Department of Obstetrics and Gynaecology, St. George's Hospital and NHS Trust, Blackshaw Road, London, SW17 0QT, UK.
Arch Gynecol Obstet. 2013 Oct;288(4):829-32. doi: 10.1007/s00404-013-2838-4. Epub 2013 Apr 12.
During abdominal myomectomy for removal of multiple fibroids, the uterine cavity may be breached. Repair of the breach is associated with a risk of development of intrauterine adhesions. We conducted a pilot study to evaluate the effectiveness of temporary placement of a Foley's catheter balloon inflated with 30 ml normal saline into uterine cavity at the end of surgery to prevent this complication.
Retrospective cohort study. When the uterine cavity was breached during open myomectomy, it was repaired with a No. 2-0 vicryl suture. A Foley catheter balloon was inserted into the uterine cavity at the end of the procedure, and the balloon distended with 30 ml of normal saline. The balloon was removed on the fourth post-operative day. Follow-up hysteroscopy was performed after 6 months.
At the time of follow-up hysteroscopy 6 months after the myomectomy, we found no intrauterine adhesions in 16 consecutive women treated with balloon, compared to 3 out of 10 (30 %) historical controls where the balloon was not used.
A Foley catheter balloon inserted into the uterine cavity following breach and repair of the uterine cavity at open myomectomy appears to prevent the formation of intrauterine adhesions.
在进行腹部子宫肌瘤切除术以切除多个肌瘤时，可能会穿透子宫腔。修复该破裂处与发生宫内粘连的风险相关。我们进行了一项初步研究，以评估在手术结束时将 30ml 生理盐水注入子宫腔的 Foley 导管球囊临时放置以预防这种并发症的有效性。
回顾性队列研究。当开腹子宫肌瘤切除术时子宫腔破裂，用 2-0 vicryl 缝线修复。手术结束时将 Foley 导管球囊插入子宫腔，并用 30ml 生理盐水使球囊膨胀。术后第 4 天取出球囊。术后 6 个月进行随访宫腔镜检查。
在子宫肌瘤切除术 6 个月后的随访宫腔镜检查中，我们发现接受球囊治疗的 16 名连续女性中无一例发生宫内粘连，而未使用球囊的 10 名历史对照中有 3 例（30%）发生宫内粘连。
在开腹子宫肌瘤切除术中，在子宫腔破裂和修复后将 Foley 导管球囊插入子宫腔似乎可以预防宫内粘连的形成。
