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4DryField vs. hyalobarrier gel for preventing the recurrence of intrauterine adhesions – a pilot study

Publication at First Faculty of Medicine |
2025

Abstract

Introduction: This was a single-center pilot study that sought to describe an innovative use of 4DryField(R) PH (premix) for preventing the recurrence of intrauterine adhesions (IUAs) after hysteroscopic adhesiolysis in patients with Asherman's syndrome (AS). Material and methods: Twenty-three patients with AS were enrolled and 20 were randomized (1:1 ratio) to intrauterine application of 4DryField(R) PH (n = 10) or Hyalobarrier(R) gel (n = 10) in a single-blind manner.

We evaluated IUAs (American Fertility Society [AFS] score) during initial hysteroscopy and second-look hysteroscopy one month later. Patients completed a follow-up symptoms questionnaire three and reproductive outcomes questionnaire six months later.

Results: The demographic and clinical characteristics, as well as severity of IUAs, were comparable in both groups. The mean initial AFS score was 9 and 8.5 in the 4DryField(R) PH and Hyalobarrier(R) gel groups, respectively (p = .476).

There were no between-group differences in AFS progress (5.9 vs. 5.6, p = .675), need for secondary adhesiolysis (7 vs. 7 patients, p = 1), and the follow-up outcomes. Conclusion: 4DryField(R) PH could be a promising antiadhesive agent for preventing the recurrence of IUAs, showing similar effectiveness and safety to Hyalobarrier(R) gel.

Our findings warrant prospective validation in a larger clinical trial.