The incidence of post-operative adhesion following transection of uterine septum: a cohort study comparing three different adjuvant therapies

Abstract

Objective: To investigate the clinical efficacy of postoperative estrogen therapy, intrauterine device (IUD) and intrauterine balloon in preventing intrauterine adhesions after transcervical resection of septum (TCRS).

Study design: 238 patients who underwent TCRS in our hospital from March 2012 to December 2013 were allocated into one of four groups. In Group 1 (50 patients), women received postoperative estrogen therapy. In Group 2 (59 patients), an intrauterine contraceptive device (IUD) was placed into the uterine cavity at the end of the operation. In Group 3 (75 patients), a Foley catheter with the balloon inflated with 4ml of normal saline solution was placed into the uterine cavity at the end of the operation for five days. In Group 4 (54 patients), women did not receive any of the above treatment (comparison group). All subjects underwent two further hysteroscopy, one and three months after the initial surgery.

Results: The intrauterine adhesion rates among the four groups at one month were 22.0%, 28.81, 26.7% and 24.1% (p>0.05); and at the third month were 0%, 1.7%, 1.3% and 3.4%, respectively (p>0.05).

Conclusions: The use of postoperative estrogen therapy, IUD or intrauterine balloon did not appear to have any benefit in reducing the incidence of postoperative intrauterine adhesion formation.

Keywords: Foley balloon; Intrauterine adhesions; Uterine septum.