This protocol addresses premenopausal women of reproductive age with cervical stricture or stenosis in whom a first-line attempt at mechanical cervical dilation failed to re-establish access to the uterine cavity.
The patient is premenopausal and of reproductive age — not postmenopausal and not receiving gonadotropin-releasing hormone analogs. Cervical stricture or stenosis is obstructing the cervical canal.
Mechanical cervical dilation using Hegar or Pratt dilators — with or without vasopressin injected into the cervix to reduce the force required for entry — did not restore the patency of the cervical canal to allow entry into the uterine cavity. This failure to reach that goal is the indication for the next-line approach.
Office hysteroscopic adhesiolysis is the established gold-standard surgical approach in this setting. The technique is tailored to the nature and degree of adhesions encountered — the complete structured algorithm and instrument selection for each clinical situation are detailed in the full protocol.
Successful access to the uterine cavity with restored patency of the cervical canal.
This minimally invasive procedure represents the gold standard approach for the management of patients with cervical stenosis.
The main objective of both medical and surgical treatments for cervical stenosis is to restore the patency of the cervical canal.
View source ↗