2019 年 35 巻 1 号 p. 41-45
Objective: We evaluated the prevalence of intrauterine adhesion (IUA) and the effectiveness of placing FD-1 and Interceed in the uterine cavity to prevent IUA after laparoscopic myomectomy.
Design: We evaluated the following: a) the prevalence of IUA in our patient cohort, b) the association, if any, between IUA and the endometrial opening, and c) the effect of prophylactic methods used to prevent IUA in the endometrial opening (+) .
Setting and patients: In this study, a second-look hysteroscopy was performed on 149 women who had previously undergone a laparoscopic myomectomy at Tonan Hospital between 2007 and 2016.
Main outcome and results: The prevalence of IUA in the endometrial opening (-) and (+) group without applying the preventive measures against IUA, was 1.9% and 30.0%, respectively, with significant difference (P<0.01). Considering only the endometrial opening (+) group, the prevalence of IUA in the untreated group and the group that received preventive treatment against IUA was 30.0% and 5.6%, respectively, with significant difference (P<0.05). Additionally, in the endometrial opening (+) group, the prevalence of IUA in the no preventive treatment group, the FD-1 group, and the FD-1 + Interceed group was 30.0%, 0%, 6.5%, respectively, with significant difference between the no preventive treatment group and the FD-1 + Interceed group (P<0.05).
Conclusion: We found that IUA occurred after laparoscopic myomectomy; therefore this procedure has to be performed with care. The placement of FD-1 and Interceed in the uterine cavity was effective in preventing IUA occurrence.