Dao Shouli, Zhang Lijun, Liu Chunhua, Tan Huafeng, Yang Junqi, Zou Kani, Wang Shubi
Department of Gynecology, Liupanshui Maternal and Child Health Hospital, Liupanshui, China.
Shuicheng District Maternal and Child Health Hospital, Liupanshui, China.
J Obstet Gynaecol. 2025 Dec;45(1):2500970. doi: 10.1080/01443615.2025.2500970. Epub 2025 Jun 2.
Intrauterine adhesion (IUA) often recurs after surgery, and hysteroscopic follow-up is essential for early detection. However, the ideal timing for follow-up is uncertain. This study examines how different follow-up timings affect IUA recurrence after surgery.
All patients (142) who received hysteroscopic surgery in our hospital between 1 January 2021 and 31 November 2024 were retrospectively recruited using the convenience sampling method. The patients were retrospectively divided into two groups based on the timing of postoperative hysteroscopic follow-up. Group A ( 71) underwent a routine follow-up at 3 months postoperatively, whereas Group B ( 71) had an early follow-up at 14 days, with additional follow-ups after each menstrual cycle for 3 months. The primary outcomes measured were uterine cavity morphology and menstrual improvement 3 months post-surgery. The recovery of uterine cavity morphology and menstrual improvement after 3 months of follow-up were compared between the two groups.
There was a significant positive correlation between the recovery of uterine cavity morphology and the number of postoperative hysteroscopies in Group B ( = 0.335, < 0.001). After 3 months following the operation, the improvement of menstruation ( = -3.423, = 0.001) and the recovery of uterine morphology ( = -3.741, = 0.001) in Group B were better than those in Group A, and the difference was statistically significant.
Early and regular hysteroscopy in patients with IUA undergoing hysteroscopic adhesion separation is effective in restoring uterine cavity morphology, preventing re-adhesion and improving menstruation.
宫腔粘连(IUA)术后常复发,宫腔镜随访对于早期发现至关重要。然而,理想的随访时机尚不确定。本研究探讨不同的随访时机如何影响术后IUA的复发。
采用便利抽样法,回顾性纳入2021年1月1日至2024年11月31日在我院接受宫腔镜手术的所有患者(142例)。根据术后宫腔镜随访时机将患者回顾性分为两组。A组(71例)术后3个月进行常规随访,而B组(71例)在术后14天进行早期随访,并在随后的3个月经周期中每个周期后进行额外随访。主要测量指标为术后3个月时的子宫腔形态和月经改善情况。比较两组随访3个月后子宫腔形态的恢复情况和月经改善情况。
B组子宫腔形态的恢复与术后宫腔镜检查次数之间存在显著正相关(r = 0.335,P < 0.001)。术后3个月,B组月经改善情况(t = -3.423,P = 0.001)和子宫形态恢复情况(t = -3.741,P = 0.001)均优于A组,差异有统计学意义。
接受宫腔镜粘连分离术的IUA患者早期定期进行宫腔镜检查,对于恢复子宫腔形态、预防再次粘连和改善月经有效。