宫腔镜联合腹腔镜行宫颈输卵管插管疏通术效果分析

目的探讨宫腔镜联合腹腔镜行宫颈输卵管插管疏通术治疗输卵管近中段阻塞的效果。方法2000年1月至2004年6月在佛山市第一人民医院选择经腹腔镜下输卵管通液后证实为输卵管近中段阻塞的患者136例,应用宫腔镜联合腹腔镜行宫颈输卵管插管疏通术。结果136例患者224条输卵管近中段阻塞。输卵管外周有粘连者186条,输卵管外观正常仅管腔阻塞38条。术后输卵管通畅154条,疏通率68.75%。64条宫角粘连的输卵管插管失败52条（52/64,81.25%）,插管疏通失败率较无宫角粘连者明显增高（P〈0.01）。随访经双侧插管疏通成功者76例,宫内妊娠28例,宫内妊娠率36.84%;插管侧输卵管妊娠7例,输卵管妊娠率9.21%（7/76）,宫内妊娠率明显高于输卵管妊娠率（P〈0.05）。导管组宫内妊娠率明显高于导丝组（P〈0.01）,两者输卵管妊娠率差异无显著性意义（P〉0.05）。结论宫腔镜联合腹腔镜输卵管插管疏通术对输卵管近中段阻塞有较好的治疗效果,影响输卵管疏通和术后妊娠率的因素主要是输卵管阻塞程度及是否有宫角粘连。     

经阴道注水腹腔镜联合宫腔镜检查不孕症的临床观察

目的 探讨经阴道注水腹腔镜(THL)联合官腔镜检查不孕症的临床效果和应用价值。方法 对46例不孕症患者施行THL联合宫腔镜检查,其中原发性不孕(原发组)和继发性不孕(继发组)各23例。观察患者的输卵管通畅性、盆腔病变情况,记录THL手术时间、总手术时间、离院时间、术后阴道壁穿刺孔愈合时间、穿刺成功率与术中及术后并发症。结果原发组术后输卵管双侧通畅13例,继发组术后输卵管双侧通畅5例;两组比较,差异有显著性(P<0.05);原发组盆腔粘连6例,继发组盆腔粘连14例,两组比较,差异有显著性(P<0.05);术后需要进一步施行常规腹腔镜手术的患者仅7例(7/46,15％);46例不孕症患者THL手术时间、总手术时间、术后离院时间和阴道壁穿刺孔愈合时间分别为(10.5±1.7)min、(32.2±4.6)min、(87.3±12.5)min和(4.5±0.5)d;穿刺成功率为96％(46/48);无直肠损伤、术后穿刺部位出血、盆腔感染等并发症发生。结论 THL具有准确、微创、安全、经济、不需住院等优点,联合应用宫腔镜检查效果更佳。THL和宫腔镜联合检查可作为不孕症早期检查的一线方法。     

经阴道注水腹腔镜

经阴道注水腹腔镜可在门诊局部麻醉下进行,检查原因不明的不孕症较腹腔镜创伤小,易发现输卵管周围的粘连,用美蓝染色通液评估输卵管通畅度较子宫输卵管造影(HSG)准确,并可观察输卵管与卵巢间的解剖关系.其在妇科的应用包括替代腹腔镜评估性交困难、痛经、盆腔痛和宫腔镜手术,替代HSG或腹腔镜二探对子宫、输卵管或子宫内膜异位症(EMs)术后作内镜随访等.并可进行汽化EMs、粘连组织和多囊卵巢综合征(PCOS)打孔等简单治疗.     

输卵管性不孕患者复孕术中行输卵管通液术的意义

目的:观察不孕患者腹腔镜复孕术中行输卵管通液术的临床意义,以寻求提高宫内妊娠率的有效方法.方法:输卵管性不孕患者130例,随机分为实验组和对照组各65例,实验组于腹腔镜复孕术中即行输卵管通液术,术后不再行通液治疗,对照组复孕术中不行输卵管通液术,而于复孕术后第1次月经干净后3～7天行常规输卵管通液治疗.观察两组患者复孕术后盆腔感染率、平均住院日、对照组的常规输卵管通液治疗后盆腔感染发生率,随访1年宫内自然妊娠率、异位妊娠率.结果:实验组和对照组复孕术后盆腔感染发生率分别为2例(3.1%)和3例(4.6%),差异无统计学意义(P>0.05);实验组患者平均住院日为4.1 ±0.8天,对照组为4.3±0.7天.差异无统计学意义(P>0.05);对照组的常规输卵管通液治疗后盆腔感染发生率为2例(3.1%),实验组为0,差异无统计学意义(P>0.05);实验组宫内妊娠率为26例(40.0%),较对照组14例(21.5%)高(P<0.05);实验组异位妊娠率为4例(6.2%),较对照组5例(7.7%)低,但差异无统计学意义(P>0.05).结论:不孕患者腹腔镜复孕术中行通液治疗,能提高复孕术后患者宫内妊娠率,有临床应用的前景.     

