Intrauterine Adhesions
About the service
Intrauterine adhesions (IUAs) are bands of fibrous tissue that form in the endometrial cavity, often in response to a uterine procedure. IUAs are often associated with menstrual abnormalities and infertility. IUAs are commonly treated with hysteroscopic resection followed by mechanical or hormonal treatments.
What are the potential causes of intrauterine adhesions syndrome?
The most common cause of intrauterine adhesions is injury following a surgical procedure involving the uterus cavity. Dilation and curettage (D&C) is a standard outpatient surgical procedure during which the cervix (opening or neck of the uterus) is stretched, and the tissue contents of the uterus are removed. Intrauterine adhesions may form following a D&C performed for pregnancy complications, such as uterine bleeding following childbirth or miscarriage, or, less commonly, for gynecologic problems that involve the uterus, such as abnormal bleeding. Other less common possible causes of adhesion formation are infections of the uterine lining (endometritis), surgical removal of fibroids in the cavity of the uterus, cesarean sections, and endometrial ablation (a surgical procedure that is used to intentionally damage the uterine lining to make menstrual periods lighter or eliminate them).
How is intrauterine adhesions syndrome treated?
Surgical treatment of intrauterine adhesions with hysteroscopic guidance is recommended. A special operating hysteroscope is used to cut the scar tissue. This is frequently done under anesthesia but, in some circumstances, may be performed in a physician's office. After cutting the adhesions, many surgeons recommend temporarily placing a device, such as a plastic catheter or balloon, inside the uterus to keep the uterus's walls apart and decrease the chance of adhesions reforming. Hormonal treatment with estrogen and sometimes NSAIDs and antibiotics are often prescribed after surgery to reduce the possibility that the adhesions will return. In severe cases, it may be necessary to have more than one surgery to remove adhesions, and sometimes office hysteroscopy is used instead of the balloon as a treatment to help maintain a typical cavity.
