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Results of centralized Asherman surgery, 2003-2013.
Fertil Steril. 2015 Dec; 104(6):1561-8.e1.FS

Abstract

OBJECTIVE

To study the success rate of hysteroscopic adhesiolysis and the spontaneous recurrence rate of intrauterine adhesions (IUAs) in patients with Asherman syndrome.

DESIGN

Cohort study.

SETTING

University-affiliated hospitals.

PATIENT(S)

A total of 638 women with Asherman syndrome were included, all diagnosed using hysteroscopy, and operated on between 2003 and 2013.

INTERVENTION(S)

Hysteroscopic adhesiolysis.

MAIN OUTCOME MEASURE(S)

Hysteroscopic adhesiolysis was classified as successful if a normalization of menstrual blood flow occurred, along with a restored, healthy, cavity anatomy, free of adhesions, with hysteroscopic visualization of ≥ 1 tubal ostium. Recurrences of adhesions were diagnosed using hysteroscopy after an initial successful procedure.

RESULT(S)

A first-trimester procedure preceded Asherman syndrome in 371 women (58.2%) and caused adhesions of grades 1-2A. In 243 (38.1%) women, a postpartum procedure caused IUAs of grades 3-5. The procedure was successful in 606 women (95%), and restoration of menstrual blood flow occurred in 97.8%; IUAs spontaneously recurred in 174 (27.3%) of these cases. High grades of adhesions were predictive of a higher chance of spontaneous recurrence of adhesions.

CONCLUSION(S)

In 95% of women with Asherman syndrome, a healthy uterine cavity was restored with hysteroscopic adhesiolysis, in 1-3 attempts, with a 28.7% recurrence rate of spontaneous IUAs.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, Spaarne Ziekenhuis Hoofddorp, Hoofddorp, the Netherlands. Electronic address: mhanstede@spaarneziekenhuis.nl.Department of Obstetrics and Gynaecology, Spaarne Ziekenhuis Hoofddorp, Hoofddorp, the Netherlands.Department of Obstetrics and Gynaecology, Spaarne Ziekenhuis Hoofddorp, Hoofddorp, the Netherlands.Department of Obstetrics and Gynaecology, Spaarne Ziekenhuis Hoofddorp, Hoofddorp, the Netherlands.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26428306

Citation

Hanstede, Miriam M F., et al. "Results of Centralized Asherman Surgery, 2003-2013." Fertility and Sterility, vol. 104, no. 6, 2015, pp. 1561-8.e1.
Hanstede MM, van der Meij E, Goedemans L, et al. Results of centralized Asherman surgery, 2003-2013. Fertil Steril. 2015;104(6):1561-8.e1.
Hanstede, M. M., van der Meij, E., Goedemans, L., & Emanuel, M. H. (2015). Results of centralized Asherman surgery, 2003-2013. Fertility and Sterility, 104(6), 1561-e1. https://doi.org/10.1016/j.fertnstert.2015.08.039
Hanstede MM, et al. Results of Centralized Asherman Surgery, 2003-2013. Fertil Steril. 2015;104(6):1561-8.e1. PubMed PMID: 26428306.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Results of centralized Asherman surgery, 2003-2013. AU - Hanstede,Miriam M F, AU - van der Meij,Eva, AU - Goedemans,Laurien, AU - Emanuel,Mark Hans, Y1 - 2015/10/01/ PY - 2015/06/09/received PY - 2015/08/30/revised PY - 2015/08/31/accepted PY - 2015/10/3/entrez PY - 2015/10/3/pubmed PY - 2016/3/26/medline KW - Asherman syndrome KW - Intrauterine adhesions KW - adhesions KW - amenorrhea KW - hysteroscopic adhesiolysis KW - hysteroscopy SP - 1561 EP - 8.e1 JF - Fertility and sterility JO - Fertil. Steril. VL - 104 IS - 6 N2 - OBJECTIVE: To study the success rate of hysteroscopic adhesiolysis and the spontaneous recurrence rate of intrauterine adhesions (IUAs) in patients with Asherman syndrome. DESIGN: Cohort study. SETTING: University-affiliated hospitals. PATIENT(S): A total of 638 women with Asherman syndrome were included, all diagnosed using hysteroscopy, and operated on between 2003 and 2013. INTERVENTION(S): Hysteroscopic adhesiolysis. MAIN OUTCOME MEASURE(S): Hysteroscopic adhesiolysis was classified as successful if a normalization of menstrual blood flow occurred, along with a restored, healthy, cavity anatomy, free of adhesions, with hysteroscopic visualization of ≥ 1 tubal ostium. Recurrences of adhesions were diagnosed using hysteroscopy after an initial successful procedure. RESULT(S): A first-trimester procedure preceded Asherman syndrome in 371 women (58.2%) and caused adhesions of grades 1-2A. In 243 (38.1%) women, a postpartum procedure caused IUAs of grades 3-5. The procedure was successful in 606 women (95%), and restoration of menstrual blood flow occurred in 97.8%; IUAs spontaneously recurred in 174 (27.3%) of these cases. High grades of adhesions were predictive of a higher chance of spontaneous recurrence of adhesions. CONCLUSION(S): In 95% of women with Asherman syndrome, a healthy uterine cavity was restored with hysteroscopic adhesiolysis, in 1-3 attempts, with a 28.7% recurrence rate of spontaneous IUAs. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/26428306/Results_of_centralized_Asherman_surgery_2003_2013_ DB - PRIME DP - Unbound Medicine ER -