The role of intrauterine balloon after operative hysteroscopy in the prevention of intrauterine adhesions: a prospective controlled study

Objective: To assess the efficacy of intrauterine Balloon in preventing intrauterine adhesions after operative hysteroscopy.Setting: Ain Shams University Hospitals.Design: A prospective controlled study.Materials and methods: 50 women for whom operative Hysteroscopy were indicated, 20 (40%) with intrauterineadhesions (group A), 20 (40%) with uterine fibroids (group B) and 10 (20%) with uterine septa (group C). Each group was classified to two subgroups, subgroup (I) with balloon and subgroup (II) without balloon. Adhesion grade was compared for each patient preoperative and 6-8 weeks postoperative. Foley catheter balloon No 10 F inflated with 3.5 ml of saline with cutting its stem above the cervix, were left intrauterine in patients in subgroup (I).The balloon removed one week postoperative under paracervical anesthesia. Diagnostic Hysteroscopy was performed 6-8 weeks postoperative to evaluate for intrauterine adhesions in all groups.Results: In group (A), 12 (60%) patients were in sub-group I, 8 (66.7%) developed no adhesions and 4 (33.3%)developed adhesions, 8 (40%) patients were in sub-group II, 3 (37.5%) developed no adhesions and 5 (62.5%)developed adhesions. for group (B), 15 (75%) were in sub-group I, from which 13 (86.7%) developed no adhesionsand 2 (13.3%) developed adhesions and 5 (25%) patients were in sub-group II, from which 3 (60%) developed noadhesions, and 2 (40%) developed adhesions. In-group (C), 5 (50%) were in sub-group (I) from which 4 (80%)developed no adhesions and 1 (20%) developed adhesions, the other 5 (50%) in-sub-group (II), 3 (60%) developed no adhesions and 2 (40%) developed adhesions. These results are of clinical and practical importance, although it shows no statistical significance in each group separately (P value 0.05), but when comparing patients in subgroupI to those in subgroup II in the three groups (P value 0.04), it is statistically significant.Conclusion: Intrauterine balloon application after operative Hysteroscopy is of great value in preventing intrauterine adhesions.