Pressure lavage under ultrasound guidance: a new approach for outpatient treatment of intrauterine adhesions

The uterus and fertility

“…Hysteroscopic adhesiolysis can be performed using the tip of hysteroscopic forceps for blunt dissection, sharp dissection with hysteroscopic scissors, or the use of a knife electrode. Fluoroscopy may enhance the procedure (88), and pressure lavage under ultrasound guidance has also been reported (89).…”

Influence of auto-cross-linked hyaluronic acid gel on pregnancy rate and hysteroscopic outcomes following surgical removal of intra-uterine adhesions

“…Several treatments have been proposed. Non-invasive procedures such as pressure lavage under ultrasound guidance or fluoroscopically-guided hysteroscopic division of adhesions have been proposed, but hysteroscopic removal remains the gold standard [4][5][6][7]. During the last decade, many barrier agents have been introduced during hysteroscopic procedures for removal of fibroids, uterine septa or polyps to prevent IUAs and in the hope of increasing the pregnancy rate.…”

Intrauterine adhesions (IUA): has there been progress in understanding and treatment over the last 20 years?

“…Accumulation of saline in the uterine cavity can dilate and mechanically disrupt IUA [37]. This technique is applicable for mild to moderate filmy adhesions.…”

“…The use of oestrogens is empirical and no datum exists concerning the dose and the length of therapy. Most authors used 1-3 months of a high dose of oestrogens [37,38,40]. Progesterone test can be used to induce the menstruation if it does not occur spontaneously.…”