title: Efficacy of a polyethylene oxide-sodium carboxymethylcellulose gel in prevention of intrauterine adhesions after hysteroscopic surgery.
abstract: OBJECTIVE
  To assess the efficacy of a polyethylene oxide-sodium carboxymethylcellulose gel (Intercoat; Gynecare, division of Ethicon, Inc., Somerville, NJ) in preventing the development of de novo intrauterine adhesions (IUAs) after hysteroscopic surgery and to rate the patency of the internal uterine ostium at 1-month follow-up diagnostic hysteroscopy.
  
  
  METHODS
  Randomized controlled study (Canadian Task Force classification I).
  
  
  METHODS
  University hospital.
  
  
  METHODS
  One hundred ten patients diagnosed during office hysteroscopy as having single or multiple lesions suitable for surgical treatment or resistant dysfunctional uterine bleeding requiring endometrial ablation.
  
  
  METHODS
  Patients were randomized to 2 groups. Group 1 underwent hysteroscopic surgery plus intrauterine application of Intercoat gel, and group 2 underwent hysteroscopic surgery only (control group). Follow-up office hysteroscopy was performed at 1 month after surgery to assess the rate and severity of IUA formation and to rate the patency of the internal uterine ostium after the surgical intervention.
  
  
  RESULTS
  Compared with the group 2, group 1 demonstrated a significant reduction in the incidence (6% vs 22%; p <.05) of de-novo IUAs. Application of the gel seemed to reduce the severity of IUAs, with fewer moderate and severe IUAs at follow-up in group 1 in comparison with group 2 (33% vs 92%). Furthermore, group 1 demonstrated significant improvement in the degree of patency of the internal uterine ostium (41.9% of cases) in comparison with diagnostic office hysteroscopy performed at enrollment (p <.05). In contrast, in group 2, worsening of patency of the internal uterine ostium was recorded in 18.2% of cases (p <.05).
  
  
  CONCLUSIONS
  Intercoat gel seems to prevent de novo formation of IUAs and to improve the patency of the internal uterine ostium at follow-up hysteroscopy. However, larger studies are needed to confirm these findings.
authors.affiliation: Department of Gynaecology and Obstetrics, and Pathophysiology of Human Reproduction, University of Naples Federico II, Naples, Italy.
authors.forename: Attilio
authors.initials: A
authors.lastname: Di Spiezio Sardo
authors.forename: Marialuigia
authors.initials: M
authors.lastname: Spinelli
authors.forename: Silvia
authors.initials: S
authors.lastname: Bramante
authors.forename: Marianna
authors.initials: M
authors.lastname: Scognamiglio
authors.forename: Elena
authors.initials: E
authors.lastname: Greco
authors.forename: Maurizio
authors.initials: M
authors.lastname: Guida
authors.forename: Vito
authors.initials: V
authors.lastname: Cela
authors.forename: Carmine
authors.initials: C
authors.lastname: Nappi
mesh_terms: D000328:Adult; D002266:Carboxymethylcellulose Sodium / Q000627:therapeutic use*; D005260:Female; D005782:Gels; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects*; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011446:Prospective Studies; D016037:Single-Blind Method; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control; D014591:Uterine Diseases / Q000209:etiology / Q000517:prevention & control*
chemical_list: D005782:Gels; D011092:Polyethylene Glycols; D002266:Carboxymethylcellulose Sodium