Effect of Pelvic Floor Neuromuscular Electrical Stimulation on Endometrial Repair after the Surgery of Moderate to Severe Intrauterine Adhesion

LIU Xiao-dan; FENG Jie-ling; WANG Jia-min; YANG Guo-xia; CHEN Yu-qing

doi:10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2022.0117

您当前的位置：

首页 >

文章列表页 >

Effect of Pelvic Floor Neuromuscular Electrical Stimulation on Endometrial Repair after the Surgery of Moderate to Severe Intrauterine Adhesion

Clinical Research | 更新时间：2024-02-19

- Effect of Pelvic Floor Neuromuscular Electrical Stimulation on Endometrial Repair after the Surgery of Moderate to Severe Intrauterine Adhesion
- Journal of Sun Yat-sen University(Medical Sciences) Vol. 43, Issue 1, Pages: 140-145(2022)
- 作者机构：
  
  1.中山大学附属第一医院妇产科，广东广州 510080
  2.中山大学附属第一医院超声科，广东广州 510080
- 作者简介：
  
  CHEN Yu-qing；E-mail：chyqing@mail.sysu.edu.cn
- 基金信息：
- DOI：10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2022.0117
  CLC： R711.7
- Received：14 June 2021，
  
  Published：20 January 2022
- 稿件说明：
移动端阅览
刘晓丹,冯洁玲,王嘉敏等.盆底神经肌肉电刺激治疗对中重度宫腔粘连术后子宫内膜修复的疗效评估[J].中山大学学报（医学科学版）,2022,43(01):140-145.

LIU Xiao-dan,FENG Jie-ling,WANG Jia-min,et al.Effect of Pelvic Floor Neuromuscular Electrical Stimulation on Endometrial Repair after the Surgery of Moderate to Severe Intrauterine Adhesion[J].Journal of Sun Yat-sen University(Medical Sciences),2022,43(01):140-145.
刘晓丹,冯洁玲,王嘉敏等.盆底神经肌肉电刺激治疗对中重度宫腔粘连术后子宫内膜修复的疗效评估[J].中山大学学报（医学科学版）,2022,43(01):140-145. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2022.0117.

LIU Xiao-dan,FENG Jie-ling,WANG Jia-min,et al.Effect of Pelvic Floor Neuromuscular Electrical Stimulation on Endometrial Repair after the Surgery of Moderate to Severe Intrauterine Adhesion[J].Journal of Sun Yat-sen University(Medical Sciences),2022,43(01):140-145. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2022.0117.

摘要

目的

探讨盆底低频神经肌肉电刺激治疗对中重度宫腔粘连术后子宫内膜修复的疗效。

方法

前瞻性收集2019年12月至2020年12月期间确诊为中重度宫腔粘连并接受治疗的107例患者的临床资料。根据患者的意愿分为实验组（盆底治疗组，50例）和对照组（常规治疗组，57例）。所有患者均行宫腔镜下宫腔粘连电切分离术（TCRA）。对照组行TCRA后予雌激素为主的人工周期治疗。实验组行TCRA后予盆底低频神经肌肉电刺激联合人工周期治疗，治疗期间进行每天30 min 的间歇性阴道电刺激。比较两组患者的粘连复发率、治疗前后子宫内膜厚度等临床预后。检测治疗前后两组患者子宫内膜中VEGF的表达水平。

结果

实验组宫腔粘连治疗后复发率为22.0%，显著低于对照组的43.9%（

＝0.017）。实验组治疗后子宫内膜厚度增加（2.19±1.69）mm较对照组（1.39±1.63）mm显著（

＝0.015）。实验组治疗后子宫内膜中VEGF的平均光密度值（AOD）表达上调0.05 （0.03~0.08）较对照组0.03 （0.01~0.04）明显（

=0.000）。

结论

盆底低频神经肌肉电刺激治疗能有效降低中重度宫腔粘连患者术后复发率，对促进血管生成，增加子宫内膜厚度有显著疗效。

Abstract

Objective

To investigate the effect of pelvic floor neuromuscular electrical stimulation on endometrial repair after the surgery of moderate to severe intrauterine adhesion.

