32)hysteroscopic principles in asherman syndrome скачать в хорошем качестве

32)hysteroscopic principles in asherman syndrome

Asherman syndrome is a condition in which there are intrauterine adhesions causing hypomenorrhea/amenorrhea, infertility. Patients do not respond to hormones.USG shows thin irregular echogenic endometrium with sometimes loss of endo- myometrial interface. Hysteroscopy is GOLD STANDARD for evaluation of uterine cavity as well as restoring the uterine morphology in the same setting. Vaginoscopic approach with miniature Bettocchi 4/5 hysteroscopes is recommended. We prefer the office setting that is without any premedication and any form of anaesthesia.Pain experienced by the patient will be guiding light.Counselling of the patient is of utmost importance as we may require to do hysteroscopy 2 to 3 times, sometimes multiple sittings to achieve our goal to restore the endometrial cavity and resume functioning by onset of menstruation or by attaining pregnancy and live birth. This video is attempt to outline hysteroscopic principles for Asherman. At our centre all intrauterine adhesions are dealt with in office.The video also highlights principles that will make the procedure safe and prevent complications like perforation and inadequate treatment. Sometimes we are unable to enter the cavity due to severe stenosis of cervical canal and internal os and doing blind dilatation is definitely risky. So using miniature hysteroscopes and low pressure settings helps in see and treat.