Chairs: Malcolm G. Munro, Christina A. Salazar

Faculty: Malcolm G. Munro, Sergio Haimovich, Christina A. Salazar, Herve Fernandez

Description: This course provides the attendee with a detailed exploration of the problem of trauma to the endometrium that is generally secondary to uterine surgery Involving the endometrial cavity. Previously framed as intrauterine adhesions (IUAs), it is now apparent that the primary issue is basilar endometrial trauma, and while manifesting with IUAs, it frequently persists despite hysteroscopic adhesiolysis. In addition to causing infertility, when patients do conceive, significant adverse impacts on pregnancy often occur, including preterm labor, placenta accreta syndrome, peripartum hemorrhage, and hysterectomy. The course will cover the causes, clinical implications, investigation, and new and future prevention and management strategies, including modification in surgical technique, adhesion-preventing adjuvants, and novel techniques, including stem cells, to foster functional endometrial repair. The faculty will address evidence and evidence gaps and explore how artificial intelligence may aid in management, particularly for determining prognosis.

Learning Objectives: At the end of this course, the participant will be able to:

1. Objective Describe the pathogenesis and clinical implications of surgically-induced endometrial trauma
2. Objective Discuss management approaches that minimize risk and optimize the changes of post operative adhesion free endometrial repair
3. Objective Describe the evidence gaps and the potential of future technology, including artificial intelligence in optimizing outcomes for patients

Course Outline

1:30 PM Welcome, Introduction and Course Overview

M. Munro

1:35 PM Endometrial Trauma or Intrauterine Adhesions? Framing the Issue - Pathogenesis and Clinical Implications

M. Munro

2:00 PM Future Technologies for Optimizing Endometrial Repair

S. Haimovich

2:25 PM The Use of Surgical Adjuvants to Minimize Intrauterine Adhesions

C. Salazar

2:50 PM Surgical Strategies for Minimizing Surgical Endometrial Trauma

H. Fernandez

3:15 PM Discussion Questions & Answers

1:30 PM Adjourn