Diagnosis and management of intrauterine adhesions by microhysteroscopy

The Authors report their experience in the diagnosis and management of intrauterine adhesions in a group of 23 patients using the microhysteroscope. This new model of hysteroscope makes it possible to diagnose clinically suspected cases and to perform lysis of the adhesions in the out-patient department, without cervical dilatation and anesthesia. The technical features of the microhysteroscope made a double evaluation of adhesions possible: a) the macroscopic classification of the site and extension of the synechiae and b) their microscopic in vivo observation to identify the less vascularized areas and to perform adhesiolysis under direct visual control. Monthly hysteroscopic examinations were performed in order to follow the results of therapy and to remove residual or newly formed adhesions. In the authors' experience the microhysteroscope may be successfully used in the early diagnosis and subsequent best management of intrauterine adhesions in patients with previous medical history of curettage in a recent pregnant uterus.