Any anti-adhesive gel compared with no gel following operative hysteroscopy | ||||||
Patient or population: women of reproductive age treated by operative hysteroscopy for myomas, polyps, septa, adhesions, or retained products of conception | ||||||
Settings: hysteroscopy unit of a tertiary referral center | ||||||
Intervention: application of auto-cross linked hyaluronic acid or polyethylene oxide–sodium carboxymethylcellulose gel | ||||||
Comparison: no application of gel | ||||||
Outcomes | Illustrative comparative risksa (95 % CI) | Relative effect (95 % CI) | No. of participants (studies) | Quality of the evidence (GRADE) | Comments: absolute effect | |
Assumed risk control | Corresponding risk intervention | |||||
Clinical pregnancy (time period not known) | Average risk population | RR 3.00 (0.35 to 25.68) | 30 (1 study) | ⊕⊝⊝⊝ (very low) | 133 more per 1,000 (from 43 fewer to 1,645 more) | |
67 per 1,000 | 201 per 1,000 (23 to 1,000) | |||||
De novo adhesions at second look hysteroscopy (1 to 3 months) | Average risk population | RR 0.65 (0.45 to 0.93) | 372 (5 studies) | ⊕⊝⊝⊝ (very low) | 102 fewer per 1,000 (from 20 fewer to 161 fewer) | |
292 per 1,000 | 190 per 1,000 (131 to 272) |