Hysteroscopic Adhesiolysis: Understanding and Treating Uterine Adhesions

Uterine adhesions, also known as intrauterine synechiae, are bands of scar tissue that form within the uterus. These adhesions can cause a range of symptoms including menstrual irregularities, infertility, and recurrent pregnancy loss. Hysteroscopic adhesiolysis is a minimally invasive procedure used to treat uterine adhesions and improve fertility outcomes.

Symptoms

Women with uterine adhesions may experience symptoms such as:

• Menstrual irregularities: including light or absent periods
• Infertility: difficulty getting pregnant
• Recurrent pregnancy loss: multiple miscarriages

Diagnosis

Diagnosing uterine adhesions usually involves a combination of medical history, physical examination, and imaging tests such as hysterosalpingography or hysteroscopy. Hysteroscopy is a procedure in which a thin, lighted tube is inserted through the cervix to allow the doctor to examine the inside of the uterus.

Causes

Uterine adhesions can be caused by:

• Dilation and curettage (D&C): a procedure to remove tissue from the uterus, commonly performed after a miscarriage or abortion
• Cesarean section: surgical delivery of a baby through an incision in the abdomen and uterus
• Infections: such as endometritis or pelvic inflammatory disease

Risk Factors

Factors that may increase the risk of developing uterine adhesions include:

• Multiple D&Cs
• History of uterine surgery
• History of infections

Treatment

Hysteroscopic adhesiolysis is the most common treatment for uterine adhesions. During this procedure, a hysteroscope is inserted through the cervix into the uterus, allowing the doctor to visualize and remove the scar tissue using small instruments. The goal of hysteroscopic adhesiolysis is to restore the normal shape and function of the uterus, improving menstrual regularity and fertility.

In some cases, adhesions may be severe or extensive, requiring multiple procedures to fully remove the scar tissue. In these situations, additional treatments such as hormonal therapy or assisted reproductive techniques may be recommended to improve fertility outcomes.

Prevention

While it may not always be possible to prevent uterine adhesions, taking certain precautions can help reduce the risk. These include:

• Avoiding unnecessary D&Cs
• Prompt treatment of uterine infections
• Minimizing the number of cesarean sections

In conclusion, hysteroscopic adhesiolysis is a safe and effective treatment for uterine adhesions, helping to improve menstrual regularity and fertility in women affected by this condition. If you are experiencing symptoms such as menstrual irregularities or infertility, it is important to consult with a healthcare provider for proper diagnosis and treatment options.