Why do sinuses appear in the uterus?

Synechia - a fusion of surfaces of the same organ or nearby surfaces of different organs.

Asherman's syndrome (synechia in the uterus) is the fusion of the walls of the uterus. The cause of the disease, as a rule, is mechanical interference and violation of the integrity of the basal layer of the endometrium, which usually occurs as a result of abortion or after childbirth. Gynecologists argue that infection is a secondary factor that leads to the appearance of synechia.

As a rule, synechia in adult women can appear most often when the fetus freezes. After cleansing the uterine cavity, the risk of developing synechia increases in this case. This is due to the fact that the remnants of the placenta activate fibroblasts and the formation of collagen before the regeneration of the endometrium. If patients have repeated miscarriages, synechia in the uterus develops in about 30% of them.

But there are other reasons that result in the development of synechia in the uterus. Often this happens:

1. After myomectomy and metroplasty.
2. As a result of diagnostic curettage of the mucous membrane of the uterus and conization of the cervix.
3. Synechia can be a consequence of using an intrauterine contraceptive.

As a rule, the symptomatology of the disease depends on the level of adhesion of the uterine cavity. Also, if the lower part of the organ is overgrown, a hematometer may form in the upper part later. If the synechiae in the uterus cavity is characterized by a significant degree of overgrowth, this can lead to problems with fetal fetalization or infertility.

Women who begin to develop synechia in the uterine cavity may complain of pain in the lower abdomen, which are especially worse during menstruation. And the intensity of pain depends on the location of the seizures. If they are located at the bottom of the uterus or in the region of the cervical canal, the pain is stronger, because the synechia prevents in this case the withdrawal of menstrual flow. If menstruation occurs without disturbances, the pain is almost not noticeable.

As a rule, synechia in the uterus always causes an increase in the pain syndrome during the onset of menstruation. The character of menstrual changes: the allocation becomes less abundant, and their duration also decreases. If the lesions of the endometrium are significant, then they become smearing, when the stage of the disease is very serious (in case of complete overgrowth of the cervical canal or uterus), menstruation disappears completely.

To date, the only treatment method used in this disease is surgical intervention: dissection of synechia under the control of a hysteroscope. The operation is performed without causing trauma to the remaining endometrium. The features of the operation depend on the degree of complication of the disease and on its type.

Experience has shown that such treatment is highly effective. However, the greater the fusion, the lower the level of effectiveness. As a rule, the most severe prognosis regarding the recovery of the menstrual cycle, reproductive function and relapse of the disease exists in the treatment of intrauterine synechia having a tuberculous etiology.

Remember that women with complications after childbirth (in the first months) and after abortions are at risk. If these patients experience complications in the form of malfunctions of the menstrual cycle, hysteroscopy should be performed to diagnose and destroy the synechia (if their formation has begun). If there is a suspicion of the presence of the remains of the fetal egg, it is necessary to perform not only curettage of the mucous uterus, but also hysteroscopy (to clarify the focus of the pathology and its removal).