The cervical function and pregnancy outcomes after. A small camera attached at the end of a tube is inserted through the neck of the uterus into the uterine cavity under direct vision. This is an abnormality that some women are born with. Apr 09, 2020 patients with a uterine septum have a small chance of also having kidney abnormalities. Hysteroscopic septum resection is worldwide considered as a standard procedure in women with a septate uterus. It may affect fertility and increase the risk of miscarriage. Hysteroscopic transcervical resection of uterine septum. We describe a patient who underwent uneventful hysteroscopic resection of a uterine septum but experienced rupture of the septum during subsequent labor.
Uterine abnormalities, like uterine septum are typically congenital present from birth and are referred to as mullerian anomalies, as the uterus develops from a specialized type of tissue called mullerian tissue. Another major factor is the frequency and intensity of uterine contractions during pregnancy after septum resection. Nonresectoscopic endometrial ablation, also referred to as secondgeneration ablation, is performed with a device that is inserted into the uterine cavity and delivers energy to uniformly destroy the uterine lining. Demonstration of three different techniques for a hysteroscopic septum resection. This website uses cookies to ensure that we give you the best experience on our website. Licciardi shows you actual footage of him performing surgery for a large uterine septum. A septum is a thick bridge of tissue that partially or completely divides the uterine cavity in half. Uterine septum causes of pregnancy loss infertility. Uterine septum resection using the hysteroscope youtube. The two groups were similar in age, bmi, average number of cycles per patient, and infertility diagnosis. Reproductive outcomes following uterine septum resection. Uterine septum is a triangular tissue that divides the uterine cavity into two.
The authors declare that they have no conflict of interest. Infertility this may be as adhesions limit the uterine muscular activity, thereby reducing the perfusion of sex steroids to the endometrium, with atrophy as a consequence. Uterine septum resection is the term commonly used to describe all surgical procedures performed to treat a uterine septum. Fertility and pregnancy outcomes following hysteroscopic met. In a retrospective cohort study, we evaluated the reproductive outcome after hysteroscopic septoplasty in 64 women with septate uterus and primary or secondary infertility. Overview hysteroscopic metroplasty of a uterine septum for. Welcome back, todays blog is a little different, as it is the first one of mine that uses a video. I have viewed many such videos on line and feel that they leave room for improvement. Surgery was traditionally done by a transabdominal approach. How long after surgical treatment of a uterine septum should a woman wait to conceive.
The res i work with usually tell their patients they can ttc after their first period after the resection. Pregnancy is possible, but there is a higher chance of miscarriage or preterm delivery. Reproductive outcome after hysteroscopic septoplasty in. This can lead to the is rare complication of postoperative uterine rupture. The uterus womb is a female reproductive organ, wherein the fertilized egg develops into a fetus baby. The patient was a 37yearold nullipara with three previous firsttrimester missed abortions. The patient is a 52 year old presenting with post menopausal bleeding. Pdf hysteroscopic resection of the vaginal septum in uterus. This video shows two uterine fibroids being removed using the hysterocope, reducing the amount of time the same resection would have taken using an older instrument, the resectoscope,and decreasing the risk of fluid overload. Video removal of fibroid using the hysteroscope hysteroscopic myomectomy video hysteroscopic intrauterine adhesions resection synaechiae clip no 1 video hysteroscopic endometrial resection resection of the endometrium by hysteroscope video hysteroscopic intrauterine adhesions resection synaechiae clip no 2 video hysteroscopic resection of uterine septum, clip no 6 video. Talk to our surgery expert for help in all your needs. Treatment of uterine septum hysteroscopy is a procedure where a small telescopic camera hysteroscope is inserted via the vagina, through the cervix, and into the uterine cavity.
