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Hum. Reprod. Advance Access published online on April 22, 2004
Human Reproduction, doi:10.1093/humrep/deh238
© 2004 by European Society of Human Reproduction and Embryology
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Received November 4, 2003
Accepted February 19, 2004

Article

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

Maurizio Guida 1, Giuseppe Acunzo 1*, Attilio Di Spiezio Sardo 1, Giuseppe Bifulco 1, Roberto Piccoli 1, Massimiliano Pellicano 1, Giuseppe Cerrota 1, Domenico Cirillo 1, Carmine Nappi 1

1 Department of Obstetrics and Gynecology, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy

* To whom correspondence should be addressed. E-mail: acunzus{at}libero.it.


  Abstract

BACKGROUND: A prospective, randomized, controlled study was performed to assess the efficacy of auto-crosslinked hyaluronic acid (ACP) gel to prevent the development of de-novo intrauterine adhesions following hysteroscopic surgery. METHODS: One hundred and thirty-two patients with a single surgically remediable intrauterine lesion (myomas, polyps and uterine septa, subgroups I-III) completed the study. Patients were randomized to two different groups: group A underwent hysteroscopic surgery plus intrauterine application of ACP gel (10 ml) while group B underwent hysteroscopic surgery alone (control group). The rate of adhesion formation and the adhesion score was calculated for each group and subgroup 3 months after surgery. RESULTS: Group A showed a significant reduction in the development of de-novo intrauterine adhesions at 3 months follow-up in comparison with the control group. Furthermore, the staging of adhesions showed a significant decrease in adhesion severity in patients treated with ACP gel. CONCLUSIONS: ACP gel significantly reduces the incidence and severity of de-novo formation of intrauterine adhesions after hysteroscopic surgery.

Key words: Key words: adhesion score/de-novo intrauterine adhesions/hyaluronic acid gel/hysteroscopic surgery


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