Successful treatment of severe uterine synechiae with transcervical resectoscopy combined with laminaria tent.

Seven patients with secondary amenorrhoea were diagnosed as having severe uterine synechiae by hysterosalpingography (HSG) and hysteroscopy, which revealed short, narrow and/or scarred uterine cavities as cone or column shapes. Laminaria tents were used to distend the uterine cavity prior to transcervical resectoscopy to completely dissect the dense adhesions. A more traditional postoperative management included an intrauterine device, oestrogen and antibiotics. Transcervical resectoscopy combined with laminaria appears to be a safe and effective means of restoring the uterine cavity. All seven patients not only achieved normal menstruation but also normal uterine cavity as confirmed by subsequent HSG and hysteroscopy. In addition, three patients thereafter became pregnant, two of whom have had successful term deliveries.