Causes, diagnosis and treatment of genital synechiae
Synechia are bridges that stretch between tissues and lead to their sticking together. Adhesions from the side of the genitals develop with synechiae of the foreskin in boys, intrauterine synechiae and synechiae of the labia in girls.
Classification
Synechiae, which are found in the uterine cavity, are classified. They are distinguished by the type of histological (tissue) structure (the method of removing intrauterine synechiae depends on it):
- film - in the form of thin layers of fibrin, which during the examination can be easily dissected with the tip of the hysteroscope. They are found in a mild form of Asherman's syndrome - when, in addition to synechiae, growths of the endometrium (inner layer of the uterus), its sclerotic and fibrous transformations are found;
- fibromuscular - consist of fibrous and muscular tissue. They are more closely connected with the endometrium, and when an autopsy is attempted, they bleed;
- connective tissue - these are full-fledged jumpers and beams made of connective tissue. They are characteristic of a severe form of Asherman's syndrome. During outpatient manipulations, it is not possible to eliminate such bridges - an operation to dissect synechiae is necessary.
There is another classification of synechiae that have developed in the uterine cavity - it takes into account the degree of involvement of the uterus and fallopian tubes in the process:
- 1st degree of Asherman's syndrome - the jumpers fill one fourth of the uterine cavity, they do not extend beyond it (to the mouths of the tubes);
- 2nd degree of Asherman's syndrome - the adhesion process occupies up to 75% of the uterine cavity, the mouths of the fallopian tubes are also retracted into it (the place of their transition into the uterus);
- 3rd degree of Asherman's syndrome - the entire uterine cavity is filled with jumpers.
Reasons
The main reasons for the development of synechiae of the labia minora in girls and the foreskin in boys:
- inflammatory damage (in particular, with infectious diseases of the urinary tract);
- allergic reactions - local and general;
- improper implementation of hygienic measures.
Also, in girls, the formation of synechiae is caused by a low content of estrogen sex hormones, although this is the norm in childhood.
The main reasons for the development of synechiae in the uterine cavity:
- abortions;
- diagnostic scraping;
- use of intrauterine spirals;
- inflammatory impression of the endometrium.
Eliminating these causes is one of the methods of treating synechiae.
Symptoms
Manifestations of synechiae of the external genitalia in children:- a film appears between the labia minora in girls, between the foreskin and the head of the penis in boys;
- with pronounced synechiae, the external opening of the urinary canal is closed - urination is difficult;
- redness, burning sensation, itching may appear in the area of the external genitalia.
Closing the urethral opening with films affects the child's behavior - with every act of urination, she has to strain, unpleasant sensations arise, so the child cries and is fussy.
Manifestations of synechiae of the uterine cavity in women:- abdominal pain that worsens during menstruation;
- a small amount of menstrual discharge;
- disruption of the menstrual cycle;
- involuntary abortions or premature births in pregnant women.
Diagnostics
Parents themselves can detect this pathology of the external genitalia in their children. But oil and creams for synechiae should not be used without a preliminary examination and recommendations of a doctor.
On our website https://dobrobut.com/ you will learn more about the diagnosis of this pathology - in particular, what synechiae look like in an infant .
In order to detect synechiae of the uterine cavity, additional diagnostic methods are required:
- hysteroscopy - examination of the uterine cavity using a hysteroscope (a type of endoscope). At the same time, long thin whitish threads are found in the uterine cavity, as well as in the cervical canal;
- ultrasound examination of the uterus and fallopian tubes (ultrasound) - with its help, areas of the fallopian tubes that have been overgrown with synechiae are detected;
- hysterosalpingography - a contrast agent is injected into the uterine cavity, then X-rays are taken.
Treatment of synechiae
Methods of treatment of this disease are conservative and surgical.
Conservative treatment methods
How to treat synechiae in a child? In girls, the pathology is treated in the early stages, before the labia minora have completely stuck together, with the help of pads with an ointment that contains estrogen. The pad is applied at night for 5-7 days. To remove synechiae, boys practice:
- ointments with anti-inflammatory effect;
- careful shifting of the foreskin during bathing.
Surgical methods of treatment
In an advanced state, synechiae of the external genitalia are removed:
- in girls - by dissection under local anesthesia;
- in boys - by separating the ligaments with the help of a probe or through an autopsy.
What to do if synechiae are detected in the uterine cavity? In non-starting cases, synechiae are removed through the cervix:
- using a hysteroscope;
- tweezers;
- electric knife;
- laser beam.
In advanced intrauterine synechiae, an operation is required for dissection (most often laparoscopic intervention is performed).
After any procedure, the doctor must tell what should happen normally after the separation of synechiae.
Prevention
Measures to prevent the formation of synechiae are:
- in children – prevention and treatment of inflammatory diseases of the external genital organs, proper use of diapers, proper hygiene measures;
- for women - refusal of abortions, competent treatment of inflammatory diseases of the genital area.
Related services:
Gynecological Check-up
Colposcopy
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