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Auto-Cross-Linked Hyaluronic Acid Gel for Prevention of Intrauterine Adhesions after Hysteroscopic Adhesiolysis: A Randomized Controlled Trial.
J Minim Invasive Gynecol. 2020 Jul 15 [Online ahead of print]JM

Abstract

STUDY OBJECTIVE

To investigate auto-cross-linked hyaluronic acid gel for prevention of intrauterine adhesion (IUA) recurrence after hysteroscopic adhesiolysis.

DESIGN

A single-center, double blind, randomized controlled trial.

SETTING

A tertiary university hospital.

PATIENTS

272 patients with moderate to severe (American Fertility Society score ≥5) IUAs underwent hysteroscopic adhesiolysis.

INTERVENTIONS

Patients were randomized to receive standard care along with auto-cross-linked hyaluronic acid gel following surgery (treatment group) or standard care only (control group). All patients had second-look hysteroscopy at 4 weeks and hormonal therapy for 2 cycles after surgery.

MEASUREMENTS AND MAIN RESULTS

260 patients were eligible and randomized while 245 patients successfully completed the study (n = 122 in treatment group; n = 123 in control group). Primary outcome measure was IUA recurrence at second-look hysteroscopy. Secondary outcome measures included improvement in American Fertility Society score and menstrual pattern. There was no significant difference with regard to IUA recurrence (31.1% vs 39.8%) or median American Fertility Society score at second-look hysteroscopy (2, interquartile range [2-4] vs 2, interquartile range [2-4]) or improvement in menstrual pattern at 3-months follow-up (87.7% vs 76.4%), in treatment and control groups, respectively.

CONCLUSION

The application of auto-cross-linked hyaluronic acid gel did not appear to improve IUA recurrence following hysteroscopic adhesiolysis.

Authors+Show Affiliations

Department of Hysteroscopic Center, Fuxing Hospital, the Eighth Clinical Medical College, Capital Medical University, Beijing, China.Department of Hysteroscopic Center, Fuxing Hospital, the Eighth Clinical Medical College, Capital Medical University, Beijing, China; Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR.Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR; IVF Unit, Hammersmith Hospital, Imperial College, London, UK.Department of Hysteroscopic Center, Fuxing Hospital, the Eighth Clinical Medical College, Capital Medical University, Beijing, China.Department of Hysteroscopic Center, Fuxing Hospital, the Eighth Clinical Medical College, Capital Medical University, Beijing, China.Department of Hysteroscopic Center, Fuxing Hospital, the Eighth Clinical Medical College, Capital Medical University, Beijing, China.Department of Hysteroscopic Center, Fuxing Hospital, the Eighth Clinical Medical College, Capital Medical University, Beijing, China.Department of Hysteroscopic Center, Fuxing Hospital, the Eighth Clinical Medical College, Capital Medical University, Beijing, China; Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR. Electronic address: tinchiu.li@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32681996

Citation

Zhou, Qiaoyun, et al. "Auto-Cross-Linked Hyaluronic Acid Gel for Prevention of Intrauterine Adhesions After Hysteroscopic Adhesiolysis: a Randomized Controlled Trial." Journal of Minimally Invasive Gynecology, 2020.
Zhou Q, Shi X, Saravelos S, et al. Auto-Cross-Linked Hyaluronic Acid Gel for Prevention of Intrauterine Adhesions after Hysteroscopic Adhesiolysis: A Randomized Controlled Trial. J Minim Invasive Gynecol. 2020.
Zhou, Q., Shi, X., Saravelos, S., Huang, X., Zhao, Y., Huang, R., Xia, E., & Li, T. C. (2020). Auto-Cross-Linked Hyaluronic Acid Gel for Prevention of Intrauterine Adhesions after Hysteroscopic Adhesiolysis: A Randomized Controlled Trial. Journal of Minimally Invasive Gynecology. https://doi.org/10.1016/j.jmig.2020.06.030
Zhou Q, et al. Auto-Cross-Linked Hyaluronic Acid Gel for Prevention of Intrauterine Adhesions After Hysteroscopic Adhesiolysis: a Randomized Controlled Trial. J Minim Invasive Gynecol. 2020 Jul 15; PubMed PMID: 32681996.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Auto-Cross-Linked Hyaluronic Acid Gel for Prevention of Intrauterine Adhesions after Hysteroscopic Adhesiolysis: A Randomized Controlled Trial. AU - Zhou,Qiaoyun, AU - Shi,Xiaoyu, AU - Saravelos,Sotirios, AU - Huang,Xiaowu, AU - Zhao,Yuting, AU - Huang,Rui, AU - Xia,Enlan, AU - Li,Tin Chiu, Y1 - 2020/07/15/ PY - 2020/04/02/received PY - 2020/05/27/revised PY - 2020/06/01/accepted PY - 2020/7/19/entrez PY - 2020/7/19/pubmed PY - 2020/7/19/medline KW - Adhesion recurrence KW - Adhesion reformation KW - Asherman syndrome KW - Hyaluronic acid gel KW - Hysteroscopy JF - Journal of minimally invasive gynecology JO - J Minim Invasive Gynecol N2 - STUDY OBJECTIVE: To investigate auto-cross-linked hyaluronic acid gel for prevention of intrauterine adhesion (IUA) recurrence after hysteroscopic adhesiolysis. DESIGN: A single-center, double blind, randomized controlled trial. SETTING: A tertiary university hospital. PATIENTS: 272 patients with moderate to severe (American Fertility Society score ≥5) IUAs underwent hysteroscopic adhesiolysis. INTERVENTIONS: Patients were randomized to receive standard care along with auto-cross-linked hyaluronic acid gel following surgery (treatment group) or standard care only (control group). All patients had second-look hysteroscopy at 4 weeks and hormonal therapy for 2 cycles after surgery. MEASUREMENTS AND MAIN RESULTS: 260 patients were eligible and randomized while 245 patients successfully completed the study (n = 122 in treatment group; n = 123 in control group). Primary outcome measure was IUA recurrence at second-look hysteroscopy. Secondary outcome measures included improvement in American Fertility Society score and menstrual pattern. There was no significant difference with regard to IUA recurrence (31.1% vs 39.8%) or median American Fertility Society score at second-look hysteroscopy (2, interquartile range [2-4] vs 2, interquartile range [2-4]) or improvement in menstrual pattern at 3-months follow-up (87.7% vs 76.4%), in treatment and control groups, respectively. CONCLUSION: The application of auto-cross-linked hyaluronic acid gel did not appear to improve IUA recurrence following hysteroscopic adhesiolysis. SN - 1553-4669 UR - https://www.unboundmedicine.com/medline/citation/32681996/Auto_Cross_Linked_Hyaluronic_Acid_Gel_for_Prevention_of_Intrauterine_Adhesions_after_Hysteroscopic_Adhesiolysis:_A_Randomized_Controlled_Trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1553-4650(20)30337-X DB - PRIME DP - Unbound Medicine ER -
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