Methods

Clinical data of 107 patients who were diagnosed with moderate to severe intrauterine adhesions and received treatment from December 2019 to December 2020 were prospectively collected. According to their voluntary choice， the patients were divided into experimental group （the group with the treatment of pelvic floor neuromuscular electrical stimulation， 50 cases） and control group （the group with conventional treatment， 57 cases）. All patients underwent the surgery of transcervical resection of adhesion （TCRA）. The control group received artificial cycle therapy after the TCRA. The experimental group was additionally treated with pelvic floor neuromuscular electrical stimulation for 30 minutes a day during the treatment. The adhesion recurrence rate and endometrial thickness were compared between the two groups before and after treatment. Also， the expression level of VEGF in endometrium of the two groups was detected before and after treatment.

Results

The recurrence rate of IUA in the experimental group was significantly lower than that in the control group （22.0%

. 43.9%，

= 0.017）. The average increased endometrial thickness in the experimental group was significantly higher than that in the control group （2.19±1.69 mm

vs.

1.39±1.63 mm，

＝0.015）. After the treatment， the average optical density （AOD） of VEGF in the experimental group was significantly higher than that in the control group ［0.05 （0.03~0.08）

. 0.03 （0.01~0.04），

=0.000］.

Conclusions

The pelvic floor neuromuscular electrical stimulation may be effective for reducing postoperative recurrence rate of patients with moderate and severe intrauterine adhesions， and it has a significant effect on promoting angiogenesis and increasing the thickness of endometrium.

关键词

Keywords

references

Fatemi HM ， Kasius JC ， Timmermans A ， et al . Prevalence of unsuspected uterine cavity abnormalities diagnosed by office hysteroscopy prior to in vitro fertilization ［J］. Hum Reprod ， 2010 ， 25 （ 8 ）： 1959 - 1965 .

Sonan Y ， Aoki S ， Enomoto K ， et al . Placenta accreta following hysteroscopic lysis of adhesions caused by Asherman’s syndrome： a case report and literature review ［J］. Case Rep Obstet Gynecol ， 2018 ， 2018 ： 1 - 4 .

Cao M ， Pan Y ， Zhang Q ， et al . Predictive value of live birth rate based on different intrauterine adhesion evaluation systems following TCRA ［J］. Reprod Biol Endocrinol ， 2021 ， 19 （ 1 ）： 13 .

Fall M ， Baranowski A ， Elneil S ， et al . EAU guidelines on chronic pelvic pain ［J］. Eur Urol ， 2010 ， 57 （ 1 ）： 35 - 48 .

Zhong F ， Miao W ， Yu Z ， et al . Clinical effect of electrical stimulation biofeedback therapy combined with pelvic floor functional exercise on postpartum pelvic organ prolapse ［J］. Am J Transl Res ， 2021 ， 13 （ 6 ）： 6629 - 6637 .

Bodombossou-Djobo M ， Zheng C ， Chen S ， et al . Neuromuscular electrical stimulation and biofeedback therapy may improve endometrial growth for patients with thin endometrium during frozen-thawed embryo transfer： a preliminary report ［J］. Reprod Biol Endocrinol ， 2011 ， 9 ： 122 .

The American Fertility Society classifications of adnexal adhesions ， distal tubal occlusion ， tubal occlusion secondary to tubal ligation ， pregnanciestubal ， Müllerian anomalies and intrauterine adhesions ［J］. Fertil Steril ， 1988 ， 49 （ 6 ）： 944 - 955 .

Baradwan S ， Baradwan A ， Al-Jaroudi D . The association between menstrual cycle pattern and hysteroscopic march classification with endometrial thickness among infertile women with Asherman syndrome ［J］. Medicine ， 2018 ， 97 （ 27 ）： e11314 .

Rein DT ， Schmidt T ， Hess AP ， et al . Hysteroscopic management of residual trophoblastic tissue is superior to ultrasound-guided curettage ［J］. J Minim Invasive Gynecol ， 2011 ， 18 （ 6 ）： 774 - 778 .

Chi Y ， He P ， Lei L ， et al . Transdermal estrogen gel and oral aspirin combination therapy improves fertility prognosis via the promotion of endometrial receptivity in moderate to severe intrauterine adhesion ［J］. Mol Med Rep ， 2018 ， 17 （ 5 ）： 6337 - 6344 .

