Clinical Analysis of 12 Cases of Intrauterine Re-adhesions Treated with Transcervical Resection of Adhesion / 中国微创外科杂志

ABSTRACT

Objective To study the clinical characteristics of intrauterine re-adhesions treated by transcervical resection of adhesion (TCRA). Methods Between January 2012 and January 2015, 12 patients with intrauterine re-adhesions after TCRA in other hospitals had fertility requirements , including 10 cases of severe intrauterine adhesions and 2 cases of moderate intrauterine adhesions .In our hospital , the 12 patients underwent laparoscopic exploration and TCRA .After operation the patients were treated with artificial cycle therapy for 3 months and then underwent hysteroscopic examination . Results In the operation, the remaining of 50%endometrium was found in 1 case, the remaining of 30%endometrium was found in 1 case, and the remaining of 20%endometrium in 9 cases.Only petechial and patchy residual endometrial islands were found in 1 case.Uterine dysplasia was found in 3 cases.Re-examinations of hysteroscopy 3 months after surgery showed 4 cases of uterine cavity normal recovery , 6 cases of moderate intrauterine adhesions, and 2 cases of mild intrauterine adhesions .Follow-up for 18-42 months (mean, 28.5 months) in the 12 cases showed 2 cases of term pregnancy and 1 case of spontaneous abortion .The other 9 patients had no pregnancy , 3 of which withdrew the treatment and 6 of which underwent further treatment . Conclusions Patients with intrauterine re-adhesions usually have seriously damaged endometrium and poor recovery .We suggest that TCRA should be completed by experienced professionals to reduce the residual endometrial destruction , so as to improve the treatment outcomes of intrauterine adhesions .