以宫腔镜手术为主的综合治疗在宫腔粘连性不孕中的应用

目的:探讨以宫腔镜手术为主的综合治疗在宫腔粘连性不孕中的应用价值。方法:回顾性分析67例宫腔粘连患者的治疗效果,均经宫腔镜下机械性粘连分离术及输卵管间质部插管通液术,术后宫腔放置宫内节育器及雌、孕激素周期治疗。结果:67例宫腔粘连中轻度粘连24例,中度粘连25例,重度粘连18例。46例1次手术成功重建宫腔,21例2次手术。术后88.1%宫腔形态正常,79.1%月经恢复正常,输卵管通畅率72.1%。术后妊娠率50.7%,活产率85.3%。无手术并发症。结论:宫腔镜对于不同程度宫腔粘连的宫腔重建微创、有效。术中注意保护子宫内膜;疏通阻塞的输卵管对提高妊娠率至关重要。     

腹腔镜诊治女性不孕症540例临床分析

目的 探讨腹腔镜技术对不孕症患者盆腔病变的诊治价值.方法 应用诊断性腹腔镜(非治疗性腹腔镜)对2003年1月至2006年12月山西医科大学第二医院妇产科540例不孕症患者的盆腔情况进行诊断,镜下美蓝通液动态观察输卵管的通畅情况,同时进行简单的治疗性操作.结果 (1)540例不孕症患者中,有盆腔病变者509例,占94.26%,其中盆腔炎居首位,子宫内膜异位症(内异症)次之,多囊卵巢居第3位.(2)盆腔炎是输卵管梗阻的首位病因,其次为盆腔结核.(3)对Ⅰ期和Ⅱ期内异症患者行病灶清除术、粘连分解术和腹腔液清除术,术后累计妊娠率达62.50%.结论 诊断性腹腔镜可以明确不孕症的盆腔病因,观察输卵管的通畅情况,同时进行简单手术治疗,对于早期轻症内异症不孕患者疗效确切,值得在基层医院推广.     

腹腔镜对女性不孕症的诊断和治疗

腹腔镜的应用,特别是联合宫腔镜、输卵管美蓝通液术,提高了对女性不孕症诊断的准确性。近年来出现的经阴道注水腹腔镜技术相对于传统腹腔镜检查有其优越性。针对不同的病因,腹腔镜可进行盆腔粘连分解术、输卵管造口术、子宫内膜异位灶破坏及切除术、卵巢多点穿刺电灼术等多种手术治疗。其具有早期、迅速明确病因,融诊断、治疗于一体,缩短诊疗时间,为术后进一步治疗提供正确的方向等优点。但腹腔镜手术并非根治性治疗,术后应积极采取各种辅助措施,增加妊娠率,以免延误最佳妊娠时机。     

宫腔镜辅助通液术治疗输卵管阻塞性不孕症的疗效观察

目的观察宫腔镜辅助通液术治疗输卵管阻塞性不孕症的疗效。方法选取2012年5月~2014年10月我院收治的输卵管阻塞性不孕症患者247例,将其随机分为试验组124例与对照组123例。试验组于月经干净后第3天或第4天在宫腔镜辅助下行通液术进行治疗;对照组于月经干净后3~7天给予传统通液术进行治疗。观察两组患者治疗后输卵管通畅程度、随访6个月后妊娠结局、治疗前后搏动指数以及阻力指数等卵巢动脉血流参数。结果与传统通液术相比,宫腔镜辅助通液术治疗输卵管阻塞性不孕症患者,输卵管疏通效果更好,随访6个月后,妊娠成功率高,差异有统计学意义(P0.05);所有患者治疗后卵巢动脉血流参数均有所改善,宫腔镜辅助通液术治疗后的改善程度明显优于传统通液术,差异有统计学意义(P0.05)。结论与传统通液术相比,宫腔镜辅助通液术治疗卵管阻塞性不孕症的疏通疗效明显,患者接受治疗后妊娠率提高,且卵巢动脉血流参数显著改善,值得临床推广与使用。     

