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Simplified therapy for Asherman's syndrome
1Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada.
Objective:
To evaluate a technique that converts a blind hysteroscopic procedure to a "septum" division.
Design:
Open noncomparative clinical study.
Setting:
Tertiary care center.
Patient(S):
Six women with Asherman's syndrome; five with complete and one with incomplete obliteration of the uterine cavity.
Intervention(S):
The patients underwent recreation of the uterine cavity by the hysteroscopic-laparoscopic technique described to establish the correct dissection plane.
Main Outcome Measure(S):
The ability to reestablish the uterine cavity; postoperative resumption of menses and fertility.
Result(S):
In all patients, the cavity of the uterus was restored; menses resumed in all women who were previously amenorrheic; and 5 women conceived, of whom four had live births and one a missed abortion. At hysteroscopy, two women incurred perforations and in another hemorrhage occurred.
Conclusion(S):
This technique appears to be effective and safe for the reconstruction of a functional endometrial cavity in women with Asherman's syndrome.