The Effect of Adjuvant Treatment to Prevent and Treat Intrauterine Adhesions: a Network Meta-Analysis of Randomized Controlled Trials

Publication date: Available online 8 September 2017 Source:Journal of Minimally Invasive Gynecology Author(s): Yu Yan, Dongmei Xu Intrauterine adhesions (IUA) can lead to partial or complete closure of the uterine cavity, which may result in symptoms including abnormal menstruation, infertility, and pelvic pain. A network meta-analysis was performed to assess the effect of adjuvant therapy on the prevention and treatment of intrauterine adhesions. We searched electronic databases, including PubMed, EmBase, and the Cochrane Library, up to May 5, 2017 without language restrictions. The primary outcomes in the present analysis were the rate of IUAs for prevention and the rate of IUA recurrence for treatment. The secondary outcomes included the IUA score and the rate of severity of IUA. The treatments were then ranked by the surface under the cumulative ranking curve (SUCRA). We included 20 articles that involved a total of 1891 patients in our analysis. In the outcomes of prevention-related studies, alginate hyaluronate-carboxymethylcellulose membrane (ACH) (N=10; SUCRA score=93.3%) was the adjuvant treatment that most effectively reduced IUA incidence. It was followed by intercoat (N=10; SUCRA score=74.7%) and misoprostol (N=10; SUCRA score=68.6%). In addition, auto-cross linked hyaluronic acid (ACP) (N=3; SUCRA score=83.2%) and intercoat (N=3; SUCRA score=66.4%) each corresponded to a relatively high preventive effect against severe IUA. In the treatment-related studies, A...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research