腹腔镜联合宫腔镜诊治输卵管性不孕52例分析

目的探讨应用宫、腹腔镜对输卵管性不孕的诊断价值及治疗效果.方法对52例经子宫输卵管碘油造影(HSG)诊断为输卵管性不孕的患者,单用腹腔镜下子宫导管内加压注入美蓝液检查证实双侧输卵管通畅者8例,一侧通畅者4例,双侧因各不同部位梗阻而不通者40例.对双侧及一侧不通的44例患者,根据不同部位病变进行治疗,如盆腔粘连松解,伞端扩张、造口及宫腔镜下输卵管间质部插管加压通液,开腹显微外科输卵管吻合、宫角植入等.结果52例输卵管性不孕患者中,双侧榆卵管通畅40例(77%),单侧通畅10例(19%),完全不通2例(3.9%).结论应用宫、腹腔镜联合检查、治疗输卵管性不孕,可避免单独使用宫腔镜、腹腔镜或开腹整形的局限性,提高诊断的准确性及治疗效果.     

宫腔镜和腹腔镜联合诊治不孕症104例分析

目的:探讨应用宫腔镜和腹腔镜联合诊治不孕症的临床价值.方法:对104例不孕症惠者行宫腔镜和腹腔镜联合诊治,观察术后妊娠率.结果:104例患者中发现94例有盆腔病变,76例有子宫腔病变,80例输卵管不通.盆腔粘连、子宫腔粘连致输卵管堵塞是不孕症的第1位病因,继发不孕均较原发不孕的发生率高(P<0.01).宫腔镜和腹腔镜联合手术后妊娠率63.5%.1例发生异位妊娠.结论:宫腔镜和腹腔镜联合应用,已成为女性不孕症必不可少的诊治手段,具有重要的临床应用价值.     

生育镜在不孕症诊治中的应用

目的探讨生育镜用于不孕症诊治的价值。方法用生育镜[包括经阴道注水腹腔镜（THL）与宫腔镜]对115例不孕症患者进行盆腔检查,观察内容包括输卵管通畅性、盆腔粘连情况等,以及盆腔完全评价率（即盆腔器官是否能被生育镜全部观察到）及术中、术后并发症。同时行THL下输卵管通液术和宫腔镜下输卵管口插管通液术。穿刺套管针成功从后穹窿穿刺入子宫直肠陷凹110例,其中原发性不孕（原发组）49例,继发性不孕（继发组）61例。既往输卵管检查为双侧阻塞者,原发组21例,继发组22例。结果术后输卵管双侧或一侧通畅者原发组34例（69．4％,34／49）,继发组42例（68．9％,42／61）,两组比较,差异也无统计学意义（P〉0．05）;既往输卵管检查为双侧阻塞者,术后双侧或一侧输卵管通畅者原发组10例（47．6％,10／21）,继发组11例（50．0％,11／22）,两组比较,差异无统计学意义（P〉0．05）。盆腔粘连者原发组21例（42．9％,21／49）,继发组37例（60．7％,37／61）,两组比较,差异无统计学意义（P〉0．05）。两组总的盆腔完全评价率为69．1％（76／110）,其中原发组为77．6％（38／49）,继发组为62．3％（38／61）．两组比较,差异无统计学意义（P〉0．05）。术后需行常规腹腔镜手术者20例（18．2％,20／110）,原发组与继发组分别为4例（8．2％,4／49）和16例（26．2％,16／61）,两组比较,差异有统计学意义（P〈0．05）;其中17例接受了微型腹腔镜手术。术中无盆腔脏器损伤、出血、直肠损伤或穿孔,术后无穿刺部位出血及盆腔感染等并发症发生。结论生育镜用于不孕症的诊治,操作简单、微创、安全、患者依从性好;对于临床或超声检查均无明显盆腔疾病证据的不孕症患者,生育镜可以取代经腹腹腔镜,成为一步到位的盆腔检查方法。     

