Influence of auto-cross-linked hyaluronic acid gel on pregnancy rate and hysteroscopic outcomes following surgical removal of intra-uterine adhesions

Thubert, T.; Dussaux, Chloé; Demoulin, G.; Rivain, A L; Trichot, C.; Deffieux, X.

doi:10.1016/j.ejogrb.2015.06.025

Cited by 30 publications

(22 citation statements)

References 26 publications

(29 reference statements)

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“…Approximately 7 days after the application, ACP is completely reabsorbed (11). The ACP gel application in hysteroscopy for subfertility and operative hysteroscopy resulted in statistical significantly lower rates of IUAs (12,13), whereas in other studies no reduction of IUAs were reported after operative hysteroscopy and hysteroscopic adhesiolysis (14,15).…”

mentioning

confidence: 97%

Prevalence of intrauterine adhesions after the application of hyaluronic acid gel after dilatation and curettage in women with at least one previous curettage: short-term outcomes of a multicenter, prospective randomized controlled trial

Hooker

Leeuw

Ven

et al. 2017

Fertility and Sterility

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mentioning

confidence: 97%

Prevalence of intrauterine adhesions after the application of hyaluronic acid gel after dilatation and curettage in women with at least one previous curettage: short-term outcomes of a multicenter, prospective randomized controlled trial

Hooker

Leeuw

Ven

et al. 2017

Fertility and Sterility

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“…A number of modalities are in use to prevent these adhesions such as mechanical agents (intrauterine device), fluid agents (Seprafilm and Hyalobarrier), and postoperative systemic treatment (estroprogestative treatment) after operative hysteroscopy. [ 23 24 ] However, none have shown to prevent adhesions or improve the reproductive outcome. [ 23 24 25 ] Hormonal treatment with estradiol valerate in a dose of 4 mg per day for 6 weeks was administered in our study.…”

Section: Discussionmentioning

confidence: 99%

“…[ 23 24 ] However, none have shown to prevent adhesions or improve the reproductive outcome. [ 23 24 25 ] Hormonal treatment with estradiol valerate in a dose of 4 mg per day for 6 weeks was administered in our study. Estrogens help by the induction of endometrial growth when used alone or in combination with progesterone.…”

Section: Discussionmentioning

confidence: 99%

A prospective randomized study comparing unipolar versus bipolar hysteroscopic myomectomy in infertile women

et al. 2017

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Study Objective:To compare the operative and reproductive outcome of hysteroscopic myomectomy using unipolar resectoscope versus bipolar resectoscope in patients with infertility and menorrhagia.Design:Randomized, prospective, parallel, comparative, single-blinded study.Design Classification:Canadian Task Force classification I.Setting:Tertiary care institute.Patients:Sixty women with submucous myoma and infertility.Interventions:Hysteroscopic myomectomy performed with unipolar resectoscope or bipolar resectoscope.Measurements:Primary outcome measures were the pregnancy-related indicators. Secondary outcome measures were the operative parameters, harmful outcomes related to the procedure, and comparison of improvement levels in the menstrual pattern after surgery between the two groups.Main Results:A total of 60 patients were randomized into two groups of equal size. Baseline characteristics were not significantly different between the two groups. Reduction in sodium level from pre- to postsurgery was significantly (P = 0.001) higher in the unipolar group. Nine patients (30%) in the unipolar group had hyponatremia in the postoperative period compared to none in the bipolar group (P = 0.002). However, there was no significant difference in the other operative parameters between the two groups. In both the groups, a significant improvement in the menstrual symptoms was observed after myomectomy. Pregnancy-related outcomes were similar in both the groups.Conclusion:The use of bipolar resectoscope for hysteroscopic myomectomy is associated with lesser risk of hyponatremia compared to unipolar resectoscope. Bipolar resectoscopic myomectomy is found to be an effective and safer alternative to unipolar resectoscopy with similar reproductive outcome.

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“…The timing of the post-operative hysteroscopy was determined according to previous studies on the occurrence of post-operative intrauterine adhesions. 7 8 The hysteroscopic findings on that follow up hysteroscopy were classified according to the European Society of Gynecologic Endoscopy (ESGE) classification for intrauterine adhesions. 9 …”

Section: Methodsmentioning

confidence: 99%

Hysteroscopic removal of retained products of conception following first trimester medical abortion

Smorgick

Levinsohn-Tavor

Ben‐Ami

et al. 2017

Gynecology and Minimally Invasive Therapy

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Study Objective:To investigate the use of operative hysteroscopy instead of traditional curettage in women with retained products of conception (RPOC) following first trimester medical abortion, with the aim of reducing post-operative intrauterine adhesions.Design:Retrospective study.Setting:Gynecology department in a University affiliated hospital.Patients:All women treated by hysteroscopy for RPOC following first trimester medical abortion using the mifepristone-misoprostol protocol for pregnancy termination or the misoprostol protocol for early missed abortion from January 2013 to August 2016.Intervention:Operative hysteroscopy for removal of RPOC. Post-operative intrauterine adhesions were assessed by diagnostic office hysteroscopy after 6–8 weeks.Measurements and Main Results:50 cases were identified. The mean time from medication administration to the operative hysteroscopy was 1.7 ± 0.7 months. Operative hysteroscopy with blunt use of the resectoscopic loop was used to remove all specimens, and all procedures were completed without intra-operative complications. Two patients (4.0%) were readmitted for fever. Pathology confirmed the presence of RPOC in 45 (90.0%) cases. On follow-up office hysteroscopy, a normal uterine cavity without evidence of intrauterine adhesions was seen in 29/29 (100%) women.Conclusion:Hysteroscopy for removal of RPOC following medical abortion is associated with low rates of complications and post-operative intrauterine adhesions.

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Influence of auto-cross-linked hyaluronic acid gel on pregnancy rate and hysteroscopic outcomes following surgical removal of intra-uterine adhesions

Cited by 30 publications

References 26 publications

Prevalence of intrauterine adhesions after the application of hyaluronic acid gel after dilatation and curettage in women with at least one previous curettage: short-term outcomes of a multicenter, prospective randomized controlled trial

Prevalence of intrauterine adhesions after the application of hyaluronic acid gel after dilatation and curettage in women with at least one previous curettage: short-term outcomes of a multicenter, prospective randomized controlled trial

A prospective randomized study comparing unipolar versus bipolar hysteroscopic myomectomy in infertile women

Hysteroscopic removal of retained products of conception following first trimester medical abortion

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