Abstract
OBJECTIVE: To investigate the preliminary effect of hysteroscopic cold knife separation combined with autologous platelet rich plasma (PRP) in the treatment of intrauterine adhesions (IUA) and prevention of postoperative re-adhesions. METHODS: Retrospectively, 110 patients with IUA treated in our hospital during January 2022 to January 2024 were selected for the study, and divided into 58 cases in the cold knife + PRP group and 52 cases in the cold knife group. Clinical outcomes, surgical parameters, sex hormone levels [estradiol (E2), luteinizing hormone (LH), follicle-stimulating hormone (FSH)], inflammatory markers [C-reactive protein (CRP), matrix metalloproteinase-9 (MMP-9), interleukin-8 (IL-8), interleukin-6 (IL-6)], and postoperative re-adhesion rates were compared between two groups. RESULTS: The cold knife + PRP group had much higher total efficacy rate of 91.88% than 75.00% in the Cold Knife group (P < 0.05). The cold knife + PRP group had less uterine distention medium absorption and intraoperative blood loss and shorter operative duration and hospitalization time than the cold knife group (P < 0.05). Higher levels of E2 but lower levels of LH and FSH were observed in the cold knife + PRP group than the cold knife group (P < 0.05). After the treatment, the cold knife + PRP group had lower levels of CRP, IL-8 and IL-6 but higher level of MMP-9 than the cold knife group (P < 0.05). The re-adhesion rate at 1, 6, and 12 months postoperatively was significantly lower in the cold knife + PRP group than the cold knife group (P < 0.05). CONCLUSION: In this preliminary study, hysteroscopic cold knife dissection combined with PRP showed a trend toward regulating sex hormone levels, mitigating inflammatory responses, and reducing re-adhesion incidence in IUA patients, suggesting its potential as a therapeutic option. However, larger-scale studies are needed to confirm these findings.