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Human Reproduction, Vol. 18, No. 9, 1918-1921, September 2003
© 2003 European Society of Human Reproduction and Embryology

Effectiveness of auto-cross-linked hyaluronic acid gel in the prevention of intrauterine adhesions after hysteroscopic adhesiolysis: a prospective, randomized, controlled study

Giuseppe Acunzo1,3, Maurizio Guida1, Massimiliano Pellicano1, Giovanni Antonio Tommaselli1, Attilio Di Spiezio Sardo1, Giuseppe Bifulco1, Domenico Cirillo1, Alex Taylor2 and Carmine Nappi1

1 Department of Obstetrics and Gynaecology, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy and 2 Minimally Invasive Therapy Unit and Endoscopy Training Centre, University Department of Obstetrics and Gynaecology, Royal Free Hospital, Hampstead, London, UK

3 To whom correspondence should be addressed. e-mail: nappi{at}unina.it

BACKGROUND: A prospective, randomized, controlled study was performed to assess the efficacy of auto-cross-linked hyaluronic acid (ACP) gel in preventing the development of intrauterine adhesions following hysteroscopic adhesiolysis. METHODS: Ninety-two patients with irregular menses and intrauterine adhesions referred to the Hysteroscopic Unit of the University of Naples "Federico II". Patients were randomized to two different groups. Group A were randomized to hysteroscopic adhesiolysis plus intrauterine application of ACP gel (10 ml) and group B were randomized to operative hysteroscopy alone (control group). Baseline adhesion scores were calculated for each patient and at 3 months after surgery. RESULTS: Group A showed a significant decrease in intrauterine adhesions at 3 months follow-up in comparison with the control group. Staging of adhesions showed a significant decrease in adhesion severity in patients treated with ACP gel. CONCLUSIONS: ACP gel significantly reduces the development of intrauterine adhesions postoperatively and its use is likely to be associated with a reduction of severe adhesions.

Key words: adhesion score/hyaluronic acid gel/intrauterine adhesions/operative hysteroscopy


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