Preliminary design of a new degradable medical device to prevent the formation and recurrence of intrauterine adhesions

Commun Biol. 2019 May 22:2:196. doi: 10.1038/s42003-019-0447-x. eCollection 2019.

Abstract

Intrauterine adhesions lead to partial or complete obliteration of the uterine cavity and have life-changing consequences for women. The leading cause of adhesions is believed to be loss of stroma resulting from trauma to the endometrium after surgery. Adhesions are formed when lost stroma is replaced by fibrous tissue that join the uterine walls. Few effective intrauterine anti-adhesion barriers for gynecological surgery exist. We designed a degradable anti-adhesion medical device prototype to prevent adhesion formation and recurrence and restore uterine morphology. We focused on ideal degradation time for complete uterine re-epithelialization for optimal anti-adhesion effect and clinical usability. We developed a triblock copolymer prototype [poly(lactide) combined with high molecular mass poly(ethylene oxide)]. Comparative pre-clinical studies demonstrated in vivo anti-adhesion efficacy. Ease of introduction and optimal deployment in a human uterus confirmed clinical usability. This article provides preliminary data to develop an intrauterine medical device and conduct a clinical trial.

Keywords: Experimental models of disease; Translational research.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Animals
  • Cell Adhesion
  • Collagen
  • Endometrium / pathology
  • Equipment Design*
  • Female
  • Humans
  • In Vitro Techniques
  • Magnetic Resonance Spectroscopy
  • Polyesters / chemistry
  • Polyethylene Glycols / chemistry
  • Random Allocation
  • Rats
  • Rats, Wistar
  • Recurrence
  • Tissue Adhesions / prevention & control*
  • Uterine Diseases / metabolism*
  • Uterus / pathology*
  • Uterus / surgery*
  • Viscosity

Substances

  • Polyesters
  • Polyethylene Glycols
  • poly(lactide)
  • Collagen