Hysteroscopy is also used to diagnose intrauterine adhesions. This is a procedure in which a thin, telescope-like instrument is inserted through the cervix to allow direct visualization of the uterine cavity. Although HSG is a useful screening test, hysteroscopy is the most accurate method of evaluating intrauterine adhesions. Both HSG and hysteroscopy can be performed in an office setting without general anesthesia. Following removal of the adhesions, many surgeons recommend temporarily placing a device, such as a plastic catheter, inside the uterus in an effort to keep the walls of the uterus apart and prevent adhesions from reforming.
Reproductive outcome appears to correlate with the type and extent of the adhesions.
After treatment, patients with mild to moderate adhesions have full-term pregnancy rates of approximately 70 to 80 percent, and menstrual dysfunction is frequently alleviated. Alternatively, patients with severe adhesions or extensive destruction of the endometrial lining may only have full-term pregnancy rates in the 20 to 40 percent range after treatment. Women with extensive damage to the endometrium unresponsive to conventional therapy by hysteroscopy may be offered gestational surrogacy. None of the material contained on this service may be reproduced, stored or transmitted in any form without prior written permission of the respective copyright holder.