Probe examination can clearly diagnose cervical-uterine adhesions

Cervical-intrauterine adhesion refers to the adhesion of the cervix and intrauterine cavity that occurs after artificial abortion, mid-term induced labor or full-term delivery, as well as after diagnostic curettage, endometrial resection and other surgeries. It depends on the area and degree of intrauterine adhesion after endometrial damage, and manifests as too little menstrual flow or amenorrhea. Various intrauterine surgeries cause trauma, leading to direct infection with pathogens, or inducing aseptic inflammatory response in the traumatic tissue of the uterine cavity, which are all important causes of intrauterine adhesion.

After the uterus is traumatized, the lytic enzyme activity of fibroblasts in the endometrium decreases, resulting in temporary excessive collagen fiber proliferation, while endometrial hyperplasia is inhibited, resulting in scar formation and adhesion.

In addition, when the estrogen level is relatively low, it may promote the formation of adhesions and make them more serious. At present, the treatment plan of supplementing low-dose estrogen after separating intrauterine adhesions is clinically effective.

After intrauterine surgery, the menstrual volume is significantly reduced or amenorrhea occurs. Some patients have cyclical abdominal pain, intrauterine blood accumulation, endometrial destruction, and uterine cavity deformation, which often lead to infertility or spontaneous abortion, premature birth, placenta previa, placenta adhesion or implantation, etc.

Therefore, the probe examination can reveal obstruction or stenosis of the internal cervical os. If the adhesion is mild, there may be a sense of breakthrough after the obstruction, and then a small amount of dark red blood will flow out after entering the uterine cavity. If there is intrauterine adhesion, the probe will feel restricted in movement after entering the uterine cavity. Most cases can be diagnosed based on typical medical history and uterine cavity examination; some cases require iodized oil hysterography or hysteroscopy.