severe Intrauterine Adhesions.
J Minim Invasive Gynecol. 2017 01 01; 24(1):80-88.JM

Abstract

STUDY OBJECTIVE

To compare the efficacy of an oxidized, regenerated cellulose adhesion barrier (Interceed; Ethicon, Somerville, NJ) combined with an intrauterine device (IUD) versus an IUD alone for preventing adhesion recurrence following hysteroscopic adhesiolysis for moderate to severe intrauterine adhesions (IUAs).

DESIGN

Retrospective case series (Canadian Task Force classification III).

SETTING

Tertiary care teaching hospital.

PATIENTS

Patients undergoing treatment for moderate to severe IUAs. The severity of IUA was determined based on the American Fertility Society scoring system (mild, moderate, or severe).

INTERVENTIONS

All cases of hysteroscopic adhesiolysis were reviewed.

MEASUREMENTS AND RESULTS

Seventy-six women with moderate to severe IUAs treated between March 2009 and August 2015 were included. After hysteroscopic adhesiolysis, 35 patients were treated with an IUD alone (group 1), and 41 patients were treated with Interceed plus an IUD (group 2). A second hysteroscopy was performed in all cases three months after the initial hysteroscopy and both groups achieved significant reduction in adhesion scores and grade, especially in group 2 (scores, p < .001; grade, p = .039). Compared with group 1, menstruation dysfunction, pregnancy rate, and live birth rate in group 2 improved with no statistical difference (menstruation improvement, p = .764; pregnancy rate, p = .310; live birth rate, p = .068). However, an adhesion-free uterine cavity was regained significantly owing to the fewer operations in group 2 compared with group 1 (median, 3 vs 4; p = .001). The interval from initial hysteroscopy to conception was significantly shorter in group 2 (median, 12 months vs 51 months; p < .001).

CONCLUSIONS

For moderate to severe IUAs, Interceed combined with an IUD may be an alternative approach for reducing adhesion recurrence after hysteroscopic adhesiolysis.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.Department of Obstetrics and Gynecology, General Hospital of PLA Guangzhou Military Area, Guangzhou, Guangdong, China.Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China. Electronic address: heyuanli310@163.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27742483

Citation

Cai, Huihua, et al. "Oxidized, Regenerated Cellulose Adhesion Barrier Plus Intrauterine Device Prevents Recurrence After Adhesiolysis for Moderate to Severe Intrauterine Adhesions." Journal of Minimally Invasive Gynecology, vol. 24, no. 1, 2017, pp. 80-88.
Cai H, Qiao L, Song K, et al. Oxidized, Regenerated Cellulose Adhesion Barrier Plus Intrauterine Device Prevents Recurrence After Adhesiolysis for Moderate to Severe Intrauterine Adhesions. J Minim Invasive Gynecol. 2017;24(1):80-88.
Cai, H., Qiao, L., Song, K., & He, Y. (2017). Oxidized, Regenerated Cellulose Adhesion Barrier Plus Intrauterine Device Prevents Recurrence After Adhesiolysis for Moderate to Severe Intrauterine Adhesions. Journal of Minimally Invasive Gynecology, 24(1), 80-88. https://doi.org/10.1016/j.jmig.2016.09.021
Cai H, et al. Oxidized, Regenerated Cellulose Adhesion Barrier Plus Intrauterine Device Prevents Recurrence After Adhesiolysis for Moderate to Severe Intrauterine Adhesions. J Minim Invasive Gynecol. 2017 01 1;24(1):80-88. PubMed PMID: 27742483.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Oxidized, Regenerated Cellulose Adhesion Barrier Plus Intrauterine Device Prevents Recurrence After Adhesiolysis for Moderate to Severe Intrauterine Adhesions. AU - Cai,Huihua, AU - Qiao,Lin, AU - Song,KaiJing, AU - He,Yuanli, Y1 - 2016/10/11/ PY - 2016/06/10/received PY - 2016/09/08/revised PY - 2016/09/22/accepted PY - 2016/10/16/pubmed PY - 2017/7/15/medline PY - 2016/10/16/entrez KW - Adhesion recurrence KW - Adhesion reduction KW - Asherman's syndrome KW - Hysteroscopy KW - Menstrual dysfunction KW - Pregnancy rate KW - Uterine synechiae SP - 80 EP - 88 JF - Journal of minimally invasive gynecology JO - J Minim Invasive Gynecol VL - 24 IS - 1 N2 - STUDY OBJECTIVE: To compare the efficacy of an oxidized, regenerated cellulose adhesion barrier (Interceed; Ethicon, Somerville, NJ) combined with an intrauterine device (IUD) versus an IUD alone for preventing adhesion recurrence following hysteroscopic adhesiolysis for moderate to severe intrauterine adhesions (IUAs). DESIGN: Retrospective case series (Canadian Task Force classification III). SETTING: Tertiary care teaching hospital. PATIENTS: Patients undergoing treatment for moderate to severe IUAs. The severity of IUA was determined based on the American Fertility Society scoring system (mild, moderate, or severe). INTERVENTIONS: All cases of hysteroscopic adhesiolysis were reviewed. MEASUREMENTS AND RESULTS: Seventy-six women with moderate to severe IUAs treated between March 2009 and August 2015 were included. After hysteroscopic adhesiolysis, 35 patients were treated with an IUD alone (group 1), and 41 patients were treated with Interceed plus an IUD (group 2). A second hysteroscopy was performed in all cases three months after the initial hysteroscopy and both groups achieved significant reduction in adhesion scores and grade, especially in group 2 (scores, p < .001; grade, p = .039). Compared with group 1, menstruation dysfunction, pregnancy rate, and live birth rate in group 2 improved with no statistical difference (menstruation improvement, p = .764; pregnancy rate, p = .310; live birth rate, p = .068). However, an adhesion-free uterine cavity was regained significantly owing to the fewer operations in group 2 compared with group 1 (median, 3 vs 4; p = .001). The interval from initial hysteroscopy to conception was significantly shorter in group 2 (median, 12 months vs 51 months; p < .001). CONCLUSIONS: For moderate to severe IUAs, Interceed combined with an IUD may be an alternative approach for reducing adhesion recurrence after hysteroscopic adhesiolysis. SN - 1553-4669 UR - https://www.unboundmedicine.com/medline/citation/27742483/Oxidized_Regenerated_Cellulose_Adhesion_Barrier_Plus_Intrauterine_Device_Prevents_Recurrence_After_Adhesiolysis_for_Moderate_to_Severe_Intrauterine_Adhesions_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1553-4650(16)31112-8 DB - PRIME DP - Unbound Medicine ER -