How are uterine adhesions treated?

Any factor that causes endometrial destruction can cause uterine cavity adhesions, and about 9l% of uterine cavity adhesions are pregnancy-related; they are commonly seen after abortion or spontaneous abortion curettage. As well as after postpartum bleeding scraping. Due to the soft wall of the pregnant uterus, it is not easy to control the depth when scraping the uterus, or excessive scratching of the uterine cavity, too much negative pressure during suction and too long. The basal layer of the endometrium is scraped off, producing postoperative uterine adhesions; repeated entry and exit of the uterine orifice with suction tip and scraper, and irregular dilatation of the cervix can aggravate the damage and increase the chance of postoperative uterine adhesions; non-pregnancy-induced uterine adhesions account for about 9%, such as endometrial tuberculosis, uterine fibroid excision, and diagnostic curettage. Hysteroscopy can resolve uterine adhesions visually, simply and safely. It is possible to determine not only the degree of adhesions, the type of adhesions, but also the toughness of the adhesions. For membranous adhesions and fibromuscular adhesions, they can be separated under hysteroscopy or surgically cut out, while for dense connective tissue-like adhesions, electrodesiccation is performed under ultrasound supervision, after which estrogen and progestin are given as a continuous medication to promote endometrial growth. The patient can resume menstruation or improve the menstrual flow, and most of the patients can resume their fertility again. If adhesions are found, can we wait for a few months or a few years, or should we have surgery immediately? Because the adhesions that are formed at the beginning are loose and easy to separate. If the adhesions are already known and are not treated. If the adhesions are not treated, they will become more difficult to separate. Secondly, the surgeon can easily enter the false passage or cause injury during the surgery to enter the uterine cavity. Such as causing perforation of the uterus or intestinal tube damage. Uterine adhesions are classified as mild, moderate and severe adhesions. Severe uterine adhesions are the most difficult of all hysteroscopic procedures. It is very easy to enter the false tract causing failure of separation of the uterine adhesions or causing injury. In the clinic, we see a lot of patients who bargain with the surgeon, saying that they do not currently have fertility requirements, they are not currently married, they are currently taking exams, they are currently busy with work. And so on for numerous reasons. Therefore, we would like to remind all patients who may be suffering from cervical adhesions to take the time to undergo a cervical adhesions separation procedure as soon as they are diagnosed. Hysteroscopy is the gold standard for separating cavity adhesions. If you know that there is currently a possibility of uterine adhesions. Please go for the surgery as soon as possible. If the adhesions have been present for a long time, the adhesions themselves can become mechanized and make surgery difficult. The adhesions are hard and non-porous, which makes surgery more difficult. It also makes it easy for the surgeon to cause damage during surgery. So, how do you know if there are adhesions? There are several signs that can alert you to the possibility of adhesions: 1) history of abortion, curettage or curettage; 2) history of myoma removal surgery; 3) history of radiofrequency ablation of fibroids; 4) history of menstruation? Low volume, even amenorrhea. The lower the menstrual volume and the longer the amenorrhea, the greater the possibility of adhesions. The more serious the degree is! 5. No regular menstruation. Such as periodic abdominal pain for about a month? If you have any of the above symptoms. Please see the doctor immediately. A diagnostic hysteroscopy can be done to detect and separate any adhesions, but neither ultrasound nor HSG can completely detect adhesions in the uterus. So when an ultrasound or HSG shows no adhesions, it does not mean that there are no adhesions.