What to do if there is intrauterine adhesion and scanty menstruation

Intrauterine adhesion is a gynecological disease. Some patients may develop intrauterine adhesions if they do not properly adjust or perform the surgery during uterine surgery. For example, curettage, abortion, etc. may cause such symptoms, which is a great hazard to women's health. At this time, timely examination and good treatment should be carried out in time.

What are intrauterine adhesions?

The normal uterine cavity has a certain amount of space, and the volume within the uterine cavity is about 5ml. The uterine cavity is lined with the endometrium. The endometrium is divided into the basal layer and the functional layer. If the endometrium is damaged due to disease (such as endometrial tuberculosis, endometritis) or uterine surgery (such as curettage, abortion, etc.), adhesions will occur in the uterine cavity where there was originally space. Mild adhesions will form some membrane-like or wispy substances in the uterine cavity, which will have little effect on menstruation and may even be unnoticeable. Severe adhesions can cause complete destruction of the endometrium, resulting in extreme reduction of menstruation or even amenorrhea.

How are intrauterine adhesions diagnosed and treated?

Intrauterine adhesions should be considered in patients with a history of endometrial tuberculosis or intrauterine surgery who experience decreased menstrual volume. Under gynecological color ultrasound, intrauterine adhesions usually manifest as interruption of the continuity of the endometrium, but a hysteroscopy is required for diagnosis. Hysteroscopic surgery refers to minimally invasive surgery performed using a hysteroscope. Hysteroscopy is an advanced device for diagnosing and treating diseases within the uterine cavity. It can clearly observe various changes in the uterine cavity and make a clear diagnosis. Hysteroscopy can both diagnose and treat intrauterine adhesions. Under direct hysteroscopy, the doctor can use instruments to separate and open the adhesions and try to restore the normal uterine cavity structure. In order to prevent adhesions from reoccurring after surgery, it may be necessary to place an IUD in the uterine cavity or use large doses of estrogen to promote the repair and growth of the endometrium.

What kind of patients with intrauterine adhesions require surgical treatment?

Intrauterine adhesions may lead to infertility or recurrent miscarriage, and some patients may experience premature birth or abnormal placental position after pregnancy. It is currently believed that moderate to severe intrauterine adhesions or fallopian tube closure should be treated with hysteroscopic adhesion lysis; mild intrauterine adhesions that lead to infertility or recurrent miscarriage should also be treated surgically. The pregnancy rate after hysteroscopic adhesion lysis is 40%~90%, but the pregnancy rate in severe adhesions is extremely low.