Prévention des synéchies après hystéroscopie opératoire

Revaux, Aurélie; Ducarme, Guillaume; Luton, Dominique

doi:10.1016/j.gyobfe.2007.11.014

Cited by 28 publications

(4 citation statements)

References 47 publications

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“…Hysteroscopy has a low intraoperative complication rate [24]. Postoperative complications in terms of intrauterine adhesions occur in 10% to 37.5% for the resection of one fibroid and up to 45% for multiple fibroids [2,25].…”

Section: Discussionmentioning

confidence: 99%

Transcervical intrauterine radiofrequency ablation of fibroids in high-risk patients with bleeding disorder

et al. 2022

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Section: Discussionmentioning

confidence: 99%

Transcervical intrauterine radiofrequency ablation of fibroids in high-risk patients with bleeding disorder

et al. 2022

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“…The authors conclude that the use of auto-cross-linked hyaluronic acid gel does not reduce the incidence and the severity of intrauterine adhesions after hysteroscopic surgery. According to a more recent review of the literature [45]—with the first author of the French comparative study [24] as co-author—the majority of the limited published studies until 2008 only evaluated the anatomic efficiency of anti-adhesion agents after hysteroscopic surgery. The authors conclude that the available data for the key reproductive outcomes are not sufficiently convincing to promote the widespread clinical use of anti-adhesive barrier agents as an effective treatment strategy for infertile women treated by operative hysteroscopy, hence their conclusion that additional randomized controlled trials are needed.…”

Section: Discussionmentioning

confidence: 99%

Anti-adhesion barrier gels following operative hysteroscopy for treating female infertility: a systematic review and meta-analysis

et al. 2014

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The aim of this study was to assess the effects of any anti-adhesion barrier gel used after operative hysteroscopy for treating infertility associated with uterine cavity abnormalities. Gynecologists might use any barrier gel following operative hysteroscopy in infertile women for decreasing de novo adhesion formation; the use of any barrier gel is associated with less severe de novo adhesions and lower mean adhesion scores. Nevertheless, infertile women should be counseled that there is at the present no evidence for higher live birth or pregnancy rates. There is a lack of data for the outcome miscarriage. Preclinical studies suggest that the use of biodegradable surgical barriers may decrease postsurgical adhesion formation. Observational studies in the human report conflicting results. We searched the Cochrane Menstrual Disorders and Subfertility Specialized Register (10 April 2013), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2013, Issue 1), MEDLINE (1950 to 4 April 2013), EMBASE (1974 to 4 April 2013), and other electronic databases of trials including trial registers, sources of unpublished literature, and reference lists. We handsearched the Journal of Minimally Invasive Gynecology (from 1 January 1992 to 13 April 2013); we also contacted experts in the field. We included the randomized comparisons between any anti-adhesion barrier gel versus another barrier gel, placebo, or no adjunctive therapy following operative hysteroscopy. Primary outcomes were live birth rates and de novo adhesion formation at second-look hysteroscopy. Secondary outcomes were pregnancy and miscarriage rates, mean adhesion scores, and severity of adhesions at second-look hysteroscopy. Two authors independently assessed eligible studies for inclusion and risk of bias, and extracted data. We contacted primary study authors for additional information or other clarification. Five trials met the inclusion criteria. There is no evidence for an effect favoring the use of any barrier gel following operative hysteroscopy for the key outcomes of live birth or clinical pregnancy (risk ratio (RR) 3.0, 95 % confidence interval (CI) 0.35 to 26, P = 0.32, one study, 30 women, very low quality evidence); there were no data on the outcome miscarriage. The use of any gel following operative hysteroscopy decreases the incidence of de novo adhesions at second-look hysteroscopy at 1 to 3 months (RR 0.65, 95 % CI 0.45 to 0.93, P = 0.02, five studies, 372 women, very low quality evidence). The number needed to treat to benefit is 9 (95 % CI 5 to 33). The use of auto-cross-linked hyaluronic acid gel in women undergoing operative hysteroscopy for fibroids, endometrial polyps, or uterine septa is associated with a lower mean adhesion score at second-look hysteroscopy at 3 months (mean difference (MD) −1.44, 95 % CI −1.83 to −1.05, P < 0.00001, one study, 24 women; this benefit is even larger in women undergoing operative hysteroscopy for intrauterine adhesions(MD −3.30, 95 % CI −3.43 to −3.17, P < 0.00001, one study, 19 women). A...

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“…5 Moreover some other severe consequences have been introduced such as placental adhesion anomalies in the following pregnancies. 6 Hysteroscopy is the most commonly suggested tool to diagnose and treat these complications. 6 Some anti-adhesive materials have been used to prevent postoperative adhesions.…”

mentioning

confidence: 99%

“…6 Hysteroscopy is the most commonly suggested tool to diagnose and treat these complications. 6 Some anti-adhesive materials have been used to prevent postoperative adhesions. 7 Hyaluronic acid gel has been studied to prevent intrauterine adhesions and favorable fertility outcomes have been reported by studies on rabbits.…”

mentioning

confidence: 99%

Using New-Crosslinked Hyaluronic Acid Gel to Prevent Intrauterine Adhesion After Hysteroscopic Septum Resection: A Prospective, Randomized, Controlled Study

Kutlu¹,

Ozkaya²,

Şanverdi³

2018

TJRMS

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Prévention des synéchies après hystéroscopie opératoire

Cited by 28 publications

References 47 publications

Transcervical intrauterine radiofrequency ablation of fibroids in high-risk patients with bleeding disorder

Transcervical intrauterine radiofrequency ablation of fibroids in high-risk patients with bleeding disorder

Anti-adhesion barrier gels following operative hysteroscopy for treating female infertility: a systematic review and meta-analysis

Using New-Crosslinked Hyaluronic Acid Gel to Prevent Intrauterine Adhesion After Hysteroscopic Septum Resection: A Prospective, Randomized, Controlled Study

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