Asherman’s Syndrome (Intrauterine Synechiae)

Asherman’s syndrome is a rare, acquired, gynecological disorder of the uterus but there is no clear consensus about management and treatment. It also known as intrauterine synechiae or uterine synechiae. Synechiae means adhesions. It is characterized by the bonding of scar tissue that lines the walls of the uterus, which decreases the volume of the uterine cavity. It can be severe (more than 75% of the front and back walls of the uterus can fuse together) to moderate and mild, where only smaller portions of the uterine wall fuses together. Patients can experience the symptoms depending on the severity of the disease, ie reduced menstrual flow, amenorrhea, increased uterine muscle cramping, abdominal pain and in some case women can develop infertility. The initiation of hysteroscopy has revolutionized its diagnosis and management and also it is considered the most valuable tool in diagnosis and management. The treatment options like hysteroscopic surgery as well as preventive (Foley catheter) and restorative therapies (hormone treatment) and newer option of stem cell treatments are also currently being explored to treat severe cases of Asherman’s syndrome.