Evidence map›Paper›PMID 38493418›Full record

SynthesisArchives of gynecology and obstetrics2024

Intrauterine interventions options for preventing recurrence after hysteroscopic adhesiolysis: a systematic review and network meta-analysis of randomized controlled trials.

Ruonan Tang, Wanlin Zhang, Xifeng Xiao, Wenyi Li, Xinxin Chen, Xiaohong Wang

Abstract readSystematic ReviewNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Archives of gynecology and obstetrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ruonan Tang *Xi'an Medical University, Xi'an, Shaanxi, China.
Wanlin Zhang *Department of Gynecology and Obstetrics, Reproductive Medicine Center, Tangdu Hospital, Air Force Medical University, No. 1 Xinsi Road, Baqiao District, Xi'an, Shaanxi, China.
Xifeng XiaoDepartment of Gynecology and Obstetrics, Reproductive Medicine Center, Tangdu Hospital, Air Force Medical University, No. 1 Xinsi Road, Baqiao District, Xi'an, Shaanxi, China.
Wenyi LiXi'an Medical University, Xi'an, Shaanxi, China.
Xinxin ChenXi'an Medical University, Xi'an, Shaanxi, China.
Xiaohong WangDepartment of Gynecology and Obstetrics, Reproductive Medicine Center, Tangdu Hospital, Air Force Medical University, No. 1 Xinsi Road, Baqiao District, Xi'an, Shaanxi, China. wangxh919@fmmu.edu.cn.ORCID http://orcid.org/0000-0002-2346-4882

Funding

Second Affiliated Hospital of Harbin Medical University 2021LCYJ035Shaanxi Provincial Health Commission 2021D022
6 · The paper itself

Abstract

purposeRecurrence of adhesions after hysteroscopic adhesiolysis is a challenging clinical problem without a unified management approach. Therefore, we conducted a network meta-analysis that considered both direct and indirect comparisons between interventions to identify optimal strategies for preventing recurrence.

methodsWe searched for research trials published up to July 2023 from PubMed, Embase and the Cochrane Database. We selected randomized controlled trials comparing the use of different interventions for the prevention of adhesion recurrence, with no language or regional restrictions. We used random-effects models to assess odds ratios (OR) and mean difference (MD) with 95% confidence intervals (CI). Adverse events associated with the interventions were also assessed. This study was registered on PROSPERO, CRD42023449068.

resultsData from 21 randomized controlled trials involving 2406 patients were synthesized, including interventions with balloon, amnion, platelet-rich plasma (PRP), intrauterine device (IUD), hyaluronic acid (HA), platelet-rich fibrin (PRF), and granulocyte colony-stimulating factor (G-CSF). The top 5 interventions for change in AFS scores were: PRP + Balloon (MD = 5.44; 95% CI, 2.63-8.25), Amnion + Balloon (MD = 5.08; 95% CI, 2.71-7.44), IUD + Balloon (MD = 4.89; 95% CI, 2.49-7.30), HA + Balloon (MD = 3.80; 95% CI, 1.78-5.82), and G-CSF + Balloon (MD = 3.84; 95% CI, 1.05-6.63). There were no statistically significant differences between interventions in the recurrence rate of moderate-to-severe uterine adhesions and the clinical pregnancy rate. Most interventions were safe.

conclusionsTo our knowledge, this is the most comprehensive network meta-analysis to date of interventions for preventing postoperative intrauterine adhesion recurrence. Our results indicate that PRP + Balloon seems to be the most effective approach.

Indexed as

HysteroscopyUterine DiseasesFemaleGranulocyte Colony-Stimulating FactorHumansHyaluronic AcidPregnancyRandomized Controlled Trials as TopicTissue AdhesionsGranulocyte Colony-Stimulating FactorHyaluronic AcidAsherman’s syndromeEndometrial damageHysteroscopic adhesiolysisIntrauterine adhesion

Identifiers

PMID38493418

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.