Effectiveness of auto-cross-linked hyaluronic acid gel in the prevention of intrauterine adhesions after hysteroscopic adhesiolysis: a prospective, randomized, controlled study.
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.
Acunzo
Giuseppe
G
Department of Obstetrics and Gynaecology, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy. nappi@unina.it
Guida
Maurizio
M
Pellicano
Massimiliano
M
Tommaselli
Giovanni Antonio
GA
Di Spiezio Sardo
Attilio
A
Bifulco
Giuseppe
G
Cirillo
Domenico
D
Taylor
Alex
A
Nappi
Carmine
C
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005782:Gels; D006801:Humans; D015907:Hysteroscopy; D011134:Polysaccharides / Q000737:chemistry* / Q000627:therapeutic use*; D012720:Severity of Illness Index; D000267:Tissue Adhesions / Q000517:prevention & control / Q000601:surgery*; D014591:Uterine Diseases / Q000175:diagnosis / Q000517:prevention & control* / Q000601:surgery*
D005782:Gels; D011134:Polysaccharides; C431864:auto-cross-linked polysaccharide