Gynaecological Surgery

Question 1

What is Asherman’s syndrome?

Answer 1

Adhesions within the uterus following damage

Question 2

Presentation of Asherman’s syndrome

Answer 2

Typically presents following recent dilatation and curettage, uterine surgery or endometritis with:

Secondary amenorrhoea (absent periods)

Significantly lighter periods

Dysmenorrhoea (painful periods)

Question 3

Diagnosis of Asherman’s syndrome

Answer 3

Hysteroscopy is gold standard investigation, and can involve dissection and treatment of the adhesions

Hysterosalpingography, where contrast is injected into the uterus and imaged with xrays

Sonohysterography, where the uterus is filled with fluid and a pelvic ultrasound is performed

MRI scan

Question 4

Management of Asherman’s syndrome

Answer 4

Dissecting the adhesions during hysteroscopy

Recurrence of the adhesions after treatment is common