What is Uterine Adhesion? Treatment

Uterine adhesion, as it is called in medicineAsherman SyndromeIt is a condition that directly affects women's reproductive health. Adhesions on the lining of the uterus can disrupt the menstrual cycle, reduce fertility, and in some cases cause severe pelvic pain. Assoc. Dr. With her experience in women's health, Nazlı Korkmaz diagnoses uterine adhesion and applies safe personalized treatment methods.

What is Uterine Adhesion (Asherman Syndrome)?

Uterine adhesion, the inner surface of the uterusdamage to the endometrium layerand it occurs as a result of these areas sticking together. This condition is especially seen after intrauterine surgical procedures or serious infections. Adhesions can partially or completely block the uterine cavity, leading to problems such as menstrual irregularities, infertility or recurrent miscarriages.

In complaints about women's health, the diagnosis and treatment plan should be created by evaluating the duration of symptoms, examination findings and personal risk factors [1][2].

Causes of Uterine Adhesion

Uterine adhesion may occur for various reasons. The most common causes are:

Since the same symptom may be caused by different causes, the choice of treatment should be based on a holistic clinical evaluation, not on a single finding [2][3].

1. Abortion and Intrauterine Interventions

• The inner layer of the uterus may be damaged after a miscarriage or during surgical abortion procedures.

• Especially repeated abortions increase the risk of adhesion formation.

2. Intrauterine Infections

• Especiallypelvic inflammatory diseaseDamage to the inner surface of the uterus may occur after PID.

  If you are wondering about the details regarding this subjectWhat is Laparoscopy?You can review our article.

• Tuberculosis or serious bacterial infections also pose a risk of adhesions.

3. Complications After Caesarean Section

• Although rare, scar formation in the inner layer of the uterus after cesarean section may increase the risk of adhesions.

4. Myomectomy or Polyp Surgeries

• Damage to the endometrium may occur during surgical removal of intrauterine myomas or polyps.

  To look at the issue from a broader perspectiveClosed Myoma SurgeryYou can review our article.

5. Radiation and Chemotherapy

• Radiation to the lining of the uterus or some chemotherapy treatments may also rarely cause adhesions.

Symptoms of Uterine Adhesion

Uterine adhesion may not occur in the same way in every woman. While some women have no symptoms, some women have serious symptoms. The most common symptoms:

Follow-up plan; It should be individualized according to age, pregnancy expectation, previous treatments and comorbidities [1][3].

• Menstrual irregularities:Decrease or complete cessation of menstrual bleeding

• Painful menstruation:Intense pain during menstruation

• Infertility:difficulty conceiving

• Recurrent miscarriages:Inability of the embryo to attach to the uterine wall

• Pelvic pain:Rarely chronic pain

Assoc. Dr. Nazlı Korkmaz evaluates these symptoms, makes the correct diagnosis and creates the appropriate treatment plan.

Diagnosis of Uterine Adhesion

Various methods are used to diagnose uterine adhesion:

Severe pain, heavy bleeding, fever, foul-smelling discharge, or rapidly increasing complaints require specialist evaluation without delay [2].

1. Hysteroscopy

• It is used to directly observe the uterine cavity.

• Hysteroscopy can be applied for both diagnostic and therapeutic purposes.

• Assoc. Dr. Nazlı Korkmaz safely removes adhesions using modern hysteroscopic methods.

2. Hysterosalpingography (HSG)

• Imaging of the uterus and tubes using x-ray method.

• It can indicate the presence of adhesions and the shape of the uterine cavity.

3. Ultrasound and 3D Ultrasound

• It is used to evaluate the thickness of the uterine lining and possible adhesions.

4. Magnetic Resonance Imaging (MRI)

• Provides more detailed information in complex or severe cases of adhesion.

Degrees of Uterine Adhesion

Uterine adhesions are classified as mild, moderate and severe according to their severity.

• Slight adhesion:A small part of the uterine cavity is adhered and usually does not cause symptoms other than menstrual irregularities.

