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Asherman's syndrome is a gynecological disorder that leads to complete or partial overgrowth of the uterine body. As a consequence, it can lead to infertility, therefore it is necessary to diagnose as soon as possible in order to start appropriate treatment. What are the causes and symptoms of Asherman syndrome. What is the treatment of this disease?

Asherman's syndromeis a rare, acquired gynecological disorder that leads to the development of scar adhesions - fibrous tissue connections found in the uterine cavity that connect opposite or adjacent areas of the uterus, leading to a reduction in its volume. In the case of Asherman's syndrome, these areintrauterine adhesionsof the highest intensity, which are responsible for the complete overgrowth of the uterine cavity.

Asherman syndrome: causes

Intrauterine adhesionsare most often a complication of medical procedures performed in the uterine cavity or in the uterus, such as excessive curettage of the uterine cavity during childbirth or abortion. This disorder can also occur after a cesarean section.
Asherman's syndrome can occur in the course of schistosomy (a disease caused by a blood parasite) or severe endometriosis ( endometriosis ).

Asherman syndrome can also be caused byendometrial ablation- a method of treating abnormal uterine bleeding that involves surgically removing the lining of the uterus called the endometrium.

Another cause of the disorder are endometrial infections (e.g. tuberculosis).

Asherman syndrome - symptoms

  • shortening or absent menstruation
  • painful bleeding
  • abdominal cramps and pains (which occur not only during the menstrual period)
  • habitual miscarriages

In many cases,secondary infertilitymay occur. Adhesions can block access to the fallopian tubes or "fill" the inside of the uterus, which prevents the embryo implantation.

CHECK>>What are the causes of FERTILITY OF WOMEN?

Asherman syndrome - diagnosis

Asherman syndrome can be diagnosed on the basis of the results of the following tests:

  • hysteroscopy , i.e. uterine endoscopy, allows you to precisely determine the size, number, location and nature of pathological changes in the mucosa lining the uterus (endometrium)
  • hysterosalpingogram(HSG) is a radiological examination to visualize the uterine cavity and fallopian tubes
  • sonohysterogram(SHG) is a fertility test that uses ultrasound technology. During the examination, an ultrasound probe is inserted into the uterus, and then a saline solution is injected, which allows for a thorough examination of the entire uterus

Asherman team - healing

Surgical removal of intrauterine adhesions is recommended. After surgery, it is recommended that a plastic catheter be temporarily placed inside the uterus to prevent re-adhesions. The next stage of therapy is hormone treatment
with estrogens and NSAIDs (non-steroidal anti-inflammatory drugs) to reduce the risk of adhesions.

CHECK>>What is embolization, i.e. treatment of uterine fibroids?

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