卵巢子宫内膜异位囊肿粘连程度及相关因素分析

目的 探讨卵巢子宫内膜异位囊肿(内异症囊肿)粘连程度与患者的临床特点、手术情况及术后复发的关系.方法 对2003年1月至2008年3月就诊于北京协和医院并进行了腹腔镜手术的662例卵巢内异症囊肿患者的临床资料及手术情况进行分析,按术中所见卵巢内异症囊肿与周围组织的粘连情况分为无粘连组31例,轻度粘连(卵巢周围膜状透明粘连,可钝性分离,无血管)组123例,中度粘连(卵巢内异症囊肿被包裹的范围＜1/2,粘连致密,需锐性分离,或者卵巢内异症囊肿被包裹的范围＞1/2,周围疏松粘连,可钝性分离)组310例,重度粘连(卵巢内异症囊肿被包裹的范围＞1/2,多累及卵巢周围脏器和组织,并且粘连致密,需锐性分离,可见血管生成)组198例.比较各组患者疼痛程度、疼痛性质、疼痛时间等临床特点及实验室检查结果、手术情况和术后复发情况,并进行相关危险度和多因素分析.结果 (1)临床特点:中、重度粘连组患者痛经、性交痛、肛门坠胀感、慢性盆腔痛以及CA125异常(>35 kU/L)比例较无粘连、轻度粘连组高,差异有统计学意义(P=0.000、0.000、0.001、0.006、0.000);重度粘连组中不孕患者占15.7%(31/198),高于无粘连组的3.2%(1/31)、轻度粘连组的11.4%(14/123)和中度粘连组的9.7%(30/310),分别比较,差异均有统计学意义(OR=1.728,P<0.05).(2)手术时间及出血量:手术时间无粘连组为(37±15)min,轻度粘连组为(42±19)min,中度粘连组为(50±20)min,重度粘连组为(63±22)min;术中出血量无粘连组为(23±12)ml,轻度粘连组为(31±27)ml,中度粘连组为(40±32)ml,重度粘连组为(70±67)ml.(3)合并其他部位内异症及腺肌病:中、重度粘连组患者中合并子宫腺肌病和(或)深部浸润型内异症患者比例更高(OR=3.466,P=0.000).(4)术后复发:我们将术后复发分为痛经复发和囊肿复发,粘连程度与卵巢内异症囊肿术后复发无明显相关性,但痛经的复发与粘连程度有关(OR=1.685,P=0.046).结论 卵巢内异症囊肿粘连程度越重,疼痛症状越明显,手术时间越长,出血量越多;中、重度粘连患者术后疼痛症状复发率高;粘连程度与囊肿复发率无关.     

输卵管性不孕者FHC综合征发生率及与输卵管、卵巢粘连程度的关系探讨

目的:探讨输卵管性不孕患者Fitz-Hugh-Curtis综合征(FHCS)的发生率及与输卵管、卵巢周围粘连程度的关系。方法:前瞻性调查308例输卵管性不孕患者,在腹腔镜手术中常规探查盆腔、升结肠、肝脏、横膈、脾、降结肠,以确定输卵管、卵巢周围粘连程度分级和FHCS遗留的典型病理改变。结果:308例中发生FHCS 38例,发生率12.3%。术中见输卵管与卵巢周围无粘连、轻微、轻度、中度及重度粘连分别为12、14、60、169和53例,发生FHCS依次为1、1、5、17及14例,重度粘连者FHCS发生率与前4组比较,差异有非常显著性(P<0.001)。结论:输卵管性不孕患者有一定的FHCS发生,故对此综合征需引起足够的重视,尤其对于输卵管、卵巢周围重度粘连者。     

Pregnancy rates after laparoscopic treatment. Differences related to tubal status and presence of endometriosis

OBJECTIVE: To examine how preexisting tubal adhesions and endometriosis affect pregnancy outcome after laparoscopic treatment in infertile women with no apparent causes of infertility other than tubal factors. STUDY DESIGN: Pregnancy outcomes in 186 infertile women for a follow-up period of 18 months after laparoscopy were analyzed. Laparoscopic manipulations consisted of adhesiolysis of tubes and removal of endometriotic lesions. RESULTS: The patients were classified into three groups, those with no tubal adhesions (group A, n = 83), unilateral tubal adhesions (group B, n = 46) and bilateral tubal adhesions with at least one tube patent (group C, n = 57). The cumulative pregnancy rate in group C (13.2%) was lower than in groups A (41.8%) and B (45.7%) 18 months after laparoscopy. The average time to conception in group A (6.7 +/- 0.8 months) tended to be shorter than that in group B (10.6 +/- 1.2 months). In group A, pregnancy rates were essentially the same between minimal/mild endometriosis and moderate/severe endometriosis. Regarding group B, women with minimal/mild endometriosis exhibited significantly higher pregnancy rates than those with moderate/severe endometriosis, while pregnancy rates in women without endometriosis fell in between. CONCLUSION: Pregnancy rates after laparoscopic treatment are different in relation to tubal status and the presence of endometriosis.     

