Asherman’s Syndrome

This is a very rare condition that occurs in women. Asherman’s syndrome is the formation of intrauterine adhesions, which typically result from scars that develop after a uterine surgery. Some of the possible causes are discussed below.

Causes:

It has been seen that the occurrence of Asherman’s Syndrome is more common with women who have had multiple dilation & curettage procedures done.

Sometimes, a severe pelvic infection that is not related to surgery can also cause this condition. A patient who has in the past had tuberculosis or schistosomiasis can also develop the Asherman’s Syndrome.

Symptoms

Asherman’s syndrome usually has the following symptoms:

• Amenorrhea (Lack Of Menstrual Periods)
• Repeated Miscarriages
• Infertility

Such symptoms, however, could also be due to other medical conditions. They are more likely to indicate Asherman’s syndrome, if they are seen suddenly after a D&C or any other uterine surgery.

A pelvic scan usually comes out clear. If the doctor suspects Asherman’s syndrome, the following tests may be done:

• Blood Tests to check for tuberculosis or schistosomiasis
• Hysteroscopy
• Infertility evaluation
• Transvaginal ultrasound examination

Procedure

The syndrome can be cured in most women by means of a surgery, although sometimes another surgery may be required. The main aim of the surgery is to cut and remove all the adhesions or scar tissue that may be present.

A Hysteroscopy is done, where a tiny camera is placed in the uterus through the cervix with the help of small instruments. Local or General anesthesia may be administered. After all the adhesions and scar tissue are removed, the uterine cavity must be kept open while it heals, to avoid adhesions from returning.

The surgeon usually places a balloon inside the uterus for many days and the patient would have to be on estrogen replacement therapy while the uterine lining heals. Additional antibiotic medication may be required if there is an infection after the procedure.

Associated Risks

Some of the risks involved in the procedure include:

• Bleeding
• Perforation of the Uterus
• Pelvic Infection

These risks are usually very rare.

Women, who are found to be infertile because of Asherman’s Syndrome, may have a successful pregnancy. Although, it has to be noted, that a successful pregnancy depends on the severity of the syndrome and other factors that affect Fertility. It has been found that in some cases, treatment of Asherman’s Syndrome does not cure Infertility.

Recovery

The patient will be observed for one to 3 hours (or until the anesthesia wears off) after the procedure. The patient may experience some cramping after the procedure, for which suitable medication would be given. Usually, there will be a little blood discharge for a few days after the procedure. Usage of tampons, sexual intercourse or any other strenuous physical activity should be avoided for at least 2 weeks after the surgery. You should call your doctor immediately if any of the following signs are seen:

• Heavy bleeding
• Fever or chills
• Severe abdominal pain
• Problem urinating
• Shortness of breath