Hysteroscopy
bipolar, IUA
CAVITY, ADHESIONS
All patients received TCRA by two experienced surgeons under general anesthesia. A 9-mm working element and a 4-mm 30˚ telescope (both from Olympus, Japan) connected with a bipolar electrode needle or loop were placed into the uterine cavity to separate the adhesions. The cutting power were set at 80 W. An automated hysteroscopic distension pump delivered 0.9 percent sodium chloride into the uterine cavity at a distension pressure of 100 mmHg. The AFS scores were recorded according to the IUA scoring system. After the procedure, sodium hyaluronate gel was applied through intrauterine injection into the uterine cavity and intrauterine balloon was placed for 7 days in all patients. A second-look hysteroscopy was scheduled at 8 weeks (± 1 week) after the initial hysteroscopy and performed in the same manner as the initial procedure. Unfortunately, some patients refused the second-look hysteroscopy due to the improvement of menstrual volume and the hope of preparing for pregnancy as soon as possible. Prior to follow-up hysteroscopy, all subjects underwent examination to rule out pregnancy. The AFS scores were also recorded by a researcher who was unaware of the treatment option during the second-look hysteroscopy.