Dear Colleagues,
Hysteroscopic adhesiolysis is the main clinical treatment for uterine adhesions. The main purpose of surgery is to restore normal uterine shape, but recurrence is still a major problem after operation. Several comprehensive measures are often used to prevent the formation of re-adhesions and promote endometrial regeneration, including estrogen therapy and placement of a uterine barrier. However, the results are not good for patients with moderate and severe uterine adhesions, with the recurrence rate being as high as 62.5%. In recent years, animal experiments and a small number of clinical trials have shown that tissue engineering therapy with stem cells can accelerate the repair of damaged endometrium. However, regardless of the source of stem cells, the new endometrial cells do not have the necessary responsiveness to estrogen and progesterone required to achieve the periodic physiological changes of the endometrial surface.
Our team has spent many years conducting clinical research on the prevention and treatment of intrauterine adhesions. Over the past 10 years we have developed and performed comprehensive adhesion prevention and treatment methods, including sharp separation operative techniques, shortened review time, intrauterine balloon placement, G-CSF intrauterine perfusion, etc. Significant curative effects have been observed using these methods, with higher pregnancy and live birth rates than those reported in the literature. However, the recurrence rate for cases with moderate and severe intrauterine adhesions is still around 25-30%, and the postoperative live birth rate remains less than 60%. Effective prevention of intrauterine adhesions and the promotion of endometrial repair remain difficult problems in clinical practice.
Prof. Dr. Xiaona Lin and Dr. Dongmei Song
Guest Editors
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