16 May Read our article and learn more on MedlinePlus: Asherman syndrome. 21 Jan asherman syndrome infertility amenorhea hysteroscopy. Asherman’s syndrome, there have been no serious Asherman’s original concept was that trau- .. Toaff R: Amenorrea e ipomenorrea traumatica ( Sindrome.
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Ultrasound, HSG and hysteroscopy are the most common follow-up methods. Prevention of adhesion recurrence As mentioned above, adhesions recurrence after surgery is one of the most important factors which can hinder reproductive outcome after IUA treatment. Efficacy of auto-crosslinked hyaluronan gel for adhesion prevention in laparoscopy and hysteroscopy: Mycobacterium tuberculosis skndrome also involve the genital tract resulting in severe IUA [ 5 ].
This may be from ashegman pregnancy, dilation and curettage, surgery, or infection e. Microscissors are usually used to cut adhesions.
According to a recent study among 61 patients, the overall rate of adhesion recurrence was The keys to success are meticulous surgery, hormonal therapy to promote uterine healing, the use of a specially designed uterine balloon to reduce the chance of scar reformation and follow-up to prove cure prior to recommending that another pregnancy be attempted. This is an open access article distributed under the terms of the Creative Commons Attribution License http: In more severe cases, adjunctive measures such as laparoscopy are used in conjunction with hysteroscopy as a protective measure against uterine perforation.
This classification is still used for its simplicity although it is considered insufficiently prognostic [ 36 ]. Treatment is rarely successful.
Asherman syndrome Ultrasound view. A novel approach, based on endometrial stem cells and the understanding of physiopathologic mechanism involved in endometrial regeneration, could represent a worthwhile area for a future research.
Multiple small adhesions in the internal ostium isthmic region. Although uterine perforation occurred in two cases, thus confirming the potential damage caused by this approach, a significant improvement in uterine length was found with no adhesion reformation in group with moderate adhesion [ 65 ]. Moderate One-fourth to three fourth of cavity involved. So far, one study supports this proposal, showing that women who were treated for missed miscarriage with misoprostol did not develop IUA, while 7.
The impact of the AS on pregnancy is well documented with a high rate of infertility, miscarriage, poor implantation following in vitro fertilization and abnormal placentation [ 34 ].
The management of Asherman syndrome: a review of literature
Many medical reports have indicated exactly the opposite. While rare in North America and European countries, genital tuberculosis is a cause of Asherman’s in other countries such as India. Journal List Reprod Biol Endocrinol v.
Open in a separate window. Asherman’s syndrome Dysfunctional uterine bleeding Endometrial hyperplasia Endometrial polyp Endometriosis Endometritis. Menstrual anomalies are often but not always correlated with severity: Monopolar surgery has provided results as satisfactory as bipolar one [ 45 ]. Acknowledgements The authors would like to acknowledge the excellent and efficient library staff at the Royal Free Hospital and Gabriele Basile for the final linguistic revision of the manuscript.
J Am Assoc Gynecol Laparosc. Hysteroscopic management of intrauterine lesions and intractable uterine bleeding. Risk factors Frequency References Miscarriage curettage eindrome Although the restoration of menses is considered a good marker of success, other diagnostic investigations are fundamental for an exhaustive evaluation. Filmy adhesion occupying less than one-quarter of uterine cavity.
Table 4 Classification by March In other projects Wikimedia Commons. None of proposed classification systems seems to offer a valuable reproductive prognosis, as a consequence, further studies are required [ 34 ].
Few cases of AS treatment using an open-surgery approach with transfundal separation of scarring uterine walls have been mentioned: Uterine perforation occurred in three cases, but only one case required a further hysteroscopic adhesiolysis [ 49 ]. It is a highly viscous gel formed by the autocross-linked condensation of hyaluronic acid, and a recent systematic review confirmed that it can prevent intraperitoneal adhesion after laparoscopic myomectomy and intrauterine adhesions after hysteroscopical procedure [ 72 ].
You may need to take antibiotics if there is an infection. Fluid and pharmacological agents for adhesion prevention after gynaecological surgery. A comparison of intrauterine balloon, intrauterine contraceptive device asher,an hyaluronic acid gel in the prevention of adhesion reformation following hysteroscopic surgery for Asherman syndrome: Dense and lateral adhesions should be treated at the end, bearing in mind the greater risk of uterine perforation and bleeding [ 4 ].
Foley catheter The Foley catheter was one of first mechanical devices used to ashermsn the uterine walls preventing the recurrence of the IUA [ 23564 ]. When inserted into the cervix, it slowly dilates it thanks to its hydrophilic property.
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