Causes. The most common cause of intrauterine adhesions is trauma to the uterus, a pelvic or uterine infection after a D&C, or an abortion. Long-term IUD use, endometriosis and certain surgical procedures (such as removal of fibroids) may also cause adhesions.
Symptoms. Not all adhesions have consequences, but the most common are infertility or recurrent miscarriage. Adhesions may also cause periods to stop or become very light or infrequent. Asherman's syndrome may also be accompanied by pelvic pain or painful menstrual periods if the adhesions block blood from leaving the cervix.
Diagnosis. Adhesions are usually diagnosed with hysterosalpingography (See "Tests Used to Diagnose Uterine Conditions").
Treatment. Adhesions are usually removed surgically.
After removal, many surgeons place a temporary plastic catheter or small balloon inside the uterus to keep the uterine walls apart and prevent more adhesions from forming. You may also start hormonal treatment with estrogens and progestins and take non-steroidal anti-inflammatory medications to further reduce the chance that the adhesions will form again. Seventy to 80 percent of women treated for mild to moderate adhesions achieve full-term pregnancies. However, only 20 to 40 percent of women with severe adhesions are able to carry a pregnancy to term.
Prevention. If you have a D&C or surgical abortion, inquire about prophylactic antibiotics, which may reduce the risk of adhesions forming. Most cases of Asherman's syndrome cannot be prevented, however.
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Preventing
Adhesions A
common complication of gynecologic surgery is post-surgical pelvic adhesions-bands
of scar tissue that form as part of the body's healing process and can
lead to infertility, pelvic pain and bowel obstruction. Ninety percent
of women who have gynecologic surgery are at risk for developing adhesions.
While not all pelvic adhesions cause problems, it is important to talk
to your health care professional about ways to minimize the formation
of pelvic adhesions following gynecologic surgery. |