What is Asherman Syndrome?

Scar tissue or other intrauterine adhesions that develop after surgery on the uterus is called Asherman syndrome. It is a rare syndrome, but most commonly is seen in those having D&C, or dilation and curettage, procedures. It can also happen after tuberculosis or schistosomiasis infections and from severe pelvic infections.

Symptoms

There are not many signs to this condition, and the symptoms that may occur can be related to other medical ailments as well. These symptoms include a lack of menstrual periods, infertility, and repeated miscarriages. If signs come after uterine surgery, it more likely is indicative of Asherman syndrome.

Diagnosis

Diagnostic testing that can help a doctor confirm an Asherman syndrome diagnosis include pelvic exams, blood tests, hyterosonogram, hysteroscopy, transvaginal ultrasound examination, and infertility evaluation.

Treatment

Surgical removal of the scar tissue or adhesions is the typical treatment for this condition. It can be done in conjunction with the hysteroscopy. The uterine cavity needs to be kept open after the surgical removal of the scar tissue to keep more adhesions from forming. There may be estrogen therapy and a small balloon put in the uterus while the lining heals. Antibiotics are typically given to reduce the chance of infection.

While there may be more than one procedure needed, this is a syndrome that is curable in most patients that get it. Pregnancy chances improve after treatment but depends on the severity of the Asherman syndrome. Difficult treatment may affect fertility as well. Not every patient will be cured of their infertility. Complications can include pelvic infection, bleeding, and perforation of the uterus.

Source: A.D.A.M. Medical Encyclopedia


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