2453 Office Hysteroscopic Adhesiolysis in a Patient with Severe Asherman's Syndrome

Abstract

Video Objective To demonstrate our technique for adhesiolysis in an office hysteroscopy setting. Setting Office Hysteroscopy. Our patient is a 40 year old nulliparous female with a history for fibroids and heavy uterine bleeding. She has had three hysteroscopic myomectomies, and a uterine artery embolization. In her evaluation prior to IVF she had a HSG and SIS that demonstrated a shortened uterine cavity and likely uterine adhesions. Interventions We demonstrate our technique for adhesiolysis of uterine synechiae utilizing a 5mm hysteroscope with a 5 fr. working channel and the semi-rigid scissors. Using internal landmarks, and a combination of blunt and sharp dissection we are able to restore the uterine cavity to its normal contour in the office, in spite of the dense adhesions. The presentation ends with a 2nd look hysteroscopy 3 weeks following the initial procedure. Conclusion Office hysteroscopy is a viable and effective option for management of severe Asherman's syndrome.