Removal of Adhesions in Uterus

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Overview

The interior of the uterus is in a womb-like structure, padded with a protective tissue called the endometrium. The layer of tissue is discarded when a woman begins menstruating. Conversely, when she is pregnant, the embryo attaches itself to the endometrial layer.

Any damage or contagion in the tissue creates adhesions of scar tissues between the uterine walls. These tissues cause either side of the wall to stick together, obstructing the cavity. This condition is named Asherman’s Syndrome. The adhesions form as thin, meek bands or thick bands, based on the acuteness of the condition.

Everything You Need to Know About Removal of Adhesions in Uterus

Inside Uterus | Asherman’s Syndrome | How common | Symptoms | Causes | Diagnose | Treated | Prevented | FAQ

What is the removal of adhesion inside the uterus?

Some women undergo curettage due to complications during pregnancy and childbirth. A few of them tend to develop adhesion between the walls of their uterus. These adhesions can minimize or cause a stoppage of menstruation. Some women do not experience any symptoms post this condition.

However, it can cause threats like menses stoppage, lower fertility, or unusual placentation. Hence, these adhesions need to be removed from the uterus. Delaying the cure can cause numerous complications, especially in women trying to conceive. It may lead to consequent miscarriages or even infertility.

Related Conditions

What is Asherman’s Syndrome?

Asherman’s Syndrome is an acquired illness. This syndrome develops after a disturbance in the basalis stratum of the uterus. It causes the formation of adhesive bands made of scar tissues between the walls of the uterus. This causes the walls to adhere to each other and blocks the uterine opening. Sometimes when it becomes very severe, it can lead to complete obstruction of the cervix. This condition is also called Intrauterine Adhesion.

How common is Asherman’s Syndrome?

As alarming as it may sound, this condition is very uncommon. Asherman’s Syndrome often goes undiagnosed, since many women do not show symptoms and it is mostly unheard of. However, studies show that around 20% of the women who undergo dilation and curettement develop this condition.

What are the symptoms of Asherman’s Syndrome?

Following are the major symptoms that women experience on developing this syndrome:

  • Menstrual flow becomes scant or completely stops
  • Disrupted and painful menstruation 
  • Severe cramps and stomach ache
  • Repeated miscarriages or infertility
  • Complete blockage of cervix
  • Retrograde menstruation (menstrual blood flows in reverse to the fallopian tube)
  • Some women do not experience any of the symptoms and despite the condition, may have regular menstruation.

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What causes Asherman’s Syndrome?

Dilation and curettement (D & C) is the most common reason for developing Asherman’s Syndrome. This process refers to the medical scraping of the uterine wall or endometrium. This cleans the lining of the uterus after a woman undergoes miscarriage or abortion. This method treats other complications such as severe bleeding. However, this treatment triggers the highest risk of developing Asherman’s Syndrome.

This is because the scraping causes inflammation in the endometrium. This leads to the formation of scar tissues or adhesives in the uterine walls. Likewise, other operations like mending the physical defects of the uterus can also lead to this syndrome. Similarly, medication involving radiation and infections in the reproductive parts also contribute to this condition.

What tests are used to diagnose Asherman’s Syndrome?

A mere physical examination cannot detect this uterine condition. However, when an examining device fails to enter the cervix, it indicates occlusion in the uterine opening. Diagnosis of the syndrome starts with the imaging of the uterus. The ideal device used to execute this procedure is the hysteroscope. It has a scope as well as a camera, which is injected into the cervix to examine the entire uterus.

Diagnosing Asherman’s Syndrome is very challenging since it cannot be effectively identified through usual scans like ultrasound. Hysterosalpingography is another successful technique to analyze this condition. It includes injecting a liquid into the uterus, after which an X-ray is generated for a distinct image of the cavity. Saline Infusion Sonography (SIS) or sonohysterosonography operates with a saline solution that runs through the uterus for a better image.

How is Asherman’s Syndrome treated?

Curing the syndrome aims at restoring the uterus to its original physical state. Hysteroscopy not only aids in diagnosing the condition but also helps in treating it. The magnified view of the uterus through the hysteroscope allows doctors to precisely snip the adhesions. They use precision scissors or laser to amend the blockage.

In severe cases, this surgery is hard, since the cervix is completely blocked, hindering the scope from entering. However, after the procedure, doctors usually prescribe oestrogen supplements to refurbish the endometrium. These hormones help in the regrowth of the cells and aid you to have regular periods.

Can Asherman’s syndrome be prevented?

Women, who undergo dilation and curettage postpartum, should take oestrogen supplements regularly. This helps the uterine wall to grow in a good state. The most effective way to prevent adhesives is to place a stent between the walls of the uterus.

Women who have had surgeries in the uterus are recommended to take a hysteroscopy before trying to get pregnant. Occasionally, if the postpartum scraping is done in three to four weeks after delivery, Asherman’s Syndrome is probable to develop.

Conclusion

Consult your fertility doctor if you think you have Uterine Adhesions and Scarring symptoms or are suffering from them.

We also like to encourage you to build care with our team of professionals. Make an appointment or give us a call to learn more.

FAQs

Can I get pregnant with Asherman’s Syndrome?

This is one of the most frequently asked questions about this condition. To become pregnant, one should have a healthy uterus with safe endometrium. However, having Asherman’s Syndrome means adhesives between the uterine walls. This makes it difficult or sometimes impossible to conceive.

Nonetheless, it is possible to conceive, even with the condition. But, it offers no room for the growth of the embryo.
Moreover, conceiving with this condition can cause difficulties or even miscarriages. And if not, the adhesives might obstruct the cervix and cause other complications in the later stages.

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Dr. Ramit Raosaheb Kamate

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Dr. Ramit Kamate is a Reproductive Medicine Consultant and Sexologist with experience of 12+ years. He specialises in Sexual Medicine for male and female, Fertility Treatment, Pre and Post Delivery Care, Normal Vaginal Delivery (NVD), Tubectomy/Tubal Ligation, Natural Cycle IVF, MTP.

Dr. Ramit Kamate finished MBBS from B J Medical College, Pune. He pursued Masters’s In Reproductive Medicine from Hamilton University, UK & IBCME Dubai. Completed Fellowship in Cosmetic Gynaecology and Sexual Medicine from USA.

Removal of Adhesions in Uterus

by | Oct 12, 2021

Removal of Adhesions in Uterus

by | Oct 12, 2021

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