Tags

Type your tag names separated by a space and hit enter

Auto-Cross-Linked Hyaluronic Acid Gel for Prevention of Intrauterine Adhesions after Hysteroscopic Adhesiolysis: A Randomized Controlled Trial.
J Minim Invasive Gynecol. 2021 02; 28(2):307-313.JM

Abstract

STUDY OBJECTIVE

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

DESIGN

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

SETTING

A tertiary university hospital.

PATIENTS

Two hundred seventy-two patients with moderate-to-severe (American Fertility Society [AFS] score ≥5) IUAs underwent hysteroscopic adhesiolysis.

INTERVENTIONS

The patients were randomized to receive standard care along with auto-cross-linked hyaluronic acid gel after 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

Two hundred sixty patients were eligible and randomized; 245 patients successfully completed the study (n = 122 in treatment group, and n = 123 in control group). The primary outcome measure was IUA recurrence at second-look hysteroscopy. The secondary outcome measures included an improvement in the AFS score and menstrual pattern. There was no significant difference with regard to IUA recurrence (31.1% vs 39.8%) or median AFS score at second-look hysteroscopy (2, interquartile range [2-4] vs 2, interquartile range [2-4]) or improvement in the menstrual pattern at 3-month follow-up (87.7% vs 76.4%), in the treatment and control groups, respectively.

CONCLUSION

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

Authors+Show Affiliations

Department of Hysteroscopic Center, Fuxing Hospital, The Eighth Clinical Medical College, Capital Medical University, Beijing (Drs. Shi, X. Huang, R. Huang, Li, Zhou, and Zhao, and Ms. Xia).Department of Hysteroscopic Center, Fuxing Hospital, The Eighth Clinical Medical College, Capital Medical University, Beijing (Drs. Shi, X. Huang, R. Huang, Li, Zhou, and Zhao, and Ms. Xia); Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR (Drs. Shi, Saravelos, and Li), China.Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR (Drs. Shi, Saravelos, and Li), China; IVF Unit, Hammersmith Hospital, Imperial College, London (Dr. Saravelos), United Kingdom.Department of Hysteroscopic Center, Fuxing Hospital, The Eighth Clinical Medical College, Capital Medical University, Beijing (Drs. Shi, X. Huang, R. Huang, Li, Zhou, and Zhao, and Ms. Xia).Department of Hysteroscopic Center, Fuxing Hospital, The Eighth Clinical Medical College, Capital Medical University, Beijing (Drs. Shi, X. Huang, R. Huang, Li, Zhou, and Zhao, and Ms. Xia).Department of Hysteroscopic Center, Fuxing Hospital, The Eighth Clinical Medical College, Capital Medical University, Beijing (Drs. Shi, X. Huang, R. Huang, Li, Zhou, and Zhao, and Ms. Xia).Department of Hysteroscopic Center, Fuxing Hospital, The Eighth Clinical Medical College, Capital Medical University, Beijing (Drs. Shi, X. Huang, R. Huang, Li, Zhou, and Zhao, and Ms. Xia).Department of Hysteroscopic Center, Fuxing Hospital, The Eighth Clinical Medical College, Capital Medical University, Beijing (Drs. Shi, X. Huang, R. Huang, Li, Zhou, and Zhao, and Ms. Xia); Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR (Drs. Shi, Saravelos, and Li), China. Electronic address: tinchiu.li@gmail.com.

Pub Type(s)

Journal Article
Randomized Controlled Trial

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, vol. 28, no. 2, 2021, pp. 307-313.
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. 2021;28(2):307-313.
Zhou, Q., Shi, X., Saravelos, S., Huang, X., Zhao, Y., Huang, R., Xia, E., & Li, T. C. (2021). Auto-Cross-Linked Hyaluronic Acid Gel for Prevention of Intrauterine Adhesions after Hysteroscopic Adhesiolysis: A Randomized Controlled Trial. Journal of Minimally Invasive Gynecology, 28(2), 307-313. 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. 2021;28(2):307-313. 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/pubmed PY - 2021/5/4/medline PY - 2020/7/19/entrez KW - Adhesion recurrence KW - Adhesion reformation KW - Asherman syndrome KW - Hyaluronic acid gel KW - Hysteroscopy SP - 307 EP - 313 JF - Journal of minimally invasive gynecology JO - J Minim Invasive Gynecol VL - 28 IS - 2 N2 - STUDY OBJECTIVE: To investigate auto-cross-linked hyaluronic acid gel for the prevention of intrauterine adhesion (IUA) recurrence after hysteroscopic adhesiolysis. DESIGN: A single-center, double-blinded randomized controlled trial. SETTING: A tertiary university hospital. PATIENTS: Two hundred seventy-two patients with moderate-to-severe (American Fertility Society [AFS] score ≥5) IUAs underwent hysteroscopic adhesiolysis. INTERVENTIONS: The patients were randomized to receive standard care along with auto-cross-linked hyaluronic acid gel after 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: Two hundred sixty patients were eligible and randomized; 245 patients successfully completed the study (n = 122 in treatment group, and n = 123 in control group). The primary outcome measure was IUA recurrence at second-look hysteroscopy. The secondary outcome measures included an improvement in the AFS score and menstrual pattern. There was no significant difference with regard to IUA recurrence (31.1% vs 39.8%) or median AFS score at second-look hysteroscopy (2, interquartile range [2-4] vs 2, interquartile range [2-4]) or improvement in the menstrual pattern at 3-month follow-up (87.7% vs 76.4%), in the treatment and control groups, respectively. CONCLUSION: The application of auto-cross-linked hyaluronic acid gel did not seem to improve IUA recurrence after 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 -