Hysteroscopic Adhesiolysis for Intra-Uterine Adhesions: Implications and Limitations in a Low Resource Setting
Eghuan Kenneth Okagua *
Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, 4-6 Harley Street, Old GRA, Port Harcourt, Nigeria.
George Mathew Ela
Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, 4-6 Harley Street, Old GRA, Port Harcourt, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: The advent of hysteroscopy has radically changed the treatment modality for intra-uterine 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.
Keywords: Hysteroscopy, adhesiolysis, intrauterine adhesions, resource poor