Hyaluronic acid in the prevention of adhesions after gynecological surgery: Systematic review and meta-analysis
Open accessAbstract
The purpose of this systematic review and meta-analysis was to evaluate the effect of hyaluronic acid on preventing adhesions after gynecological surgery. The search was conducted in electronic databases including PubMed, The Cochrane Library, ClinicalTrials.gov, Scopus, Embase, and Google Scholar. Clinical trials that reported original data concerning the evaluation of the effect of hyaluronic acid in the prevention of adhesions after gynecological surgery in women of reproductive age were included. 12 studies were included for qualitative analysis. We have conducted two meta-analyses: postoperative incidence of moderate or severe adhesions was significantly higher in the control group compared to the group that received hyaluronic acid gel (p = 0.0010); moreover, the proportion of sites with adhesions was statistically significantly higher in the control group compared to the experimental group (p < 0.00001). According to our results, hyaluronan gel application reduces the postoperative incidence of moderate or severe adhesions and the proportion of sites with adhesions in patients suffering from different gynecological diseases. Therefore, our data could popularize the usage of hyaluronic acid for the prevention of adhesions and encourage investigators to further develop antiadhesive barriers based on this molecule.
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A recent meta-analysis of 12 clinical trials demonstrated that HA gel application significantly reduces the incidence and severity of postoperative adhesions in gynecological surgery.
“A recent meta-analysis of 12 clinical trials demonstrated that hyaluronic acid (HA) gel application significantly reduces the incidence and severity of postoperative adhesions in gynecological surgery.”
From Biomaterials in Postoperative Adhesion Barriers and Uterine Tissue Engineering (2025) · cites this paper as [126]
Patients treated with HA had a notably lower rate of moderate or severe adhesions (p = 0.0010) and a significantly smaller proportion of adhesion-affected sites (p < 0.00001) compared to controls.
“Patients treated with HA exhibited a notably lower rate of moderate or severe adhesions (p = 0.0010) and a significantly smaller proportion of adhesion-affected sites (p < 0.00001) compared to controls.”
From Biomaterials in Postoperative Adhesion Barriers and Uterine Tissue Engineering (2025) · cites this paper as [126]
Cites
The PRISMA 2020 statement: An updated guideline for reporting systematic reviews
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., et al. (2021) · BMJ · doi:10.1136/bmj.n71 · Cited by 108,283 · see citing works
Time to redefine endometriosis including its pro-fibrotic nature
Vigano, P., Candiani, M., Monno, A., Giacomini, E., Vercellini, P., & Somigliana, E. (2018) · Human Reproduction · doi:10.1093/humrep/dex354 · Cited by 235 · see citing works
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Biomaterials in Postoperative Adhesion Barriers and Uterine Tissue Engineering
Fazel Anvari-Yazdi, A., Badea, I., & Chen, X. (2025) · Gels · doi:10.3390/gels11060441 · Cited by 20 · see citing works
- Authors
- Adamyan, L., Pivazyan, L., Krylova, E., Kurbatova, K., Tarlakyan, V., & Stepanian, A.
- Affiliations
- Russian University of Medicine (RU)
- Ministry of Health of the Russian Federation (RU)
- Sechenov University (RU)
- Corresponding author
- Pivazyan, Laura
- Venue
- Journal of Endometriosis and Uterine Disorders
- Publisher
- Elsevier BV
- Published
- 2024-06
- Volume
- 6
- Pages
- 100070
- ISSN
- 2949-8384 (ISSN-L)
- OpenAlex
- W4392907416
- Cited by
- 18
- References
- 2
- Citations by year
- 2026: 8 · 2025: 6 · 2024: 4
- FWCI
- 1.99
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Endometriosis and Uterine Disorders (publishedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Intestinal and Peritoneal Adhesions
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Keywords
- hyaluronic acid, postoperative adhesions, gynecologic surgery, anti-adhesion barrier, adhesion prevention, women of reproductive age
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