Pressure lavage under ultrasound guidance: a new approach for outpatient treatment of intrauterine adhesions

OBJECTIVE: To present pressure lavage under ultrasound guidance (PLUG) as a new therapeutic procedure for selected cases of intrauterine adhesions (IUA). DESIGN: An open clinical investigation with no control group. SETTING: Teaching hospital. PATIENT(S): Seven consecutive patients referred to our department for secondary amenorrhea due to IUA. INTERVENTION(S): A newly developed technique based on sonohysterography was used to monitor the effects of intrauterine injections of saline solution on the continuous accumulation of saline in the uterine cavity for the mechanical disruption of IUA. MAIN OUTCOME MEASURE(S): Lysis of intrauterine adhesions, restoration of menses, and increased pregnancy rate in infertile patients. RESULT(S): Five patients with mild IUA obtained satisfactory lysis of adhesions by the use of the PLUG technique. A second-look hysteroscopy after 1 month showed that filmy adhesions persisted in two patients with moderate IUA. These adhesions were removed successfully during hysteroscopy. Restoration of menses was obtained and has continued in all patients. Two of the three infertile patients became pregnant. CONCLUSION(S): This technique is safe and ideal as an in-office procedure. PLUG allows complete lysis in mild IUA cases, and the need for therapeutic, and possibly follow-up hysteroscopy, can be avoided. In moderate IUA cases, the procedure may represent a useful initial step in reducing the need for operative hysteroscopy.     

Adhesion reformation after laparoscopic adhesiolysis: where, what type, and in whom they are most likely to recur

STUDY OBJECTIVE: To assess if the severity or extent of adhesions, the organs involved, or presence of endometriosis predict recurrence or de novo adhesion formation. DESIGN: Comparison of adhesion scores at initial operative laparoscopy and at second-look laparoscopy using the revised American Fertility Society adhesion classification system (Canadian Task Force classification I). SETTING: A university-affiliated reproductive endocrinology and infertility center. PATIENTS: In all, 38 women with moderate to severe adhesions who underwent laparoscopic adhesiolysis and second-look laparoscopy. INTERVENTIONS: Adhesion scores were assessed at 6 sites in the peritoneal cavity before initial laparoscopic adhesiolysis and compared with adhesion scores at second-look laparoscopy. Adhesions were evaluated by extent, severity, organ involvement, and presence or absence of endometriosis to evaluate potential determinants of recurrence and de novo adhesion formation. All adhesions were totally removed at initial laparoscopy, all patients received 1000 mL of Ringer's lactate solution intraperitoneally at the end of procedures, and the same surgeon treated all patients. MEASUREMENTS AND MAIN RESULTS: Adhesion scores decreased in extent [23.3% (p = .005)] and severity [26.3% (p = .001)]. Dense adhesions decreased 31% (p < .000) and filmy adhesions decreased 35% (p = .048). Extent of adhesions assessed at less than one-third, one-third to two-thirds, and more than two-thirds decreased by 33% (p = .002), 42% (p = .000), and 31% (p < .000), respectively. Severity and extent of adhesions of abdominal wall decreased by 45% (p = .003) and 40% (p = .016); of bowel by 33% (p = .002) and 31% (p = .012); and of posterior cul-de-sac by 14% (p = .040) and 9.5% (p = .091), respectively. Severity and extent of adhesions involving both adnexa decreased by 12% to 15%, respectively, which was not statistically significant. Presence of endometriosis did not affect adhesion recurrence. De novo adhesions developed at 48 (21%) of 228 potential sites occurring in 22 of 38 patients, and were most frequent and severe on the adnexa and least on the abdominal wall. CONCLUSION: Both extent and severity of adhesions are significantly reduced by laparoscopic adhesiolysis. Initial extent and severity of adhesions did not predict recurrence; however, the involved organ did, being most frequent on the adnexa and least frequent on the abdominal wall and bowel.     

