Abstract
Objective: The purpose of this study was to evaluate the menstrual and uterine shape in patients diagnosed with severe intrauterine adhesion (IUA) on hysteroscopy and to assess the outcome following hysteroscopic adhesiolysis.
 Materials and methods: It is a retrospective study of patients with severe intrauterine adhesion who attended with complain of infertility, abortion , and repeated dilatation and curettage to our institution from January 2017 and December 2017. Post hysteroscopic adhesiolysis the inserted of urinary balloon catheter and intrauterine device (IUD). The sodium hyaluronate gel was administered inside the uterus and oral cyclical hormonal treatment was initiated after the surgery to all patients to prevent reformationof adhesion, and promote endometrial regeneration respectively. The outcome of menstrual pattern and uterine shape were retrospectively analyzed. Data analyzed was performed with SPSS for Windows, version 20.0). Statistically significant level was set at p<0.05.
 Results: In a total number of 64 patients with severe intrauterine adhesion and mean age of 30.1 years old were participated in this study. No identification of any complication around the hysteroscopy adhesiolysis. Out of 64 severe IUA patients, 59 (92.1%) patients had second, 42 (65.6%) had the third hysteroscopic adhesiolysis procedure required. After 3 months follow-up, restore of uterine shape and 95 % of patients in progress to normal menstruation, which was considered as significant (p<0.05).
 Conclusion: The patients with severe intrauterine adhesion (IUAs) have found significant progress of normal pattern of menstruation with normal shape of the uterine cavity following hysteroscopic adhesiolysis. The repeat procedure and strategies are necessary for prevention of adhesions.
 Bangladesh Journal of Medical Science Vol.19(3) 2020 p.475-479
Highlights
Intrauterine adhesions occur following injury to the uterine endometrium, which may lead to development of adhesion formation
Total 64 patients hysteroscopically diagnosed with severe intrauterine adhesions by American Fertility Society (AFS), classification of IUAs.[12] who was treated at the Third Xiangya Hospital, Central South University, China, over a period of January 2017 to December 2017
Hypomenorrhoea has been frequently menstrual character which was found in IUA patients (Table 3 and Fig-1)
Summary
Intrauterine adhesions occur following injury to the uterine endometrium, which may lead to development of adhesion formation. The uterine wall adherence each other may cause minimal, marginal, or complete obliteration of the uterine cavity during their healing mechanism.[1,2,3] The intrauterine adhesions may extend the endometrium, myometrium, or connective tissue, which proceed to menstrual disturbance, failure to conceive and abortion.[3] most of the IUA patients present with infertility and menstrual problems.[3] Intrauterine adhesions usually result from post traumatic or post infectious injury to the basalis layer of the endometrium leading to healing by fibrosis with the resultant obliteration of the uterine cavity. The frequently of dilatation and curettage (D&C), infection, ischaemia, exposure to foreign materials may develop of intrauterine adhesions. The frequently of dilatation and curettage (D&C), infection, ischaemia, exposure to foreign materials may develop of intrauterine adhesions. 2-
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