Prevention of de novo adhesion formation in patients with Asherman's syndrome

Ceska Gynekol. 2021;86(4):273-278. doi: 10.48095/cccg2021273.

Abstract

Objective: To summarize recent data and knowledge of secondary prevention of the recurrence of intrauterine adhesions in patients with Ashermans syndrome.

Methods: Analysis of literature evidence and clinical experience of the authors.

Results: Ashermans syndrome is iatrogenic disease with problematic therapy. One of the basic issues is a need for repeated surgical interventions since the recurrence of adhesions is very frequent. Secondary prevention is a crucial factor for successful therapy in these patients. The methods applied include second--look hysteroscopy, hormonal treatment and different types of barriers. To compare their efficacy is difficult and the results of meta-analysis are contradictory.

Conclusion: There are many different possibilities of secondary prevention of the recurrence of intrauterine adhesions; unfortunately, none of them is perfect. The usage of solid or semi-solid barriers in combination with the support of endometrium regeneration with hormonal therapy seems most reasonable.

Keywords: Asherman‘s syndrome; endometrial cancer; hysteroscopy; intrauterine adhesions; prevention; treatment.

Publication types

  • Meta-Analysis

MeSH terms

  • Endometrium / pathology
  • Female
  • Gynatresia* / etiology
  • Gynatresia* / pathology
  • Humans
  • Hysteroscopy / adverse effects
  • Pregnancy
  • Tissue Adhesions / etiology
  • Tissue Adhesions / prevention & control
  • Uterine Diseases*