safety and effectiveness of juveena™ hydrogel system following tcgp at high-risk for intrauterine adhesions

Conditions: Intrauterine Adhesion

Summary: this study is to determine whether intrauterine instillation of juveena hydrogel following adhesiogenic hysteroscopic procedures (tcgp + juveena) can safely and effectively reduce the incidence and severity of intrauterine adhesions (iua) compared to tcgp alone.

this is a prospective, multicenter, randomized controlled subject and evaluator-blinded pivotal study to investigate the safety and effectiveness of the juveena hydrogel system when used to reduce the occurrence of iua in women undergoing tcgps associated with a high prevalence of post-procedural iua (i.e., adhesiolysis for moderate to severe adhesions or myomectomy of multiple or large myoma). a second look hysteroscopy (slh) will be performed at the week 8 visit to evaluate the presence and severity of iua.

Eligibility criteria:
inclusion criteria: 1. premenopausal 2. candidate for one of the following hysteroscopic procedures: 1. adhesiolysis of moderate to severe adhesions confirmed hysteroscopically 2. hysteroscopic myomectomy confirmed via imaging in subjects with symptomatic disease 3. subject agrees to all protocol requirements including returning for specified visits within intervals identified within this protocol. 4. subject is willing to undergo an slh at the week 8 visit. 5. subject agrees to abstain from sexual intercourse or use a reliable form of barrier contraception following the study procedure through the week 8 visit. 6. subject has signed the irb/ec approved informed consent exclusion criteria: 1. postmenopausal 2. iud present at time of tcgp (unless removed before or during procedure) 3. past history of endometrial cancer or atypical endometrial hyperplasia (endometrial intraepithelial neoplasia). 4. planned intrauterine interventions post-tcgp through the week 8 visit. 5. recent intrauterine surgery within 6 weeks before the planned study procedure. 6. pregnant (positive pregnancy test) or lactating. 7. pregnancy within the last 6 weeks prior to the planned study procedure for a trimester loss (≤13 weeks gestation) within 3 months of planned study procedure for all other pregnancies. 8. active sexually transmitted infection (i.e., positive testing for gonorrhea/chlamydia), or genital or urinary tract infection at the time of procedure (e.g., cervicitis, vaginitis, endometritis, salpingitis, or cystitis) or other active and/or systemic infection. 9. use of systemic corticosteroids within 1 week of study procedure. 10. treated with long-acting injectable hormone/hormone implant that would still be active at the time of the tcgp. 11. known allergy to fd\&c no.1 dye or polyethylene glycol (peg). 12. known clotting defects or bleeding disorders. 13. any other general health or mental condition that in the opinion of the investigator could represent an increased risk for the subject, affect the primary outcomes of this study and/or impact the subject's ability to comply with protocol requirements. 14. participating or considering participation in a clinical trial of another investigational drug or device during this study.