Objective To evaluate the prognosis of comprehensive treatment with a predominance of hysteroscopic eleetrosurgery in the treatment of intrauterine adhesion （IUA）. Methods A retrospective analysis was performed on 218 patients who were treated with hysteroscopic electrosurgery between January 2010 and June 2013 at Huhei Province Maternal and Child Health Hospital. According to the treatment of estrogen dosage and cycles after operation, the patients were divided into A, B and C group. They were treated with 9 mg/day Estradiol valerate（E2V）for three cycles, 6 rag/day E2V for two cycles, 4 mg/day E2V for one cycle, respectively. The shape of uterus cavity and menstrual cycle were evaluated after three months and the pregnancy rate was followed up. Results The shape of uterus cavity returned to basically normal in 86.2% of the patients （188/218）. Menstruation improved in 75.7% of the patients （165/218）. The pregnancy rate after operation was 44.5% （97/218） and the live delivery rate was 48.5% （47/97）. There was no difference in the rate of recovery of uterus cavity and the rate of menstrual improvement between Ⅱ and m degree IUA （P 〉0.05）. But comparing them between Ⅱ and Ⅳ degree of IUA or above, between Ⅲ and Ⅳ degree IUA or above, the difference was significant （P〈0.05）. At the same degree of IUA, there was no difference in the rate of recovery of uterus cavity and the rate of menstrual improvement among group A, B and C （P 〉0.05）. Conclusion The comprehensive treatment with a predominance of hysteroscopic electrosurgery in the treatment of IUA is effective. The prognosis of mild or moderate IUA is better than severe IUA. Reducing dosage of estrogen and shortening treatment cycles appropriately would not affect the prognosis of IUA.
Chinese Journal of Practical Gynecology and Obstetrics
transcervieal resection of adhesions