The first case of intrauterine adhesion was published in 1894 by Heinrich Fritsch, but it was only after 54 years that a full description of Asherman syndrome (AS) was carried out by Israeli gynecologist Joseph Asherman. Specifically, he identified this pathology in 29 women who showed amenorrhea with stenosis of internal cervical ostium. The true
incidence is unknown and is estimated to be around 0,3% in the general population and up to 21% after postpartum curettage.

Intrauterine adhesions are composed of fibrotic tissue, which may result in the adherence of opposing surfaces. The adhesions could be filmy or dense, simple or multiple and focal or total. It is possible that, after injury to the endometrium, fibrosis may follow with the potential for adhesion formation. The impact of AS or adhesions is important. There seems to be a high rate of infertility, poor implantation and miscarriage.

The goals of the hysteroscopic treatment are: 1) restoration of the triangular cavity, 2) visualization and confirmation of permeability of the ostiums, at least one of them, 3) avoid the destruction of normal endometrium, 4) minimal manipulation of normal endometrium and 5) avoid uterine perforation.

 

Full article: Hysteroscopy Newsletter

http://www.hysteroscopy.info

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