Endometrial resection, also known as hystero resection is a procedure performed in women who are having menstrual problems. Septum resection is worth considering in women who can conceive to improve fecundity and to decrease the rates of miscarriage and preterm labor. Uterine septum resection improves obstetrical outcomes. Pdf hysteroscopic transcervical resection of uterine septum. The wedgelike partition may involve only the superior part of the cavity resulting in an incomplete septum or a subseptate uterus, or less frequently the total length of the cavity complete septum and the cervix. The actual resection is typically very easy to do, minimally invasive depending on the size of the septum and heals pretty quickly from what i am told. To explore the method of diagnosis for uterine septum and the clinical effect of hysteroscopic transcervical resection of the septum. Need help in finding the best surgeon for uterine septum resection in indore. Hysteroscopic treatment of uterine septa is a safe, simple, and effective procedure. Hysteroscopic septal resection in women with septate uteri and a history of miscarriage increases the proportion of women who have live births. I was immediately put on bc to keep my lining thin, and prevent pregnancy.
Here, we report a case of spontaneous recurrent rupture uterus at 32 weeks of gestation in a 28yearold woman with previous history of hysteroscopic resection of uterine septum after development. The septum usually starts at the top of the uterus the fundus and can reach down to the uterine opening the cervix. The procedure starts from the lower part of the septum and. Lightguided hysteroscopic resection of complete septate. Preand postseptal resection reproductive outcomes were compared in women with infertility and prior pregnancy losses operated on for uterine septum from 2003 to 2010. Vercellini et al first tried resection of cervical and corporal septum of 7 patients with complete uterine septum and duplicate cervix at the same time, and they used the traditional method with another 9 patients to remove the uterine septum and keep cervical septum intact. A uterine septum is a common anomoly of the uterus that is seen in 1 15 per 1,000 women shown in the picture at right. This is only one treatment option for this purpose and basically replaces hysterectomy a complete surgical removal of the uterus. A septum therefore may involve only part of the uterine fundus or may be complete through the cervix and, possibly, involve the vagina american fertility society, 1988. The diagnosis of uterine septum was accomplished by. Other patients have skeletal problems in association with the uterine septum. You would use 57excision of vaginal septum for this procedure. What you will see is actual footage of me performing surgery to repair a large uterine septum.
On the other hand, in patients for whom ivfet is indicated, septum resection is required before the beginning of the cycle in order to minimize the adverse effect of the septum on fecundity and early pregnancy. Hysteroscopic resection of fibroids what is a hysteroscopy. Hysteroscopy is camera examination of the uterine cavity hysteros uterus. The randomised uterine septum transsection trial trust. Unusual cause of uterine perforation secondary to methylene blue chromopertubation after hysteroscopic septum resection murat apia, hakan nazika, b, hakan aytana, raziye narina abstract in the present case uterine perforation during the laparoscopic tubal passage control after hysteroscopic resection of septum is presented. After surgery, the infertility rate was significantly higher in patients with complete. Aug 08, 2016 demonstration of three different techniques for a hysteroscopic septum resection. Surgery for a uterine septum womens health medhelp. This uterine abnormality, present from birth, essentially divides the uterus in half, hindering a womans chances for successful implantation of an embryo and. Pilot randomised controlled trial of hysteroscopic septal. A septum of over 2cm may result in weakness during uterine enlargement in pregnancy. Mar 19, 2009 brought to you by video clip showing transvaginal hysteroscopic resection of uterine septum. A septate uterus is a uterine anomaly that may affect reproductive outcome, and is associated with an increased risk for miscarriage, subfertility and preterm birth. We believe that this is the first korean report on the use of a hysteroscopy for vaginal septum resection in a patient with uterus didelphys with obstructed hemivagina.