A cohort study comparing 4 mg and 10 mg daily doses of postoperative oestradiol therapy to prevent adhesion reformation after hysteroscopic adhesiolysis

This is a retrospective cohort study conducted in a national training centre for hysteroscopy between January 2012 and December 2014 to compare the clinical outcome of two doses of oestradiol valerate (4?mg and 10?mg daily) in the prevention of recurrence of adhesions after hysteroscopic adhesiolysis. A total of 176 women who suffered from Asherman syndrome with moderate to severe intrauterine adhesions were included: 91 subjects received a 10?mg daily dose of oestradiol and 85 subjects received a 4?mg daily dose of oestradiol in the postoperative period. Second look hysteroscopy was performed 4–6 weeks after the initial surgery. There was no difference in age and preoperative American Fertility Society (AFS) adhesion score between the two groups. The proportion of women in whom menstruation had returned to normal in the 10?mg group (49/91?=?53.8%) was significantly (p?相似文献   

A randomized clinical trial on the benefit of adhesiolysis in patients with intraperitoneal adhesions and chronic pelvic pain.

OBJECTIVE: To see whether surgical adhesiolysis would improve pelvic pain in women with pelvic adhesions. DESIGN: Randomized clinical trial comparing surgery (adhesiolysis) with no surgery with final analysis of results after 9-12 months. SETTING: Department of Gynecology, Leiden University Medical Center, the Netherlands. SUBJECTS: 48 women known by laparoscopy to have stage II-IV pelvic adhesions. INTERVENTIONS: Midline laparotomy and surgical adhesiolysis. MAIN OUTCOME RESULTS: Pelvic pain assessed by the McGill pain score, subjective pain assessment and disturbance of daily activities. RESULTS: 24 women were randomly allocated to undergo surgical adhesiolysis and 24 to a control group who did not have surgery. After 9-12 months there were no significant differences between the two groups overall with regard to pelvic pain. A subgroup of women with severe, vascularized and dense adhesions involving bowel (stage IV) had significantly less pelvic pain after adhesiolysis for two of the three methods of assessment. CONCLUSIONS: Adhesiolysis for the treatment of pelvic pain is not indicated in women with light or moderate degree pelvic adhesions. It may be beneficial in those with severe adhesions involving the intestinal tract.     

The Effect of Estrogen in the Prevention of Adhesion Reformation after Hysteroscopic Adhesiolysis: A Prospective Randomized Control Trial

Study ObjectiveTo evaluate whether estrogen therapy can reduce adhesion reformation after hysteroscopic adhesiolysis.DesignA single-center, single blinded, randomized controlled trial.SettingA tertiary University Hospital.PatientsA total of 207 patients with mild (American Fertility Society [AFS] score 1–6) and severe (AFS score 7–12) intrauterine adhesion who underwent hysteroscopic adhesiolysis.InterventionsPatients were randomized to a treatment group or a control group, stratified according to the preoperative AFS adhesion score. The treatment group received estrogen, and the control group did not. All patients had second-look hysteroscopy at 4 weeks and third-look hysteroscopy at 8 weeks after surgery.Measurements and Main ResultsPrimary outcome measures were adhesion reformation rate and AFS score at third-look hysteroscopy. Secondary outcome measures included adhesion reformation rate and AFS score at second-look hysteroscopy and menstrual pattern improvement rate at 3 months after operation. Among subjects with mild intrauterine adhesion, there was no significant difference between the treatment group and control group with regard to adhesion reformation rate at third-look hysteroscopy (10.6% vs 13.6%), AFS score (mean ± standard deviation) at third-look hysteroscopy (1.1 ± 1.2 vs 1.3 ± 1.2), and menstrual pattern improvement rate at 3-month follow-up (89.4% vs 86.4%). Similarly, among those with severe intrauterine adhesion, there was no significant difference between the treatment group and control group in adhesion reformation rate at third-look hysteroscopy (32.6% vs 26.7%), AFS score (mean ± standard deviation) at third-look hysteroscopy (2.5±2.2 vs 2.7±2.1), and menstrual pattern improvement rate at 3-month follow-up (84.8% vs 73.3%).ConclusionPostoperative estrogen therapy did not appear to reduce the incidence or severity of adhesion reformation, nor did it improve the menstrual pattern, regardless of whether the pre-existing intrauterine adhesion was mild or severe.