Seprafilm Slurry in the Prevention of Uterine Scarring in Patients Undergoing Hysteroscopic Myomectomy

Seprafilm is an FDA-approved temporary bioresorbable barrier that physically separates
opposing tissue surfaces. The physical presence of the membrane separates adhesiogenic
tissue while the normal tissue repair process takes place. When used in the abdominopelvic
cavity, it has been shown to reduce the incidence of adhesions.

The intrauterine cavity is a potential space where the walls of the uterus are collapsed
upon itself in the normal state. It has been demonstrated that the trauma of removing a
submucosal fibroid with electrocautery exposes the uterus to great potential for
intrauterine adhesions since the raw charred surface is directly opposed to the opposite
endometrial surface. Previous studies have shown that the placement of hyaluronic acid in
the intrauterine cavity after a myomectomy is not only safe, but also decreases the
incidence of intrauterine adhesions.

The investigators hypothesize that by placing a slurry of Seprafilm in the intrauterine
cavity and creating a temporary physical barrier between the walls of the uterus, that they
will be able to prevent iatrogenic intrauterine adhesions. Given that approximately 24 to 48
hours after placement, the membrane becomes a hydrated gel that is slowly resorbed within
one week, the investigators anticipate that the patient will have minimal to no discomfort;
since no physical device is being left in the endometrial cavity, the uterus will not be
contracting more than it does in its normal postoperative state.