Optimal timing of hysteroscopic follow-up to prevent the recurrence of intrauterine adhesions: a retrospective study

J Obstet Gynaecol. 2025 Dec;45(1):2500970. doi: 10.1080/01443615.2025.2500970. Epub 2025 Jun 2.

Abstract

Background: 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.

Methods: 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 (n = 71) underwent a routine follow-up at 3 months postoperatively, whereas Group B (n = 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.

Results: There was a significant positive correlation between the recovery of uterine cavity morphology and the number of postoperative hysteroscopies in Group B (r = 0.335, P < 0.001). After 3 months following the operation, the improvement of menstruation (Z = -3.423, P = 0.001) and the recovery of uterine morphology (Z = -3.741, P = 0.001) in Group B were better than those in Group A, and the difference was statistically significant.

Conclusion: 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.

Keywords: Oestrogen; hysteroscopic; intrauterine adhesions; intrauterine device; progesterone.

Plain language summary

This study investigates the impact of different follow-up timings for hysteroscopic surgery on intrauterine adhesions (IUA) recurrence after treatment. Between 1 January 2021 and 1 January 2024, 142 patients were divided into two groups based on the timing of their second postoperative examination. Group A had a routine review 3 months following surgery, whereas Group B had multiple follow-ups starting 14 days post-surgery. The results showed that Group B had significantly better recovery in uterine cavity morphology and menstrual improvement after 3 months. The study concludes that early and regular hysteroscopic follow-ups are effective in restoring uterine cavity shape, preventing re-adhesion and improving menstruation in patients with IUA post-surgery.

MeSH terms

  • Adult
  • Aftercare* / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Hysteroscopy* / methods
  • Hysteroscopy* / statistics & numerical data
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Secondary Prevention* / methods
  • Time Factors
  • Tissue Adhesions / prevention & control
  • Tissue Adhesions / surgery
  • Uterine Diseases* / prevention & control
  • Uterine Diseases* / surgery
  • Uterus / pathology
  • Uterus / surgery