Ultrasound‐guided repeat intrauterine balloon dilatation for prevention of adhesions

Ludwin, Artur; Martins, Wellington P.; Ludwin, I.

doi:10.1002/uog.20223

Cited by 15 publications

(9 citation statements)

References 8 publications

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“…Recently, due to increased endometrial injury and endometrial infection, the incidence of IUA has increased [2]. At the present, standard therapies for IUA, such as transcervical resection of adhesions, have been widely applied to cure patients with IUA, but the recurrence rate after treatment remains high [1,3]. Specifically, severe IUA is closely related to secondary infertility and miscarriage [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

MiR-543 Inhibits the Migration and Epithelial-To-Mesenchymal Transition of TGF-β-Treated Endometrial Stromal Cells via the MAPK and Wnt/β-Catenin Signaling Pathways

Wang

Liu

Wei

et al. 2021

Pathol. Oncol. Res.

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Intrauterine adhesion (IUA) is one of the most prevalent reproductive system diseases in females. MicroRNAs (miRNAs) are reported to be master regulators in a variety of diseases, including IUA, but the role of microRNA-543 (miR-543) in IUA remains to be elucidated. In this study, we observed that miR-543 was downregulated in transforming growth factor-beta (TGF-β)-treated endometrial stromal cells (ESCs). Functionally, we observed that miR-543 suppressed the migration, epithelial-to-mesenchymal transition (EMT), and inhibited expression of extracellular matrix (ECM) proteins in TGF-β-treated ESCs. Mechanistically, MAPK1 is targeted by miR-543 after prediction and screening. A luciferase reporter assay demonstrated that miR-543 complementarily binds with the 3′ untranslated region of mitogen-activated protein kinase 1 (MAPK1), and western blot analysis indicated that miR-543 negatively regulates MAPK1 protein levels. In addition, results from rescue assays showed that miR-543 inhibits the migration and EMT of TGF-β-treated ESCs by targeting MAPK1. In addition, we observed that miR-543 inactivates the Wnt/β-catenin signaling pathway through inhibiting the phosphorylation of MAPK1 and β-catenin. Finally, we confirmed that miR-543 represses migration, EMT and inhibits levels of ECM proteins in TGF-β-treated ESCs by targeting the Wnt/β-catenin signaling pathway. Our results demonstrated that miR-543 suppresses migration and EMT of TGF-β-treated ESCs by targeting the MAPK and Wnt/β-catenin pathways.

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Section: Introductionmentioning

confidence: 99%

MiR-543 Inhibits the Migration and Epithelial-To-Mesenchymal Transition of TGF-β-Treated Endometrial Stromal Cells via the MAPK and Wnt/β-Catenin Signaling Pathways

Wang

Liu

Wei

et al. 2021

Pathol. Oncol. Res.

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“…For example, women with IUA acquired better menstruation after treatment with a Foley catheter balloon as compared with an intrauterine device, and it has been proposed as an adjunctive treatment for IUA . Ultrasound‐guided intrauterine balloon dilatation might even be applied to the adhesiolysis of mild‐to‐moderate IUA, enabling affected women to avoid a hysteroscopic operation . In addition, Wei et al .…”

Section: Discussionmentioning

confidence: 99%

“…14 Ultrasound-guided intrauterine balloon dilatation might even be applied to the adhesiolysis of mild-to-moderate IUA, enabling affected women to avoid a hysteroscopic operation. 8,10 In addition, Wei et al 15 showed that intrauterine balloon placement did not increase the risk of infection and that most women were able to tolerate the procedure. In the present study, therefore, women were treated with balloon dilatation 10 days after surgery to bluntly separate fresh loose adhesions in the cavity and the lower segment of the uterus, preventing the formation of dense and muscle adhesions without the formation of new wounds.…”

Section: Discussionmentioning

confidence: 99%

“…However, the recurrence rate is up to 62.5% . Several methods have been reported for preventing IUA recurrence, such as hyaluronic acid gel, artificial cycle hormone therapy, intrauterine balloon, and intrauterine devices; however, the effects are still uncertain . Therefore, it is important to find a standardized strategy for managing women with IUA after TCRA surgery.…”

