The Role of Special Intrauterine Balloon and Intrauterine Contraceptive Device after TCRA in the Treatment of Intrauterine Adhesions

Abstract

Background It is of vital importance to focus on the prevention of intrauterine adhesion(IUA) relapse. Up to now, which method has a higher efficacy is still a matter of controversy. We tried to find a better method. Methods In this retrospective cohort study, all of the 69 included IUA patients experienced transcervical resection of adhesion(TCRA), and after surgery, 31 patients were placed special intrauterine balloon(IUB) and 38 patients were placed intrauterine contraception device(IUD). All IUA patients had undergone post-operative hormone sequential therapy with estrogen-progesterone and adequate course of antibiotics therapy. Fisher’s exact test, logistic regression method, Kaplan–Meier method and Cox proportional hazards regression model were used for statistical analysis. Results The readhesion rate significantly varied from patients in IUB group and IUD group, in 15.39% and 54.06% respectively(P = 0.002). For recurrent moderate IUA patients, the severity of patients in IUB group had been significantly reduced than IUD group(P = 0.035). For severe IUA patients, cold knife management had a greater advantage than electric instrument(P = 0.011). There was a significant difference in the intrauterine pregnancy rate of IUA patients in IUB group and IUD group after treatment, in 55.56% and 14.29%, respectively(P = 0.015). Conclusions Patients in this special IUB group had better outcomes than IUD. For preventing readhesion and improving conception rate, the use of cold knife during procedure, placing IUB, estrogen therapy and adequate course of antibiotics therapy after TCRA all have positive influence.

The effect of a combined indomethacin and levonorgestrel-releasing intrauterine system on short-term postplacement bleeding profile: a randomized proof-of-concept trial

“…Studies on IND/Cu-IUDs have shown the same or better contraceptive efficacy as Cu-IUDs alone and significantly lower rates of removal for bleeding/pain and discontinuation. [41][42][43] Though overall bleeding patterns with Cu-IUDs and LNG-IUS differ markedly, the reduction of uterine bleeding through the addition of indomethacin to the LNG-IUS 8 device observed in our study is consistent with the beneficial impact on bleeding volume seen with IND/Cu-IUDs.…”