Parashar Shreya, Pajai Sandhya, Tarang Tanmay
Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.
Cureus. 2023 Aug 16;15(8):e43553. doi: 10.7759/cureus.43553. eCollection 2023 Aug.
Intrauterine adhesions (IUAs) are the formation of scar tissues in the endometrial cavity. The fibrous tissue in the uterus decreases the space inside the uterine cavity. It includes both endometrium and myometrium. It may lead to hypomenorrhea or amenorrhea, pain, difficulty in conceiving, and recurrent abortion. IUA is caused by uterine tissue damage mostly during surgical procedures such as dilatation and curettage. Other causes may include pregnancy-related complications, miscarriage, abnormal bleeding, infections, fibroid removal, and cesarean section (C-section). Patients generally do not have any symptoms and hence are unaware of the condition. The main therapeutic procedure presently used is hysteroscopic transcervical resection of adhesion (TCRA) with hormonal therapy and nondegradable stent as postoperative adjuvant therapy. It has some major limitations such as failure to prevent recurrence and preserve fertility along with difficulty in endometrial tissue repair due to its anatomical site. These limitations have forced the researchers to think about a better treatment modality. In recent times, a better treatment modality has evolved with stem cell therapy. Therefore, this review presents the recent and advanced therapeutic modalities for the treatment of IUAs.
宫腔粘连（IUAs）是子宫内膜腔内瘢痕组织的形成。子宫内的纤维组织会减少子宫腔内部的空间。它包括子宫内膜和肌层。它可能导致月经过少或闭经、疼痛、受孕困难和反复流产。宫腔粘连主要是由手术过程中子宫组织受损引起的，如刮宫术。其他原因可能包括与妊娠相关的并发症、流产、异常出血、感染、肌瘤切除和剖宫产（C -section）。患者通常没有任何症状，因此 unaware of the condition（原文此处有误，应是“对病情不知情”，结合语境推测正确表达为“对病情毫无察觉”）。目前主要的治疗方法是宫腔镜下宫颈粘连切除术（TCRA），并辅以激素治疗和不可降解支架作为术后辅助治疗。它有一些主要局限性，如无法预防复发和保留生育能力，以及由于其解剖位置导致子宫内膜组织修复困难。这些局限性促使研究人员思考更好的治疗方式。近年来，随着干细胞治疗，一种更好的治疗方式出现了。因此，本综述介绍了治疗宫腔粘连的最新和先进治疗方式。
