What is Asherman Syndrome?
Medikoe Health Expert
Koramangala, bengaluru, karnataka, india, Bengaluru Jul 14, 2019
Asherman syndrome is a rare condition which is described as the formation of scar tissue in the uterine cavity. It usually develops after uterine surgery and occurs in women who have had several dilatation and curettage procedures. A D&C is usually performed following an incomplete miscarriage, retained placenta after delivery, or as an elective abortion. It can also be caused by a severe pelvic function or pelvic surgeries like caesarean section or removal f fibroids or polyps.
In severe cases, the entire front and back walls of the uterus can fuse. In less severe cases, the adhesions appear in smaller areas of the uterus. The adhesion can be thick or thin and may be merged.
What are the Symptoms of Asherman Syndrome?
Following are the symptoms of Asherman Syndrome:
- Lack of menstrual periods
- Repeated miscarriages
All the above symptoms could be related to several conditions, but they are more likely to indicate Asherman syndrome if they occur suddenly after a D&C or other uterine surgery.
How is Asherman Syndrome diagnosed?
Just doing the pelvic exam may not reveal problems in most cases. Tests done to diagnose Asherman syndrome are:
Hysterosalpingography: This procedure uses a real-time form of X-ray called fluoroscopy to examine the uterus and fallopian tubes of a woman who is having difficulty becoming pregnant. It is also used to evaluate miscarriages resulting from abnormalities within the uterus and to determine the presence of tumour masses, adhesions and uterine fibroids.
Avoid this procedure if you have a chronic pelvic infection or STD.
Hysteronogram: This procedure is done to evaluate the inner lining of the uterus. It is required in women who have abnormal or excessive bleeding. The procedure usually takes 30 minutes to one hour.
A speculum is used to open the cervix, and a catheter is inserted into the cervix and fixed in position. After it, the speculum is removed, and a transvaginal probe is inserted into the vagina. The radiologist takes the images of the endometrium.
Transvaginal ultrasound examination: It is performed by inserting a transducer into the vagina with your bladder empty. It allows the radiologist to see and magnify uterus and ovaries. You may experience some discomfort. The injection of saline water into the uterus may cause temporary cramping.
How is Asherman syndrome treated?
The treatment of Asherman Syndrome involves surgery to cut and remove the adhesions or scar tissue. The surgery is usually done with hysteroscopy in which small instruments and a camera is placed into the uterus through the cervix.
After removing the scar tissue, the uterine cavity is kept open while it heals to prevent adhesions from returning. The doctor may ask you to take estrogen while the uterine lining heals. You may need antibiotics if there is an infection.
Asherman Syndrome may require more than one procedure sometime, but it can often be cured with surgery.
Women who are infertile because of Asherman syndrome may be able to become pregnant after the treatment. However, successful pregnancy depends on the severity of Asherman syndrome and the difficulty of the treatment.