Every woman, at some point in her life, goes through an episode of gynecological illness. Worldwide there are millions of women who suffer from different types of such conditions that affect the female reproductive organs, like the breasts, the uterus, ovaries, fallopian tubes, vagina, and vulva. If not given timely attention, gynecological disorders can have devastating results.
One such disorder is the Asherman Syndrome (intrauterine adhesions). Also known as intrauterine synechiae or uterine synechia, it is a rare and acquired gynecological condition.
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What Happens in Asherman Syndrome?
Named after Dr. Asherman, an Israeli gynaecologist, this syndrome is defined by the growth of scar tissue inside the uterus and/or cervix, because of which the walls of these organs are stuck together, causing the uterus to shrink. In severe cases, the whole front and back walls of the uterus can get fused. In the milder cases, smaller areas of the uterus get affected due to the adhesions. The adhesions can be thick or thin, can form sparsely or in a merged format.
What Causes Asherman Syndrome?
Other causes include:
- ● Endometriosis: A disorder where the tissue which lines the inner part of the uterus starts growing outside it
- ● Radiation treatment
- ● Formation of scar tissue after a cesarean section
- ● Pelvic surgeries for the removal of polyps or fibroids
- ● Due to the usage of sutures to stop hemorrhages
- ● Infections in the reproductive organs
What are the Symptoms of Asherman Syndrome?
Other symptoms can be difficulty or inability to conceive, recurrent miscarriages, stillbirth, and increased cramping. Some women get no symptoms, and their periods are regular too.
At the same time, if your periods are absent, sparse, or irregular, this can also be due to:
- ● Stress
- ● Obesity
- ● Polycystic Ovarian Syndrome (PCOS)
- ● Intake of a contraceptive pill
- ● Pregnancy
- ● Menopause
- ● Sudden weight loss
What are the ways to Diagnose Asherman’s Syndrome (intrauterine adhesions)?
- ● Hysterosalpingogram (HSG): This technique can help your doctor to evaluate the condition of your fallopian tubes and uterus. During this, a particular dye is injected into the uterus. This makes it easier for your doctor to identify the issue in the uterine cavity, any blockages, or growths in the fallopian tubes, on an X-ray.
- ● Saline Infusion Sonography (SIS): It is also referred to as Sonohysterosonography or ultrasound of the uterus. In the SIS method, your doctor uses a saline solution that flows into the uterus to give a clearer image of any irregularities.
- ● Hysteroscopy: The best diagnostic method to identify Asherman Syndrome (intrauterine adhesions) is hysteroscopy. In this procedure, your doctor will dilate your cervix and then insert a hysteroscope, a telescope-like instrument with a camera attached to it. This instrument can prove extremely useful in looking inside the womb and also find out the presence of scar tissue.
How is Asherman Syndrome Treated?
Conducted under general anesthesia, in this, your doctor will pass a hysteroscope till your uterus, and then with the help of micro-scissors, or an electrocautery loop, or a laser, he or she will cut the adhesions. Once the procedure is done, there are some devices that doctors recommend using during the preliminary phase of healing. One of the devices is the Foley catheter, which has an inflated balloon that keeps the surfaces of the uterus separate to prevent the formation of any adhesions.
You will also be given antibiotics; to avoid any infection and even for the betterment of the uterine lining. After a few days, your doctor will perform a repeat hysteroscopy to check if the surgery was successful. Only after this you can be assured that you are free from Asherman Syndrome.