Section: Introductionmentioning

confidence: 99%

“…7 Several methods have been reported for preventing IUA recurrence, such as hyaluronic acid gel, artificial cycle hormone therapy, intrauterine balloon, and intrauterine devices; however, the effects are still uncertain. 8 Therefore, it is important to find a standardized strategy for managing women with IUA after TCRA surgery. Xu et al 9 reported that early second-look hysteroscopy after hysteroscopic adhesiolysis (within 2 months) significantly improved IUA reproductive outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Effects of early second‐look hysteroscopy combined with intrauterine balloon dilatation on reproductive outcomes for women with intrauterine adhesions

Sun

Shi

Liang

et al. 2020

Intl J Gynecology & Obste

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Objective:To investigate the effect of early second-look office hysteroscopy combined with intrauterine balloon dilatation on prognosis and pregnancy rate for women with intrauterine adhesions. Methods:A retrospective analysis of 156 women diagnosed with intrauterine adhesions by hysteroscopy at Shenyang Women's and Children 's Hospital, China, from April 2017 to January 2019. The study women underwent intrauterine balloon dilatation 10 days after transcervical resection of adhesion (TCRA) and hysteroscopy 20 days after TCRA (n=81). The control women underwent hysteroscopy 3 months after TCRA (n=75).Estrogen and aspirin were routinely administered postoperatively to all women. Data, including American Fertility Society (AFS) scores assessed by hysteroscopy, endometrial thickness measured by ultrasound, and menstruation and pregnancy outcomes assessed by interview, were compared between the two groups. Results:The degree of intrauterine adhesions, menstrual status, and endometrial thickness were improved in both groups after TCRA. Greater improvement in AFS score, menstruation, and endometrial thickness was observed in the study group than in the control group. After follow-up, more women in the study group achieved pregnancy (48.1% vs 30.7%, P<0.05). Conclusion:Early second-look of hysteroscopy combined with intrauterine balloon dilatation after hysteroscopic TRCA might improve the prognosis and postoperative pregnancy rate for women with intrauterine adhesions. K E Y W O R D S Balloon dilatation; Early second-look; Intrauterine adhesion; Prognosis; Reproductive outcomes; Transcervical resection of adhesion 1 | INTRODUCTION Intrauterine adhesions (IUA), also known as Asherman syndrome, are a common cause of secondary infertility among women of childbearing age. Endometrial damage caused by intrauterine operations or infections are the major causes of IUA, which lead to partial or complete occlusion of the uterine cavity. 1 IUAs are often secondary to intrauterine operations such as dilation and curettage. 2 Most effected women have hypomenorrhea, amenorrhea, and periodic abdominal pain, but a few also have normal menstruation. 2,3 Due to the high rate of induced abortion in China, the incidence of IUA is also increasing. 4 The prevalence of IUA is reported to be approximately | 193 Sun ET AL.20% after induced abortion, but rises to 40% for women with multiple intrauterine operations. 5Hysteroscopy is the gold standard for clinical diagnosis and treatment of IUA, 6 and most confirmed cases are treated by transcervical resection of adhesion (TCRA). However, the recurrence rate is up to 62.5%. 7 Several methods have been reported for preventing IUA recurrence, such as hyaluronic acid gel, artificial cycle hormone therapy, intrauterine balloon, and intrauterine devices; however, the effects are still uncertain. 8 Therefore, it is important to find a standardized strategy for managing women with IUA after TCRA surgery. Xu et al. 9 reported that early second-look hysteroscopy after hysteroscopic adhesiolysis (within...

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Auto–Cross-Linked Hyaluronic Acid Gel for Prevention of Intrauterine Adhesions after Hysteroscopic Adhesiolysis: A Randomized Controlled Trial

Zhou

Shi

Saravelos

et al. 2021

Journal of Minimally Invasive Gynecology

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Ultrasound‐guided repeat intrauterine balloon dilatation for prevention of adhesions

Cited by 15 publications

References 8 publications

MiR-543 Inhibits the Migration and Epithelial-To-Mesenchymal Transition of TGF-β-Treated Endometrial Stromal Cells via the MAPK and Wnt/β-Catenin Signaling Pathways

MiR-543 Inhibits the Migration and Epithelial-To-Mesenchymal Transition of TGF-β-Treated Endometrial Stromal Cells via the MAPK and Wnt/β-Catenin Signaling Pathways

Effects of early second‐look hysteroscopy combined with intrauterine balloon dilatation on reproductive outcomes for women with intrauterine adhesions

Auto–Cross-Linked Hyaluronic Acid Gel for Prevention of Intrauterine Adhesions after Hysteroscopic Adhesiolysis: A Randomized Controlled Trial

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