[Treatment of uterine synechiae without hysteroscopy in a semiurban setting in Cameroon]. / Traitement des synéchies utérines en l'absence d'hystéroscopie en milieu semi-urbain au Cameroun.

We evaluated the outcome of treatment of uterine synechiae (or adhesions, also known as Asherman syndrome) by cervical dilatation and sequential estrogen and progestogen administration for three months. This retrospective cohort study examined records of 86 women with infertility or menstrual disorders or both and treated from October 2004 to November 2011 for synechiae diagnosed by hysterosalpingography. The data analyzed included age, presenting complaint, and treatment outcome. During the study period, 86 women were seen for uterine synechiae but only 81 files could be included. The patients' mean age was 25.52 (range: 19-40 years), with 37% in the age group of 25-29 years. Of these 82 women, 71 reported menstrual disorders and 60 infertility. After treatment, 11/60 (18%) became pregnant and 35/71 (49%) recovered normal menstrual profiles. The reference treatment for uterine synechiae is hysteroscopy, which yields good results. In poor settings, however, hysteroscopy remains inaccessible, and the old method of cervical dilation and sequential estrogen and progestogen therapy is an acceptable alternative.