Hysteroscopic Adhesiolysis for Intra-Uterine Adhesions: Implications and Limitations in a Low Resource Setting
Résumé
Background: The advent of hysteroscopy has radically changed the treatment modality for intrauterine adhesion (IUA) which is a challenge for women of reproductive age, causing menstrual abnormalities and infertility and occurring in about 1.5% of the general population. Hysteroscopic techniques are now considered the gold standard for the treatment of IUA but it is unfortunately neither readily accessible nor affordable in resource poor settings. Aim: To present the efficacy of this treatment modality and advocate for its popularization in resource poor settings. Case Report: A 38-year-old housewife, P2 +1 (2 alive, 2 previous caesarean sections), presented with features of IUA and 6 months amenorrhoea following dilatation and curettage (D&C) for a blighted ovum. She had hysteroscopic adhesiolysis, Foleys catheter insertion and hormonal therapy. Resumption of menstruation occurred within one month of the procedure and post operative investigation results suggests a capacious uterine cavity. Conclusion: Hysteroscopy is the way forward in the treatment of IUAs instead of the traditional method of blind D&C but advocacy is needed to bring it within the reach of women in resource poor settings.
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