Asherman’s Syndrome-Causes, Symptoms and Treatment

Asherman’s Syndrome

Asherman’s syndrome is a condition in which the uterus cavity develops scar marks or tissues which are known as adhesions.  Asherman’s syndrome is also known as intrauterine adhesions or the Fritsch syndrome and is characterized by fibrosis of endometrium. The symptoms and the extent to which the scar tissues develop may vary from case to case and depends mainly on the case of the adhesions. Let’s known more about this condition Symptoms of Asherman’s Syndrome

Causes of Asherman’s Syndrome

In most cases, this condition is caused due to procedures or operations which are conducted on the uterus after pregnancy.  The scar tissue that gets developed can be formed due to infection of the uterus or instrumentation of a uterus that is not pregnant.  The following is a detailed description of the procedures that can cause Asherman’s syndrome:

  • D&C
  • Uterine surgery
  • Pelvic infection that develops after delivery
  • Miscarriage or abortion
  • Pelvic tuberculosis
  • Dilation and evacuation or retained use of conception

Symptoms of Asherman’s Syndrome

In some cases, there may be no symptoms of Asherman’s syndrome as it is asymptomatic.  The following are some of the symptoms of Asherman’s syndrome:

  • Pelvic pain which is mostly cyclic in nature.  This happens in the case when the tissue blocks the flow of the menstrual blood.  This further causes cramping of the uterus and extreme pelvic pain and discomfort.
  • Infertility is another symptom of Asherman’s syndrome.
  • Miscarriage or repeated miscarriages may also be possible identifiers of this syndrome or condition.
  • Irregularities in the menstrual cycle may also be the possible symptoms of Asherman’s syndrome. Lighter periods or no periods at all are also menstrual problems which are recognized to be symptoms of this condition.  This happens in the case when the scar tissue replaces the normal endometrium and there is very little endometrium during the menstrual flow days.

Treatment of Asherman’s Syndrome

There are several effective and identified treatment methods of Asherman’s syndrome. In a more general way, the treatments of this problem involve breaking of the scar tissue and preventing its re growth. The treatment is carried out in two stages:

Removal of scar tissue

This is the first step of the treatment of Asherman’s syndrome. In this process, the scar tissue is broken up and the uterine cavity is opened.  These procedures are done using hysteroscope.  There is rapid recovery after this procedure and it is a day surgery where the patient is discharged on the same day.  Another aim of the surgery is to identify the tubal Ostia as well.

Preventing the reformation of the scar tissue after removal of adhesions

This is the second stage processor of the treatment for Asherman’s syndrome.  In many cases, once the scar has been removed using the first step, it often comes back.  To avoid this from happening, doctors use the estrogen procedure in which a balloon is placed in the cavity of the uterus after the removal of the adhesions.

There are different methods used to pursue this second step and some of them include endometrial biopsy, transvaginal ultrasound, repeated office hysteroscopy and oral estrogen.  The success of the treatment rate can vary from patient to patient.

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