Experience of complex therapy in the treatment of patients with Asherman’s syndrome


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Background. The incidence of Asherman’s syndrome (AS) is growing and accounts for 24 to 62% in the structure of infertility according to various sources; its effective treatment is still the subject of scientific research and evaluation due to the high probability of disease recurrence, which is up to 63%. Objective. Evaluation of the effectiveness of treatment of patients with AS using hysteroscopic adhesiolysis in combination with irrigation of the uterine cavity with cavitated solutions, pelotherapyand magnetotherapy. Methods. The study included 29 patients with AS of varying severity identified by diagnostic hysteroscopy. All patients underwent surgical hysteroscopy with various options for dissection of intrauterine synechiae and the introduction of an adhesion barrier. After surgery, a set of therapeutic and prophylactic measures was used: cyclic hormonal therapy (estradiol/dydrogesterone 2/10 mg) for 3-4 cycles; from the 2nd month after surgery - 5 procedures of low-frequency ultrasonic cavitation with 0.05% aqueous chlorhexidine or immuno-fan solution intrauterinely 2 courses, and intravaginal pelotherapy with Dead Sea mud in combination with magnetotherapy (after the completion of the low-frequency ultrasonic cavitation course) - 1-2 courses. Results. The absence of synechiae after treatment was noted in 23 patients (79.3%), relapse - in 6 (20.7%) with in 3-4 months after surgery. Of 19 patients planning a pregnancy, 10 (52.6%) got pregnant: 8 had a spontaneous pregnancy, 2 - as a result of IVF. In 7 (70%) patients, pregnancy ended in childbirth, in one - spontaneous miscarriage, in 2 - non-developing pregnancy. Conclusion. The study showed that an integrated approach using laser adhesiolysis and anti-adhesion barrier with subsequent rehabilitation measures can improve the results of treatment of patients with AS.

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作者简介

E. Glukhov

Ural State Medical University; Center for Operative Gynecology"Women's Clinic"

Email: 9222241411@mail.ru
Dr. Sci. (Med.), Professor at the Department of Obstetrics and Gynecology

G. Dikke

Academy of Medical Education n.a. F.I. Inozemtsev

E. Neff

Center for Operative Gynecology"Women's Clinic"

V. Glukhova

Ural State Medical University; Center for Operative Gynecology"Women's Clinic"

D. Berezina

Ural State Medical University

参考

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