Clinical effect of intrauterine balloon versus intrauterine device after transcervical resection of adhesions

Abstract:

Objective：To investigate the clinical effect of intrauterine balloon versus intrauterine device（IUD） as an adjuvant therapy after transcervical resection of adhesions（TCRA）. Methods：A total of 80 patients who were diagnosed with intrauterine adhesion and underwent TCRA in our department from August 2014 to July 2016 and selected intrauterine balloon or IUD as a barrier after surgery were enrolled. Among these patients，24 used intrauterine balloon to prevent readhesion after TCRA，and 56 used IUD. All patients underwent hysteroscopy again within three months after initial hysteroscopy. Results：There were no significant differences between the two groups in age，number of times of pregnancy-related curettage，American Fertility Association（AFS） score before treatment，menstruation，degree of adhesion，and postoperative follow-up time（P>0.05）. There was no significant difference in recovery of men－struation between the two groups after treatment（P>0.05）. The intrauterine balloon group had a pregnancy rate of 54.2%（13/24） and a live birth rate of 8.33%（2/24），and the IUD group had a pregnancy rate of 48.2%（27/56） and a live birth rate of 21.42%（12/56）；there were no significant differences between the two groups（P>0.05）. There were significant differences between the two groups in AFS score before the second hysteroscopy（2.50±2.41 vs. 1.06±1.65，P<0.05），time to pregnancy after surgery（11.23±6.93 vs. 6.89±4.39，P<0.05），and recovery of uterine morphology（P<0.05）. Conclusion：As the anti-adhesion barrier after TRCA，IUD is ad－vantageous over intrauterine balloon in improving postoperative AFS score，shortening the time to pregnancy，and promoting the re－covery of uterine morphology. The method for the application of intrauterine balloon after TRCA needs further discussion.