Simplified therapy for Asherman's syndrome.

OBJECTIVE

To evaluate a technique that converts a blind hysteroscopic procedure to a "septum" division.

DESIGN

Open noncomparative clinical study.

SETTING

Tertiary care center.

PATIENT(S): Six women with Asherman's syndrome; five with complete and one with incomplete obliteration of the uterine cavity.

INTERVENTION(S): The patients underwent recreation of the uterine cavity by the hysteroscopic-laparoscopic technique described to establish the correct dissection plane.

MAIN OUTCOME MEASURE(S): The ability to reestablish the uterine cavity; postoperative resumption of menses and fertility.

RESULT(S): In all patients, the cavity of the uterus was restored; menses resumed in all women who were previously amenorrheic; and 5 women conceived, of whom four had live births and one a missed abortion. At hysteroscopy, two women incurred perforations and in another hemorrhage occurred.

CONCLUSION(S): This technique appears to be effective and safe for the reconstruction of a functional endometrial cavity in women with Asherman's syndrome.