- 作者：Songshu Xiao ; Yajun Wan ; Min Xue ; 287932636@qq.com" class="auth_mail ; Xiangyang Zeng ; Fang Xiao ; Dabao Xu ; Xi Yang ; Pu Zhang ; Wen Sheng ; Junlei Xu ; Sai Zhou
- 关键词：Comprehensive treatment ; Hysteroscopic adhesiolysis ; Intrauterine adhesions
- 刊名：International Journal of Gynecology and Obstetrics
- 出版年：May, 2014
- 年：2014
- 卷：125
- 期：2
- 页码：121-124
- 全文大小：172 K
Objective
To analyze data from the hysteroscopic adhesiolysis of moderate-to-severe intrauterine adhesions (IUAs), and to review the disease etiology, changes in menstruation, uterine recovery, and reproductive prognosis of women after comprehensive therapy.Methods
In a retrospective descriptive analysis, clinical data were assessed from 683 patients with moderate-to-severe IUAs who were treated by hysteroscopic adhesiolysis at Third Xiangya Hospital, Changsha, China, between January 2007 and December 2011. Patients underwent comprehensive treatment. After hysteroscopic adhesiolysis, a persistent balloon urinary catheter was inserted, together with an intrauterine device (IUD). Intrauterine sodium hyaluronate gel was injected to prevent adhesion reformation, and oral estrogen was administered to promote endometrial regeneration. The outcomes were menstrual changes and uterine recovery under hysteroscopy, and the reproductive prognosis of patients with fertility intentions.
Results
At the 3-month follow-up, the postoperative recovery of uterine shape was better than the recovery of menstruation among patients with moderate-to-severe IUAs. Among the 475 patients with fertility intentions, the pregnancy and live birth rates were 66.1% (314/475) and 64.0% (201/314), respectively.
Conclusion
Comprehensive treatment prevented the recurrence of IUAs to a certain extent, but some severe endometrial injuries were found to be irreparable, reducing the rate of subsequent pregnancy and live birth.