Objective  To evaluate the clinical efficacy of hysteroscopy combined with laparoscopy in moderate to severe intrauterine adhesions.

  Methods  A total of 120 patients diagnosed as moderate to severe intrauterine adhesions by uteroscopy with birth demand in our hospital were randomly divided into two groups. The patients in the observation group performed laparoscopic-hysteroscopic hysteroscopic adhesiolysis, while those in the control group were operated transcervical resection of adhesion(TCRA). The clinical efficacy in improvement of menstruation and prevention of re-adhesion of two groups were observed. The pregnancy outcomes in 2 years of follow-up were observed.

  Results  All the 120 patients successfully completed the surgeries. The improvement rates of menstruation at 1-, 3-month were 85.0%(51/60), 76.7%(46/60), respectively, in observation group, and 70.0%(42/60), 58.3%(34/60), respectively, in control group. The re-adhesion rates at 1-, 3-month were 14.3%(9/60), 21.7%(13/60) in observation group, and 28.3%(16/60), 40.0%(24/60), respectively, in the control group. The pregnancy rate was 47.3%(26/55) in the observation group, and 28.6%(16/56) in the control group at 2-year follow up.

  Conclusion  Laparoscopic combined with hysteroscopy surgery for intrauterine adhesions is safe and practicable, and has preferable efficacy in the recovery of uterine normal function, postoperative menstruation recovery, prevention of re-adhesion and improvement of pregnancy.