Fluoroscopically guided synechiolysis for patients with Asherman’s syndrome: menstrual and fertility outcomes

Thomson, Angus J.M.; Abbott, Jason; Kingston, Ashley; Lenart, Meegan; Vancaillie, Thierry G.

doi:10.1016/j.fertnstert.2006.06.035

Cited by 82 publications

(59 citation statements)

References 18 publications

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“…Thomson et al, reported on 30 patients with Asherman's syndrome who underwent hysteroscopic adhesiolysis under fluoroscopic guidance and repeated the procedure monthly until the endometrial cavity was reestablished [1]. Amenorrhea and hypomenorrhea were improved in 81.5 % of these patients and the conception rate was 53 %.…”

Section: Discussionmentioning

confidence: 99%

“…Intrauterine adhesions (IUAs) causing amenorrhea after curettage for the treatment of postpartum hemorrhage were first described by Heinrich Fritsch in 1894 [1]. The Israeli gynecologist Joseph Asherman described the cases of 29 women with amenorrhea due to stenosis of the internal cervical os in 1948 [2].…”

Section: Introductionmentioning

confidence: 99%

“…The exact prevalence of the condition is difficult to determine, but the incidence has been increasing over the past few decades, probably due to increases in iatrogenic endometrial trauma as well as better diagnostic techniques including transvaginal ultrasonography and hysteroscopy [6,7]. The treatment of Asherman's syndrome improved dramatically with the emergence of hysteroscopy [1]. Hysteroscopy has evolved from a diagnostic procedure to a therapeutic approach, and it plays an important role in the management of Asherman's syndrome as a standard surgical resolution [8].…”

Section: Introductionmentioning

confidence: 99%

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Hysteroscopic adhesiolysis for patients with Asherman's syndrome: menstrual and fertility outcomes

Yamamoto

Takeuchi

Izuchi

et al. 2013

Reprod Medicine & Biology

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Purpose Most patients with Asherman's syndrome present with infertility and menstrual problems. In this retrospective clinical study, we analyzed patients with Asherman's syndrome who underwent hysteroscopic adhesiolysis to examine their associated symptoms, disease etiologies, and fertility outcomes. Methods Twenty‐seven patients with Asherman's syndrome that were diagnosed using hysteroscopy were recruited. The chief complaints were infertility, hypomenorrhea, and amenorrhea. Each case of Asherman's syndrome was classified according to the American Fertility Society classification. Hysteroscopic adhesiolysis was performed in all cases and concomitant transabdominal ultrasonography was conducted in cases with extensive and dense adhesions. Results There were no complications associated with the hysteroscopic procedure. Normal menstrual cycles resumed in all cases. Of the 16 infertile patients, 9 conceived. Three patients achieved term deliveries and one patient is currently pregnant. None of the patients had obstetric complications. Two patients had spontaneous abortions, one had an ectopic pregnancy, one had an abortion at 16 weeks’ gestation due to cervical incompetence, and one had a molar pregnancy and required uterine artery embolization for uncontrolled hemorrhaging during a dilatation and curettage procedure. Conclusions Hysteroscopic adhesiolysis with transabdominal ultrasonography is a suitable treatment method for Asherman's syndrome. Subfertile patients with Asherman's syndrome undergoing adhesiolysis should be appropriately informed about the risk of associated life‐threatening complications and preterm delivery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hysteroscopic adhesiolysis for patients with Asherman's syndrome: menstrual and fertility outcomes

Yamamoto

Takeuchi

Izuchi

et al. 2013

Reprod Medicine & Biology

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“…The progress of the procedure is determined by injecting radiographic contrast medium, and visualised with the use of an image intensifier [38][39][40]. …”

Section: Fluoroscopically Guided Techniquementioning

confidence: 99%

“…Pseudo-pockets of adhesions in AS can be radiographically detected and help the oriented dissection of these areas lowering the risk of perforation [38][39][40]. Severe AS lysis should only be attempted in fully equipped theatres with the possibility to switch from ultrasound to radiology or laparoscopy during the same session.…”

Section: Intraoperative Complicationsmentioning

confidence: 99%

Intrauterine adhesions (IUA): has there been progress in understanding and treatment over the last 20 years?

et al. 2008

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We review the current evidence about the treatment modalities of intrauterine adhesions (IUA) or Asherman's Syndrome (AS). Systematic approach, audit and well-structured research is mandatory in order to establish the best treatment for the individual needs of patients. The clinical practice changed significantly over the last 20 years with technological advances in hysteroscopy and imaging techniques. Hysteroscopic treatment seems effective and safe. IUA or AS is a rather uncommon finding in general gynaecological practice. The referral to a tertiary centre will help to centralise the most difficult cases and create the opportunity to study more in detail the efficacy of each treatment modality and to compare the different treatment techniques.

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Surgery for Intrauterine Adhesions

Kumar

2016

Gynecologic and Obstetric Surgery

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Fluoroscopically guided synechiolysis for patients with Asherman’s syndrome: menstrual and fertility outcomes

Cited by 82 publications

References 18 publications

Hysteroscopic adhesiolysis for patients with Asherman's syndrome: menstrual and fertility outcomes

Hysteroscopic adhesiolysis for patients with Asherman's syndrome: menstrual and fertility outcomes

Intrauterine adhesions (IUA): has there been progress in understanding and treatment over the last 20 years?

Surgery for Intrauterine Adhesions

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