Treatment of Asherman's Syndrome in an Outpatient Hysteroscopy Setting

Asherman’s Syndrome or Intrauterine adhesions is an acquired uterine condition where fibrous scarring forms within the uterine cavity, resulting in reduced menstrual flow, pelvic pain and infertility. Until recently, the molecular mechanisms leading to the formation of fibrosis were poorly understood, and the treatment of Asherman’s syndrome has largely focused on hysteroscopic resection of adhesions, hormonal therapy, and physical barriers. Numerous studies have begun exploring the molecular mechanisms behind the fibrotic process underlying Asherman’s Syndrome as well as the role of stem cells in the regeneration of the endometrium as a treatment modality. The present review offers a summary of available stem cell-based regeneration studies, as well as highlighting current gaps in research.

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Endometrial Perivascular Progenitor Cells and Uterus Regeneration

Journal of Personalized Medicine ◽

10.3390/jpm11060477 ◽

2021 ◽

Vol 11 (6) ◽

pp. 477

Author(s):

Shiyuan Li ◽

Lijun Ding

Keyword(s):

Stem Cells ◽

Mesenchymal Stem Cells ◽

Embryo Implantation ◽

Endometrial Receptivity ◽

Perivascular Cells ◽

Asherman’S Syndrome ◽

Outermost Layer ◽

Adventitial Cells ◽

Structure And Functions ◽

Large Vessels

Ovarian steroid-regulated cyclical regeneration of the endometrium is crucial for endometrial receptivity and embryo implantation, and it is dependent on the dynamic remodeling of the endometrial vasculature. Perivascular cells, including pericytes surrounding capillaries and microvessels and adventitial cells located in the outermost layer of large vessels, show properties of mesenchymal stem cells, and they are thus promising candidates for uterine regeneration. In this review, we discuss the structure and functions of the endometrial blood vasculature and their roles in endometrial regeneration, the main biomarkers and characteristics of perivascular cells in the endometrium, and stem cell-based angiogenetic therapy for Asherman’s syndrome.

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See-and-treat outpatient hysteroscopy: an analysis of 1109 examinations

Reproductive BioMedicine Online ◽

10.1016/j.rbmo.2009.11.024 ◽

2010 ◽

Vol 20 (3) ◽

pp. 423-429 ◽

Cited By ~ 22

Author(s):

Cagri Gulumser ◽

Nitish Narvekar ◽

Mamta Pathak ◽

Elsa Palmer ◽

Sarah Parker ◽

...

Keyword(s):

Outpatient Hysteroscopy

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Uterine necrosis following B Lynch suture: a rare complication

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180206 ◽

2018 ◽

Vol 7 (2) ◽

pp. 745

Author(s):

Susheela Chaudhary ◽

Parul Singh ◽

Meenakshi B. ◽

Anjali Gupta ◽

Monika Ramola

Keyword(s):

Postpartum Haemorrhage ◽

Rare Complication ◽

Breech Presentation ◽

Uterine Wall ◽

Artery Ligation ◽

Asherman’S Syndrome ◽

Uterine Artery Ligation ◽

Endometrial Cavity ◽

Variable Extent ◽

Uterine Fundus

The B-Lynch uterine suture brace is a relatively new technique used for treatment of postpartum haemorrhage. These uterine compression sutures have achieved hemostasis while preserving fertility in many women and thus their efficacy and safety have been time tested. Very few complications have been reported following B Lynch suture. These include Asherman’s syndrome, hematometra, pyometra, localized areas of uterine necrosis and full-thickness defects in the lower uterine segment or uterine fundus and erosion of uterine wall. Herewith, reporting a case of 23-year-old woman who underwent cesarean section for breech presentation. She had atonic PPH for which uterine artery ligation was done along with B-lynch suture. She developed uterine necrosis for which hysterectomy was done. Microsections showed that endometrial cavity was filled with gangrenous slough extending to variable extent in myometrium and cervix.

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