Prevention of de-novo adhesion formation in patients with Asherman´s syndrome

Abstract

Objective: To summarize recent data and knowledge of secondary prevention of recurrence of intrauterine adhesions in patients with Asherman´s syndrome.

Methods: Analysis of literature evidence and clinical experience of the authors.

Results: Asherman´s syndrome is iatrogenic disease with problematic therapy. One of the basic issues is need of repeated surgical interventions since the recurrence of adhesions is very frequent. Secondary prevention is crucial factor for successful therapy in these patients. Second-look hysteroscopy, hormonal treatment and different types of barriers are possibilities which can be applied. To compare efficacy is difficult and the results of meta-analysis are contradictory.

Conclusion: There are many different possibilities of prevention of recurrence of intrauterine adhesions, unfortunately none of them is perfect. The usage of solid or semi-solid barrier in combination with support of regeneration of endometrium with hormonal therapy seems most reasonable.