Treatment of Asherman's Syndrome with Severe Intrauterine Adhesions When Standard Hysteroscopic Techniques Are Not Possible or Safe
This protocol covers the surgical management of Asherman's syndrome in cases where severe, cohesive intrauterine adhesions (IUAs) render conventional hysteroscopically directed treatment approaches impractical or unsafe.
Clinical Scenario
Severe cohesive IUAs can obliterate the uterine cavity to a degree where standard hysteroscopic techniques cannot be safely carried out. This clinical situation requires a dedicated surgical strategy to restore the cavity — distinct from routine hysteroscopic adhesiolysis.
Treatment Approach
The protocol involves a structured surgical technique — myometrial scoring — designed to recreate the uterine cavity using electrosurgical instrumentation. The complete procedural sequence, instrument selection, and technical parameters are covered in the full protocol.
Complete regimen available on access →
References
DOI: 10.1016/j.jmig.2016.11.008
Techniques have been described for the treatment of severe cohesive IUAs when typical hysteroscopically directed techniques are not possible or safe.
Myometrial scoring has been effective for creation of a uterine cavity in women with severe IUAs.
In this technique, six to eight 4-mm deep incisions are created in the myometrium using electrosurgery with a Collins knife electrode from the fundus to the cervix.
View source ↗