Management of false passage created during hysteroscopic adhesiolysis for Asherman’s syndrome

Abstract

False passage in the uterus, if unrecognised, will almost certainly lead to perforation of the uterus and associated complications. We present our experience of the management of a false passage encountered during hysteroscopic surgery for the treatment of severe Asherman's syndrome. Five women with severe Asherman's syndrome resulting in complete obliteration of the uterine cavity and a false passage created during hysteroscopy were included in our study. A subsequent hysteroscopy was performed under ultrasound guidance with preoperative oestrogen therapy to increase endometrial thickness. In all 5 cases, the uterine cavity was successfully entered during the repeat hysteroscopy, which enabled the adhesiolysis procedure to be completed. There was satisfactory improvement in menstrual pattern and significant reduction in intrauterine the adhesion score. Two of the three patients who wished to conceive did become pregnant. The early recognition of a false passage inadvertently created during hysteroscopy is crucial in preventing further damage to the uterus.

Keywords::

• Asherman's syndrome
• false passage
• intrauterine adhesiolysis
• oestrogen therapy
• ultrasound guidance

Acknowledgements

This work was supported by a grant from the XiCheng District Outstanding Asset Fund of Beijing (20120043).

Declaration of interest: The authors report no declarations of interest. The authors alone are responsible for the content and writing of the paper.