PREvention of Intrauterine Adhesion After Hysteroscopic Surgery With Novel deGradable Film
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Intrauterine Adhesion
- Sponsor
- Womed
- Enrollment
- 23
- Locations
- 6
- Primary Endpoint
- Safety (Adverse Events)
- Status
- Completed
- Last Updated
- 4 years ago
Overview
Brief Summary
Intrauterine adhesions (IUA) are the major long-term complication of intrauterine procedures and are associated with pelvic pain, menstrual disorders, obstetrical complication and infertility.
Womed Leaf is a medical device specifically designed for intrauterine use that prevents intra-uterine adhesions. It is a film that acts as a mechanical barrier to keep uterus walls separated during healing. It is then naturally discharged through the cervix and vagina in less than 30 days.
The PREG1 clinical investigation is designed to evaluate Womed Leaf safety under clinical conditions, in women scheduled for a hysteroscopic myomectomy as well as its efficacy.
Detailed Description
Intrauterine adhesions (IUA) are defined as "fibrous strings at opposing walls of the uterus and/or cervix leading to partial or complete obliteration of the cavity". IUAs are the major long-term complication of intrauterine procedures and are associated with pelvic pain, menstrual disorders, obstetrical complications and infertility. Womed Leaf™ is a sterile, degradable polymer film specifically design for intrauterine use. It is inserter in the uterus like an intrauterine device. Once released it will self-deploy into the uterine cavity to form a mechanical barrier keeping uterus walls separated during healing, for several days, thus preventing the formation or recurrence of intrauterine adhesions. It is degraded and discharged naturally through the cervix and vagina in less than 30 days. The PREG1 clinical investigation is a prospective multicenter, single arm study, designed to evaluate Womed Leaf safety under clinical conditions, in women scheduled for a hysteroscopic myomectomy as well as its efficacy in preventing IUA at second look hysteroscopy.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Women ≥ 40 years AND no childbearing wish, OR history of permanent sterilization;
- •Subject scheduled for hysteroscopic myomectomy for one or more myoma(s) where one myoma is at least 10 mm in size (≥10mm) as estimated by pre-operative ultrasound measurement of the largest diameter,
- •Hysterometry prior to device insertion ≥ 6cm and ≤ 9cm.
- •Subjects who are willing to provide a written informed consent as approved by the applicable Ethics Committee prior to participating in this clinical investigation.
- •Subjects who can comply with the study follow-up or other study requirements
Exclusion Criteria
- •Pre-operative exclusion criteria:
- •Current pregnancy
- •Abnormal uterine cavity according to ESHRE classification I to VI, such as unicornis, bicornis, septate, duplex
- •Known or suspected endometrial hyperplasia
- •Medical history of cervical or endometrial cancer
- •Active pelvic infection or medical history of pelvic peritonitis
- •Intrauterine device in situ
- •Known contraindication or hypersensitivity to PEO or PLA, and to medications such as aspirin....
- •Concurrent medical condition with a life expectancy of less than 12 months
- •Full endometrial ablation
Outcomes
Primary Outcomes
Safety (Adverse Events)
Time Frame: 30 days
The number and severity of polymer film related adverse event
Efficacy (Rate of Patient With no IUA)
Time Frame: At second look hysteroscopy between 4 and 8 weeks
Freedom from intrauterine adhesion
Efficacy (Intrauterine Adhesion Severity According to AFS Classification)
Time Frame: At second look hysteroscopy between 4 and 8 weeks
Severity of IUAs according to American Fertility Society (AFS) classification systems of adhesions. Pronostic classification =\> Hysteroscopy score Stade I (mild) =\> 1-4 Stade II (moderate) =\> 5-8 Stade III (severe) =\> 9-12
Efficacy (Intrauterine Adhesion Severity According to ESGE Classification)
Time Frame: At second look hysteroscopy between 4 and 8 weeks
Severity of IUAs according to European Society of Gynecological Endoscopy (ESGE) classification systems of adhesions. I =\> Thin or filmy IUA easily ruptured by HSC sheath alone. Cornual areas normal II =\> Singular dense IUA connecting separate parts of the uterine cavity. Visualization of both tubal ostia possible. Cannot be ruptured by HSC sheath alone IIa =\> Occluding IUA only in the region of the internal cervical os. Upper uterine cavity normal III =\> Multiple dense IUA connecting separate parts of the uterine cavity. Unilateral obliteration of ostial areas of the tubes IV =\> Extensive dense IUA with (partial) occlusion of the uterine cavity. Both tubal ostial areas (partially) occluded Va =\> Extensive endometrial scarring and fibrosis in combination with grade I or grade II IUA with amenorrhea or pronounced hypomenorrhea Vb =\> Extensive endometrial scarring and fibrosis in combination with grade III or grade IV IUA with amenorrhea
Secondary Outcomes
- Adverse Events(30 days)
- Device Technical Success(During operation: T=0)
- Device Manipulation(During intervention: T=0)
- Womed Leaf Residuals(At second look hysteroscopy: 4-8 weeks)
- Womed Leaf Discharge Feedback : Time Interval in Days Between Surgery and Discharge(At second look hysteroscopy: 4-8 weeks)
- Womed Leaf Discharge Feedback Questionnaire (Polymer Tolerance Assessed on a Scale From 1 (no Discomfort) to 10 (Extremely Disturbing))(At second look hysteroscopy: 4-8 weeks)