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

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.