Comparison of Anti -adhesion Membrane Plus Intrauterine Device and Chitosan Plus Balloon in Treatment of Severe Intrauterine Adhesions after Transcervical Resection

YI Ling; CUI Yan-ping; HU Qing-lan

doi:10.3969/j.issn.1674-1889.2017.01.006

Abstract：Objective:To compare the therapeutic effects of two kinds of treatment methods, the interceed anti-adhesion membrane plus intrauterine device (IUD) and the Chitosan plus Foley balloon (placing IUD after 48 hours), on severe intrauterine adhesions after routine transcervical resection. Methods:A total of 84 cases who were diagnosed as severe intrauterine adhesion by hysteroscopy from September 2012 to November 2015 were retrospectively analyzed. They were randomly divided into 2 groups:Group 1 (Interceed plus IUD group, 41 cases) in which placed Interceed and IUD after transcervical resection of adhesions (TCRA), and Group 2 (Chitosan plus balloon, 43 cases) in which after separation of adhesions, injected Chitosan in intrauterine, indwelled Foley balloon (removed after 48 hours) and placed IUD. After 3 cycles of oral estrogen and progesterone treatment in both groups, IUDs were removed with a hysteroscopy on the 4th month. Results:There were significant differences in the cure rates of severe intrauterine adhesions between two groups (Z=3.780, P<0.001). There were 56.10%(23/41) cured cases and 36.59%(15/41) improved cases in the group 1. In the group 2, only 13.95%(6/43) cases were cured, and 69.77% (30/43) cases improved. There was no significant difference in the incidence of intrauterine re-adhesions between the 2 groups (χ2=0.036, P=0.850). The increased menstrual volume after TCRA in the group 1 was more than that in the group 2 (t=3.111, P=0.003). There was no significant difference in the pregnancy rate between the 2 groups (χ2=0.403, P=0.526). Conclusions:With estrogen and progesterone treatment after TCRA, the Interceed anti adhesion membrane plus IUD can effectively improve uterine cavity shape and menstrual volume in those patients with severe intrauterine adhesions, which is better than Chitosan plus Foley balloon.