Hysteroscopic Synechiolysis

Hysteroscopic Synechiolysis

Fertility Enhancing Endoscopic Surgeries 1

A relatively new kind of entity, intra-uterine adhesion (IUA) is a condition of complete or partial obliteration of the cavity of uterus by adhesions and this results in menstrual abnormalities, infertility and pregnancy loss. Cases of such abnormalities have increased exponentially in the last twenty years or so. But what are intrauterine adhesions? They are nothing but the scars that are resulted from trauma to the uterine lining. They are becoming more common these days. The percentage of women who are suffering from this condition is rising steadily, much to the alarm of the doctors and the medical fraternity!

In earlier times, hysteroscopy was performed under general anesthesia with the use of a spinal needle in parallel to the hysteroscope to perform synechiolysis. It was done by injecting a radiographic contrast medium and then it was observed with the use of an image intensifier. Cyclic high-dose estrogen therapy was used to stimulate endometrial proliferation. Repetitive procedures were then performed to regrow the endometrium.

Almost half of the women who suffer from this condition have the problem of infertility. Hence, it is very imperative that this condition be treated at the earliest under some expert guidance.

The only treatment of this problem is surgery and it consists of removing these adhesion bands by dividing them. Nowadays this is done under hysteroscopic guidance. The experts in this field are very limited, so it is a good idea to ask friends and family for references before going in for treatment. The ultimate goal of this procedure is to make sure that the uterine lining is restored. Thus, after the procedure the patient can hope to conceive naturally and have a good shot at starting a family and having children.

What is the procedure?
  • To start with, a hysteroscope is introduced into the uterus.
  •  Cavity of the uterus is distended with liquids and the uterus is visualized.
  • The adhesion bands are divided by using sharp scissors.
  • The division of the bands is done under visual control taking care not to damage the healthy endometrium.

In an alternate method, treatment of these adhesions is done using an instrument called the resectoscope. It is useful to divide the adhesions with loop of energy source. The bands can be divided easily with this method. The intrauterine adhesions can also be treated with fiber-optic lasers and they may be sometimes used to divide intrauterine adhesions as well. Depending on the severity of the condition and availability of resourses, the doctor may decide to use whichever method s/he deems fit, in that case.

The results of hysteroscopic treatment are generally achieved within a single sitting. Normal menstruation is restored in over 90% of patients after this procedure is completed.

It is a relatively new method and treatment for infertility and should be taken up only by an entrusted institution or an infertility clinic. There are very few experts in this field with the necessary expertise. So, before you go in for treatment, do test the waters and do your research. Since, the occurrence of this condition is on the rise, so the experts in this condition are also increasing to treat the masses.


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Maharashtra, India


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