Analysis of clinical efficacy of moderate and severe intrauterine adhesions following uterine arterial embolization

Abstract

Objective To evaluate the efficacy of moderate and severe intrauterine adhesion (IUA) following uterine arterial embolization (UAE) after hysteroscopic adhesiolysis. Methods A analysis of clinical efficacyl was performed. According to American Fertility Society (AFS) scoring system, 60 cases following UAE were used for the observation group, 60 cases without following UAE were used for the control group. Hysteroscopic adhesiolysis was performed in two groups. Second-look hysteroscopic examination was performed to all patients at 3 months postoperatively for evaluation of IUA. Primary endpoint was the reduction rate of IUA at 3months afer hysteroscopic adhesiolysis. The secondary endpoint includes total AFS score, and score of each individual AFS category. Results At 3 months after surgery, the observasion group resulted in significantly lower effective rate for reduction of adhesion, the effctive rate were 37.04% (20/54) and 82.46% (47/57)(P<0.05); the tatal AFS score of the observation group (6.06±3.18), and significantly lower than that of the control group (3.88±3.01, P<0.05), meanwhile, with regard to their adhension area, adhension type, menstrual pattern, the score of the observation group (1.78±1.37, 2.50±1.51, 1.78±0.74), and significantly lower than that of the control group (1.12±0.93, 1.89±1.51, 0.86±0.99) (P=0.004, 0.037, 0.01). The observation group had singnificantly lower proportion than that of the control group (P<0.05). Conclusions The women with moderate and severe intrauterine adhesion following UAE had singnificantly the lower effective rate for reduction of adhesion, the higher rate of re adhesion and the poorer outcome of regerenation after hysteroscopic adhesiolysis. Gynecologist strictly grasps indications of uterine arterial embolization. Key words: Embolization, therapeutic/AE; Uterine diseases/ET/TH; Tissue adhesions/ET/TH