Intrauterine adhesions (IUA), also known as Asherman syndrome, are caused by partial or complete occlusion of the uterine cavity due to endometrial damage, resulting in abnormal menstruation, infertility and recurrent miscarriages, and are associated with trauma, pregnancy and infection. In patients with moderate to severe endometrial adhesions, the endometrial basal layer is severely damaged, the regenerative capacity of the endometrium and glands is low and the tolerance of the endometrium is poor, resulting in a poor clinical prognosis. In recent years, with the development of hysteroscopic techniques, hysteroscopic colectomy (TCRA) has become the standard treatment for uterine adhesions with targeted separation or incision of uterine adhesions under direct vision. However, the prevention of postoperative re-adhesion remains a challenge in clinical management. Uterine adhesions (IUA) are the mutual adhesions of the myometrium and/or cervical canal of the uterus after damage to the basal layer of the endometrium due to various factors. The clinical manifestations are: in menstruation, it causes secondary decrease in menstrual flow, amenorrhea, and periodic lower abdominal pain due to poor menstrual flow; in fertility, it mainly affects secondary infertility, habitual miscarriage, abnormal miscarriage, premature birth, stillbirth, etc. A few pregnancies can reach full term, but it is often combined with serious obstetric complications such as placental residue, placental implantation, and postpartum hemorrhage. 36.1% of patients show decreased menstrual flow, 22.2% show decreased menstrual flow, and 22.2% show decreased menstrual flow. 36.1% of the patients showed decreased menstrual flow, 22.2% showed infertility secondary to curettage, 16.7% showed amenorrhea after curettage, 8.3% showed recurrent miscarriage, 11.1% showed cyclic abdominal pain secondary to curettage, and 5.6% showed no obvious clinical manifestations and were found to have cavity adhesions on preconception ultrasound. Most of the uterine adhesions are caused by trauma due to uterine surgical operations, and the literature reports that more than 90% of IUA are caused by uterine surgical operations that damage the basal layer of the endometrium, with an average of 2 (S=2.6) clearings; the time between the last clearing and the appearance of clinical symptoms ranges from 2 months to 4 years, with an average of 2.1 (S=1.7) years. In recent years, with the increase of uterine operations, the incidence of IUA has gradually increased and has become a common problem endangering the physical and mental health of women of childbearing age. The clinical symptoms and ancillary examinations of IUA often lack specificity, and ultrasound images often need to be distinguished from double uterus, stump-angle uterus and longitudinal uterus, etc. If necessary, 3D ultrasound examination is performed to help exclude uterine malformations. In addition, for patients with low menstrual flow as the main clinical manifestation, ultrasound examination only reveals “thin endometrium”, which should be distinguished from idiopathic reduced menstrual flow and endocrine level abnormalities. A comprehensive analysis of the patient’s medical history, sex hormone profile and the assistance of ultrasound and hysteroscopy is not difficult to make a diagnosis. Because of the difficulty in diagnosis, the high risk of surgery and the high recurrence rate after surgery, the choice of treatment plan has always been a challenge in clinical treatment. With the development of hysteroscopic technology, hysteroscopic colectomy (TCRA) has become the standard method for the treatment of uterine adhesions by targeting the separation or incision of uterine adhesions under direct vision. However, the prevention of postoperative re-adhesion remains a challenge in clinical management. In patients with uterine adhesions, the basal layer of the endometrium is more severely disrupted, resulting in a low regenerative capacity of the endometrium and glands. High-dose estrogen cycle therapy is currently recommended to prevent the formation of new postoperative adhesions and to promote endometrial coverage. The rationale is that cyclic estrogen can stimulate the growth of endometrium, which can rapidly cover the fibrotic scars of previous adhesions and accelerate the epithelialization of the exposed areas so that they do not re-adhere to each other and facilitate the growth of new endometrium, so as to improve the volume and duration of menstruation and restore the normal shape of the uterine cavity. The endometrial changes monitored by ultrasound before and after surgery in our patients with clinical cavity adhesions suggest that their endometrium was thin before treatment, with an average thickness of only 4.12 mm; after three months of treatment with estrogen 9 mg/d manual cycle for cavity adhesions, their endometrial thickness improved compared with that before surgery, and the difference with the preoperative endometrial thickness was statistically significant, which indicates that high-dose estrogen shock therapy helps endometrial growth and repair. endometrial growth and repair. The recovery of endometrium and clinical cure rate of patients with moderate cavity adhesions were better than those of patients with severe cavity adhesions, which was considered to be related to the extent of endometrium remaining before surgery and the regenerative ability of endometrium, and showed that the recovery of cavity adhesions after surgery was closely related to the area of cavity adhesions before surgery and the degree of adhesions and other underlying conditions. However, this study also reflects that the prognosis of clinical treatment of cavity adhesions is not satisfactory, and re-adhesions after TCRA for IUA are common, and their treatment is still a difficult clinical problem. Research data show that the rate of re-adhesion after severe IUA is still as high as 20%-62%. Our clinical experience shows that the cure rate of moderate IUA after surgery is 59.1%, the improvement rate is 36.4%, and there is a successful pregnancy in the postoperative follow-up; the cure rate of severe IUA group after surgery is only 21.4%. This is mainly related to the significant decrease in endometrial regeneration capacity after severe destruction of the basal layer of the endometrium. Thus, it is necessary to supplement the treatment regimen with artificial cycles after electrodesection and separation of uterine adhesions, and the estrogen dosage of 9 mg/d is relatively safe and effective. The endometrial thickness of the uterine cavity was thicker than that before surgery, but still did not reach the normal range, and the clinical outcome was not yet satisfactory. The endometrial recovery and clinical cure rate of patients with moderate cavity adhesions were better than those of the group with severe cavity adhesions, suggesting that the clinical prognosis of patients with cavity adhesions is related to the degree and extent of preoperative cavity lesions and the area and growth of the residual endometrium.