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.
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.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
23
Womed Leaf uterine film will be inserted immediately after the myomectomy, following per-operative hysterometry.
UZ Gent
Ghent, Belgium
CHU Nîmes
Nîmes, France
CHU Bicêtre (APHP)
Paris, France
Bergman Clinics
Amsterdam, Netherlands
Zaans Medical Center
Amsterdam, Netherlands
Isala Zwolle
Zwolle, Netherlands
Safety (Adverse Events)
The number and severity of polymer film related adverse event
Time frame: 30 days
Efficacy (Rate of Patient With no IUA)
Freedom from intrauterine adhesion
Time frame: At second look hysteroscopy between 4 and 8 weeks
Efficacy (Intrauterine Adhesion Severity According to AFS Classification)
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
Time frame: At second look hysteroscopy between 4 and 8 weeks
Efficacy (Intrauterine Adhesion Severity According to ESGE Classification)
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
Time frame: At second look hysteroscopy between 4 and 8 weeks
Adverse Events
Number of adverse events (AE) at 30 days
Time frame: 30 days
Device Technical Success
Defined as the rate of success of the following 2 steps : insertion and release
Time frame: During operation: T=0
Womed Leaf Residuals
Presence of Womed Leaf residuals in the uterus
Time frame: At second look hysteroscopy: 4-8 weeks
Womed Leaf Discharge Feedback : Time Interval in Days Between Surgery and Discharge
Uterine film discharge experience as recalled by subject using a survey to be asked to the patient
Time frame: At second look hysteroscopy: 4-8 weeks
Device Manipulation
Device manipulation duration from insertion to withdrawal.
Time frame: During intervention: T=0
Womed Leaf Discharge Feedback Questionnaire (Polymer Tolerance Assessed on a Scale From 1 (no Discomfort) to 10 (Extremely Disturbing))
Uterine film discharge experience as recalled by subject using a survey to be asked to the patient
Time frame: At second look hysteroscopy: 4-8 weeks
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