• Medium adhesion:A significant part of the uterine cavity is affected; Menstrual bleeding may decrease and the chance of pregnancy may decrease.

• Severe adhesion:The uterine cavity has largely closed; Menstruation may stop completely and the possibility of becoming pregnant is seriously reduced.

This classification plays a critical role in determining the treatment plan. Assoc. Dr. Nazlı Korkmaz evaluates the degree of adhesion and determines the most appropriate surgical and medical approach.

Uterine Adhesion and Menstrual Irregularity

Since adhesions disrupt the normal function of the lining of the uterus, menstrual irregularities are common.

• menstrual bleedingdecreased (hypomenorrhea)or complete cessation (amenorrhea) are among the most obvious symptoms.

• Painful menstruation (dysmenorrhea) may be seen in some patients.

• It is important for women who experience menstrual irregularities to pay particular attention to their past surgical history.

Uterine Adhesion Treatment Methods

Treatment of uterine adhesion varies depending on the degree of adhesion and the patient's pregnancy plan. Treatment options include:

1. Hysteroscopic Surgery

• It is the most effective and safe method.

• Adhesions are cut with hysteroscopy and the uterine cavity is reopened.

• During this procedure, care is taken to protect the inner layer of the uterus.

• Assoc. Dr. Nazlı Korkmaz increases the success rate by performing hysteroscopic surgery with experience.

2. Drug Treatment and Intrauterine Stents

• Hormone therapy may be applied to prevent the inner layer of the uterus from sticking after surgery.

• When necessary, a small stent or balloon is placed in the uterus to prevent adhesions from forming again.

3. Follow-up and Rehabilitation

• After surgery, regular ultrasound and hysteroscopic control is performed.

• It is important to follow up for 1-3 months for the inner layer of the uterus to fully heal.

Innovative Methods in the Treatment of Uterine Adhesion

Modern medicine in the treatment of uterine adhesionhysteroscopic surgeryprefers. Besides:

• Hormone treatments that support endometrial regenerationHelps prevent adhesion from reoccurring.

• In some casesbiological barriers or balloonsIt ensures that the uterine cavity remains open.

• Assoc. Dr. Nazlı Korkmaz increases the success rate by using both surgical and medical methods together, depending on the patient's condition.

Uterine Adhesion and Pregnancy

When left untreated, uterine adhesion can significantly reduce the chances of pregnancy. The possibility of pregnancy increases by surgically removing adhesions and protecting the inner layer of the uterus.

• The success rate for mild adhesions is around 70-80%.

• In moderate and severe adhesions, time and careful follow-up are required for pregnancy.

Assoc. Dr. Nazlı Korkmaz treats uterine adhesion in patients planning pregnancy and closely monitors the pregnancy process.

Uterine Adhesion Prevention Methods

Although it is not possible to completely prevent uterine adhesion, some precautions can reduce the risk:

1. Safe surgical practices:An experienced physician should be preferred for intrauterine interventions.

2. Early treatment of infections:Pelvic infections must be treated promptly and correctly.

3. Caution after miscarriage:Post-abortion follow-up and hormonal support are important.

4. Controlled process after pregnancy:Regular follow-up should be done after cesarean section or uterine surgery.

Frequently Asked Questions (FAQ)

Does uterine adhesion cause symptoms in every woman?

• No, some women may not have symptoms. However, infertility or menstrual irregularities may raise suspicion.

What happens if the adhesion is not treated?

• Difficulty getting pregnant, recurrent miscarriages and serious menstrual problems may occur.

Will adhesion recur after surgery?

• There is a risk of recurrence, but it is minimized with hysteroscopic surgery and appropriate follow-up.

Does uterine adhesion prevent having children?

• Yes, fertility may be affected, especially in moderate and severe adhesions. The success rate increases with surgical intervention.

References

• [1] WHO - Women's health- Women's health and preventive health approach according to life periods.
• [2] ACOG - Clinical Guidance- Clinical guide archive in the field of gynecology and obstetrics.
• [3] NICE - Gynaecological conditions- Guidelines for the evaluation and treatment of gynecological diseases.