Hanstede MMF ， Van Der Meij E ， Goedemans L ， et al . Results of centralized Asherman surgery， 2003-2013 ［J］. Fertil Steril ， 2015 ， 104 （ 6 ）： 1561 - 1568 .

Zhang X ， Liu W ， Zhou Y ， et al . Comparison of therapeutic efficacy of three methods to prevent re-adhesion after hysteroscopic intrauterine adhesion separation： a parallel， randomized and single-center trial ［J］. Ann Palliat Med ， 2021 ， 10 （ 6 ）： 6804 - 6823 .

Salma U ， Xue M ， Ali Sheikh M ， et al . Role of transforming growth factor-β1 and smads signaling pathway in intrauterine adhesion ［J］. Mediators of inflammation ， 2016 ， 2016 ： 4158287 .

Conforti A ， Alviggi C ， Mollo A ， et al . The management of Asherman syndrome： a review of literature ［J］. Reprod Biol Endocrinol ， 2013 ， 11 ： 118 .

Yang H ， Wu S ， Feng R ， et al . Vitamin C plus hydrogel facilitates bone marrow stromal cell-mediated endometrium regeneration in rats ［J］. Stem Cell Res Ther ， 2017 ， 8 （ 1 ）： 267 .

Li B ， Zhang Q ， Sun J ， et al . Human amniotic epithelial cells improve fertility in an intrauterine adhesion mouse model ［J］. Stem Cell Res Ther ， 2019 ， 10 （ 1 ）： 257 .

Yokomizo R ， Fujiki Y ， Kishigami H ， et al . Endometrial regeneration with endometrial epithelium： homologous orchestration with endometrial stroma as a feeder ［J］. Stem Cell Res Ther ， 2021 ， 12 （ 1 ）： 130 .

Xiao L ， Song Y ， Huang W ， et al . Expression of SOX2， NANOG and OCT4 in a mouse model of lipopolysaccharide-induced acute uterine injury and intrauterine adhesions ［J］. Reprod Biol Endocrinol ， 2017 ， 15 （ 1 ）： 14 .

Liu L ， Yang H ， Guo Y ， et al . The impact of chronic endometritis on endometrial fibrosis and reproductive prognosis in patients with moderate and severe intrauterine adhesions： a prospective cohort study ［J］. Fertil Steril ， 2019 ， 111 （ 5 ）： 1002 - 1010 .e2.

杨欢，常亚杰，陈玉清 . 重度宫腔粘连子宫内膜修复中微血管密度及VEGF的表达及其临床意义［J］. 新医学， 2016 ， 47 （ 10 ）： 671 - 674 .

Yang H ， Chang YJ ， Chen YQ . Clinical significance of VEGF expression and microvessel density in severe intrauterine adhesion patients before and after transcervical resection of adhesion ［J］. J New Med ， 2016 ， 47 （ 10 ）： 671 - 674 .

Views

319

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Endometrial Expression of Oxytocin Receptor in Women with Repeated Implantation Failure During Implantation Window and in Normal Women During Menstrual Cycle

Clinical Efficacy of Severe IUA with Transcervical Resection and Artificial Cycle Treatment

Effect of Estradiol-17 Beta and Estrone on Gap Junction Intercellular Communication and Connexin of Human Endometrial Cell

Related Author

Xiao-dan LIU

Jie-ling FENG

Jia-min WANG

Guo-xia YANG

Yu-qing CHEN

XIA Ting-ting

LI Jie

ZHANG Yuan

Related Institution

Center for Reproductive Medicine, The Third Affiliated Hospital of Sun Yat-sen University

Reproductive Medical Center, The First Affiliated Hospital of Sun Yat-sen University

Reproductive Medical Center, Tenth Shanghai People's Hospital, Tongji University

Department of Obstetrics, The Third Affiliated Hospital of Sun Yat-sen University

Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University

Postal code：510080
Tel：020-87690764，87690974，87690694 Email：xbmed@mail.sysu.edu.cn
Technical support is provided by Beijing Founder electronics co., LTD 京ICP备09064830号-19 京公网安备11010802024621
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