Effectiveness of auto-crosslinked hyaluronic acid gel in the prevention of intrauterine adhesions after hysteroscopic surgery: a prospective, randomized, controlled study.
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.
Guida
Maurizio
M
Department of Obstetrics and Gynecology, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy.
Acunzo
Giuseppe
G
Di Spiezio Sardo
Attilio
A
Bifulco
Giuseppe
G
Piccoli
Roberto
R
Pellicano
Massimiliano
M
Cerrota
Giuseppe
G
Cirillo
Domenico
D
Nappi
Carmine
C
D000328:Adult; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D015994:Incidence; D011134:Polysaccharides / Q000008:administration & dosage / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013997:Time Factors; D000267:Tissue Adhesions / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control; D014591:Uterine Diseases / Q000473:pathology / Q000517:prevention & control*; D014599:Uterus
D011134:Polysaccharides; C431864:auto-cross-linked polysaccharide