Asherman's syndrome medical therapy: Difference between revisions
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'''Editor(s)-in-Chief:''' {{CMG}}; [[User:Csinfor|Canan S Fornusek, Ph.D.]]; '''Associate Editor-In-Chief:''' {{skhan}} | '''Editor(s)-in-Chief:''' {{CMG}}; [[User:Csinfor|Canan S Fornusek, Ph.D.]]; '''Associate Editor-In-Chief:''' {{skhan}} | ||
==Overview== | ==Overview== | ||
Medical therapy usually follows surgical removal of fibrous bands in the uterus causing the condition. Estrogen provides stimulation for endometrial proliferation. | Medical therapy usually follows surgical removal of fibrous bands in the uterus causing the condition. Estrogen provides stimulation for endometrial proliferation. Anti-adhesive gels may also be employed to prevent recurrence. | ||
==Medical Therapy== | ==Medical Therapy== | ||
Hormonal therapy with synthetic or conjugated [[estrogen]] is usually prescribed following surgery to stimulate endometrial growth thereby preventing the walls of the uterus from re-adhering. | Hormonal therapy with synthetic or conjugated [[estrogen]] is usually prescribed following surgery to stimulate endometrial growth thereby preventing the walls of the uterus from re-adhering. | ||
More studies are needed to evaluate which method of treatment is most likely to have a successful outcome. | Acunzo et al found a significant effect of hyaluronic acid compared to no gel barrier for prevention of new IUA after hysteroscopic adhesiolysis. However, a large study comparing intrauterine balloon, Intrauterine contraceptive device ([[Intrauterine device|IUCD]]) and [[Hyaluronic acid|hyaluronic]] acid gel demonstrated that the balloon and IUCD were more effective than the gel. Fertility data was not accounted for in this analysis so long term results cannot be determined. Another retrospective cohort study compared balloon, IUCD, hyaluronic acid and controls. In this study no difference between balloon and IUCD was seen, yet these two modalities were significantly more effective than hyaluronic acid. | ||
According to the literature the only specific infection that causes Ashermans Syndrome is genital tuberculosis. There is no evidence in the literature that prophylactic antibiotics can prevent secondary intrauterine infectious complications. However, when obvious infection is seen, antibiotics are mandatory. | |||
More studies are needed to evaluate which method of treatment is most likely to have a successful outcome. Future randomized trials are needed to prove if stem cell treatment will have a clinical role in Ashermans Syndrome. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WikiDoc Help Menu}} | {{WikiDoc Help Menu}} | ||
{{WikiDoc Sources}} | {{WikiDoc Sources}} | ||
Revision as of 18:05, 4 September 2022
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Editor(s)-in-Chief: Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Canan S Fornusek, Ph.D.; Associate Editor-In-Chief: Saud Khan M.D.
Overview
Medical therapy usually follows surgical removal of fibrous bands in the uterus causing the condition. Estrogen provides stimulation for endometrial proliferation. Anti-adhesive gels may also be employed to prevent recurrence.
Medical Therapy
Hormonal therapy with synthetic or conjugated estrogen is usually prescribed following surgery to stimulate endometrial growth thereby preventing the walls of the uterus from re-adhering.
Acunzo et al found a significant effect of hyaluronic acid compared to no gel barrier for prevention of new IUA after hysteroscopic adhesiolysis. However, a large study comparing intrauterine balloon, Intrauterine contraceptive device (IUCD) and hyaluronic acid gel demonstrated that the balloon and IUCD were more effective than the gel. Fertility data was not accounted for in this analysis so long term results cannot be determined. Another retrospective cohort study compared balloon, IUCD, hyaluronic acid and controls. In this study no difference between balloon and IUCD was seen, yet these two modalities were significantly more effective than hyaluronic acid.
According to the literature the only specific infection that causes Ashermans Syndrome is genital tuberculosis. There is no evidence in the literature that prophylactic antibiotics can prevent secondary intrauterine infectious complications. However, when obvious infection is seen, antibiotics are mandatory.
More studies are needed to evaluate which method of treatment is most likely to have a successful outcome. Future randomized trials are needed to prove if stem cell treatment will have a clinical role in Ashermans Syndrome.
References