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Durations of intrauterine balloon therapy and adhesion reformation after hysteroscopic adhesiolysis: a randomized controlled trial

Published:December 10, 2019DOI:https://doi.org/10.1016/j.rbmo.2019.11.017

      Abstract

      Research question

      Does placing an intrauterine balloon for different durations (7, 14 or 28 days) affect the recurrence of intrauterine adhesions after hysteroscopic adhesiolysis?

      Design

      Prospective randomized control trial involving 138 patients recruited over a 12-month period and followed up post-operatively for 15 months. The primary outcome measure was the rate of adhesion reformation at third-look hysteroscopy.

      Results

      At third-look hysteroscopy, 8 weeks after the initial hysteroscopy, the adhesion recurrence rate in women who had an intrauterine balloon for 28 days (20%) was significantly (P < 0.01) lower than that of women who had the balloon for 14 days (55%) or 7 days (36.8%).

      Conclusions

      Placing an intrauterine balloon for 28 days instead of 7 or 14 days after hysteroscopic adhesiolysis resulted in a greater reduction in the recurrence rate of adhesions. However, the study was underpowered to address whether the ongoing pregnancy rate could be improved by keeping the balloon in the uterine cavity for a longer period of time.

      Graphical abstract

      Keywords

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      Biography

      Yuhuan Liu is a Professor of Obstetrics and Gynecology at the Capital Medical University, Beijing, China. She is Director of the Hysteroscopic Center and Gynecology at Fuxing Hospital, Beijing. Her current research focuses on uterine lesions and reproduction.
      Key message
      This randomized controlled trial found that placing an intrauterine balloon for 28 days instead of 7 or 14 days after hysteroscopic adhesiolysis resulted in greater reductions in the recurrence of adhesion.