How effective is operative hysteroscopy for Asherman syndrome?

Asherman syndrome involves bands of scar tissue, also called intrauterine adhesions, that can partly or fully join the uterine walls. Through a hysteroscope passed through the vagina and cervix, a surgeon can inspect the cavity and carefully separate scar tissue without an abdominal incision.

Treatment may improve the space inside the uterus and help menstrual flow or fertility, but it cannot repair every effect of previous scarring. Dense or widespread adhesions may need more than one procedure. The uterine lining also needs time and appropriate care to heal.

Before treatment, ask how the adhesions were mapped, whether the procedure is intended to address symptoms, fertility, or both, and whether a second-look hysteroscopy or ultrasound is planned. Your clinician may recommend measures to keep the uterine walls apart while healing and may prescribe treatment tailored to your situation.

Track bleeding, pain, fever, and the return of periods after the procedure. Attend every follow-up visit, because symptoms alone may not show whether scar tissue has re-formed.

Seek urgent medical advice for heavy bleeding, worsening pelvic pain, fever, foul-smelling discharge, fainting, or difficulty passing urine after hysteroscopy. These can signal bleeding, infection, or another complication requiring examination.

Contact the treating team if periods do not return as expected, pain persists, or you are trying to conceive and need a plan for timing and monitoring.

Ask how severe and extensive the adhesions are, what improvement is realistic for your goals, whether repeat treatment may be needed, how the cavity will be checked afterward, and when it is safe to try for pregnancy.