Treatment of Asherman's Syndrome

Asherman's syndrome describes the development of adhesions inside the uterine cavity following intrauterine infections or uterine curettage. These adhesions can cause infertility, recurrent miscarriages, ectopic pregnancy, or a blockage of menstrual flow and pelvic pain.

Asherman's syndrome is treated hysteroscopically (hysteroscopy is a procedure where a small telescopic camera (hysteroscope) is placed via the vagina, through the cervix, and into the uterine cavity). Preoperatively imaging studies such as an HSG (hysterosalpingogram) are performed in order to determine the extent of the adhesions. The operative hysteroscope is then used to resect the septum, usually with the use of hysteroscopic scissors. Laparoscopy is performed during the hysteroscopy to obtain an abdominal view of the uterus and assure that uterine perforation does not occur.

Postoperatively, patients are usually observed in the hospital for a few hours and can resume normal daily activities within 24 hours. A course of estrogen therapy is also given to promote regrowth of the uterine lining.