Endometriumadhäsionen

Endometriumadhäsionen, also known as intrauterine adhesions or Asherman's syndrome, are fibrous bands that form inside the uterus. These adhesions can range from thin membranes to dense scar tissue and can partially or completely obliterate the uterine cavity. The most common cause of endometriumadhäsionen is trauma to the endometrium, particularly following procedures such as dilatation and curettage (D&C), especially if performed after a pregnancy or for retained products of conception. Other contributing factors can include uterine infections, such as endometritis, or surgical interventions like myomectomy or hysteroscopic procedures.

The symptoms associated with endometriumadhäsionen can vary. Some individuals may experience no symptoms, while others may suffer from menstrual irregularities like amenorrhea (absence of menstruation), hypomenorrhea (scanty periods), or dysmenorrhea (painful periods). Infertility is a significant consequence, as the adhesions can interfere with embryo implantation and subsequent pregnancy. Recurrent miscarriages can also occur.

Diagnosis typically involves imaging techniques such as transvaginal ultrasound, saline infusion sonohysterography (SIS), or magnetic resonance imaging (MRI). However, the gold standard for diagnosis and simultaneous treatment is hysteroscopy, a procedure where a thin, lighted scope is inserted into the uterus to visualize the cavity directly. Treatment aims to surgically divide or remove the adhesions, usually through hysteroscopic adhesiolysis. The goal of treatment is to restore the normal uterine cavity shape, thereby improving menstrual patterns and fertility potential. Post-operative management may include hormonal therapy to promote endometrial healing and prevent re-adhesion.