Ashermans syndrome (AS) is an acquired uterine condition that occurs when scar tissue (adhesions) form inside the uterus and/or the cervix. It is characterized by variable scarring inside the uterine cavity, where in many cases the front and back walls of the uterus stick to one another. AS can be the cause of menstrual disturbances, infertility, and placental abnormalities. Although the first case of intrauterine adhesion was published in 1894 by Heinrich Fritsch, it was only after 54 years that a full description of Asherman syndrome was carried out by Joseph Asherman. A number of other terms have been used to describe the condition and related conditions including:  uterine/cervical atresia, traumatic uterine atrophy, sclerotic endometrium, and endometrial sclerosis.There is not any one cause of AS. Risk factors can include myomectomy, cesarean section, infections, age, genital tuberculosis, and obesity. Genetic predisposition to AS is being investigated. There are also studies that show that a severe pelvic infection, independent of surgery may cause AS. AS can develop even if the woman has not had any uterine surgeries, trauma, or pregnancies. While rare in North America and European countries, genital tuberculosis is a cause of Ashermans in other countries such as India. History
The condition was first described in 1894 by Heinrich Fritsch (Fritsch, 1894) and further characterized by the Israeli gynecologist Joseph Asherman (1889–1968) in 1948.It is also known as Fritsch syndrome, or Fritsch-Asherman syndrome.
Triamterene (trade name Dyrenium among others) is a potassium-sparing diuretic often used in combination with thiazide diuretics for the treatment of high blood pressure or swelling. The combination with hydrochlorothiazide, is known as hydrochlorothiazide/triamterene. Side effects
Common side effects may include a depletion of sodium, folic acid, and calcium, nausea, vomiting, diarrhea, headache, dizziness, fatigue, and dry mouth. Serious side effects may include heart palpitations, tingling/numbness, fever, chills, sore throat, rash, and back pain. Triamterene can also cause kidney stones through direct crystallization or by seeding calcium oxalate stones. Triamterene is best avoided in patients with chronic kidney disease due to the possibility of hyperkalemia. People using this drug should use salt substitute cautiously.Triamterene may impart a blue fluorescent color to the urine. Caution with certain disease states
Diabetes: Use with caution in people with prediabetes or diabetes mellitus as there may be a change in glucose control. Liver impairment: Use with caution in people with severe liver dysfunction; in cirrhosis, avoid electrolyte and acid/base imbalances that might lead to hepatic encephalopathy. Kidney failure: combined triamterene and indomethacin therapy caused reversible acute kidney injury in some people.Kidney stones: Use with caution in people with kidney stones. Use should be avoided if the creatinine clearance is less than 10 ml/minute. Mechanism of action
Triamterene directly blocks the epithelial sodium channel (ENaC) on the lumen side of the kidney collecting tubule.