What should you know about hysteroscopy for Asherman syndrome?

Asherman syndrome, also called intrauterine adhesions, occurs when bands of scar tissue join areas inside the uterus. The space available for the uterine lining can become reduced or distorted. Some people notice periods stopped or became much lighter, while others have pelvic pain, difficulty conceiving, or pregnancy difficulties. These symptoms can have other causes, so they need individual assessment.

A hysteroscope gives the clinician a direct view of the uterine cavity. If adhesions are found, operative hysteroscopy may allow them to be separated with fine instruments. The aim is to restore the shape of the cavity as safely as possible; the plan depends on where the adhesions are, how extensive they are, and whether preserving fertility is a goal.

Bring details about previous uterine procedures, pregnancy history, changes in bleeding, pain, and fertility plans. Ask whether imaging or a camera examination is needed first, and which form of anaesthesia is planned. Your specialist may explain that treatment is scheduled around the menstrual cycle and may discuss follow-up to check how the cavity has healed.

After operative hysteroscopy, follow instructions about medicines, activity, sex, and vaginal products. Mild cramping or light bleeding may occur after the procedure. Keep the follow-up appointment, because symptoms alone cannot show whether the uterine cavity has healed or whether adhesions have returned.

Call your surgical team if bleeding is heavy, pain is severe or increasing, or you develop fever, chills, foul-smelling discharge, faintness, or a general feeling of illness. Seek urgent medical help for severe abdominal pain, collapse, difficulty breathing, or bleeding that leaves you weak. If periods remain absent or markedly changed after recovery, report this at follow-up rather than assuming the procedure has failed.

Ask: Where are the adhesions and how extensive do they appear to be? Will the procedure be diagnostic or operative? Could treatment require more than one procedure? What follow-up will assess the uterine cavity? How might the plan affect attempts to conceive or a future pregnancy?