Effectiveness of autocrosslinked hyaluronic acid gel after laparoscopic myomectomy in infertile patients: a prospective, randomized, controlled study

Objective: To assess the efficacy of autocrosslinked hyaluronic gel in postsurgical adhesion prevention after laparoscopic myomectomy.Design: Prospective, randomized, controlled study.Setting: University of Naples "Federico II".Patient(s): Thirty-six infertile women with symptomatic myomas were randomly divided into two groups of 18 patients each.Intervention(s): Laparoscopic myomectomy with subserous sutures or interrupted figure 8 sutures, with (group A) or without (group B) application of autocrosslinked hyaluronic acid (HA) gel.Main Outcome Measure(s): Rate of postsurgical adhesions at 60-90 days of follow-up.Result(s): The rate of subjects who developed postoperative adhesions was significantly lower in group A in comparison with group B (27.8% vs. 77.8%). In both groups, the rate of adhesions was significantly higher in patients treated with interrupted figure 8 sutures than with subserous sutures.Conclusion(s): Autocrosslinked HA gel is a promising resorbable agent barrier for the reduction of postoperative adhesions after laparoscopic myomectomy. Moreover, the type of suture is a factor influencing the postsurgical adhesion formation. (C) 2003 by American Society for Reproductive Medicine.