Reproductive outcomes after resection of intrauterine septum. Hysteroscopic transcervical resection of uterine septum ncbi. Demographic characteristics of the patients at the time of surgery and the initial pregnancy outcome following septum resection are shown in table 1. My understanding of a didelphic uterus is that there are actually two uteri, and it is inoperable. Video hysteroscopic resection of uterine septum, clip no 6. If you have a question or want to contact me please do so through. Preoperatively, imaging studies, such as an hsg hysterosalpingogram, are performed in order to determine the length and thickness of the septum. Well go over the different types of vaginal septum and. However, because of the septum s broad base and the rigidity of the operative resectoscope, we opted. Jan 23, 2015 metroplasty has also been used to manage primary infertility but the causal relationship between this problem and the presence of a uterine septum is less clear.
I had to remove my email and instagram from all my youtube videos as i was getting a ton of spam. Read about how we use cookies and how you can control them in our cookie notice. No uterine perforation had occurred and no rigid scissors or other nonelectrosurgical modalities like laser were used during the resection of uterine septum. To determine the reproductive outcome following hysteroscopic septum resection in women with a septated uterus and a history of spontaneous miscarriages or premature deliveries study design. They told me it was likely that i would suffer miscarriages in future pregnancies if the embryo implants into the septum rather than the uterine wall, and that the miscarriage risk is in both first and second trimesters unfortunately. Endometrial resection recovery womens health articles. Excision of the complete longitudinal vaginal septum followed by hysteroscopic partial resection of a thick uterine septum with laparoscopic assistance was performed. Uterine bleeding was minimal and postoperative recovery was without any problems. These techniques are also referred to as standard or firstgeneration ablation.
The tissue is a left over remnant from normal, embryonic uterine development and is most commonly discovered with an hsg hysterosalpingogram. Video clips 4d ultrasound scan fetal video clips video clips of the ivf and icsi procedures hysteroscopy video clips laparoscopy video clips pregnancy video clips jordan video clips the construction of the website the internet for the medical doctor. Overall, 24 women at their first pregnancy with an early singleton intrauterine pregnancy and incidental diagnosis of septate uterus were prospectively selected for the purpose of the study table i. The main outcome measure was complete resection of uterine septum. Recurrent uterine rupture after hysterescopic resection of. Hysteroscopy is a minor surgical procedure utilizing a thin fiberoptic tube or hysteroscope to see the inside of the uterus endometrial cavity. This vedio demonstrates the removal of a deep septum. Pdf do the types of treatments after hysteroscopic resection of. This study aims to assess whether hysteroscopic septum resection improves reproductive outcome in women.
In this condition, the cavity of the uterus is separated by a long piece of tissue, while the outside of the uterus has a normal shape. A uterine septum is usually asymptomatic until a woman experiences repeated pregnancy loss and the septum is identified on a hysterosalpingogram. In some women the uterus womb is divided into 2 halves by a thin wall of tissue, called a septum. Hysteroscopic septum resection using the versapoint system. A retrospective, cohort study investigating reproductive outcomes following septum resection was conducted. An arcuate uterus contains a residual cranial septum that is smaller than an incomplete septum but definitions between the two conditions are not standardized, a cause for discrepancies in the literature. A uterine septum is an upsidedown, triangular shaped piece of tissue which divides all or part of the uterine cavity in two. A hysteroscopic approach aims to reduce morbidity and shorten the recovery period. Because i am a nut i worked later in the day after my septum resection from home, in yoga pants.
Furthermore, the extent of resection is often a difficult decision. Video clips 4d ultrasound scan fetal video clips video clips of the ivf and icsi procedures hysteroscopy video clips laparoscopy video clips pregnancy video clips jordan video clips the construction of the website the internet for the medical. Reproductive prognosis after hysteroscopic metroplasty in 102 women. Hysteroscopy allows the doctor to diagnose and treat a variety of uterine abnormalities which may cause infertility, recurrent miscarriages, abnormal bleeding and pain. Patients who had no other apparent cause for spontaneous miscarriage or preterm. Onehundred ninety cases of patients with uterine septum who. Book doctors appointment online and get best treatment. Hysteroscopic metroplasty of a uterine septum for primary infertility. Resection of uterine septum using gynaecoradiological.
Hysteroscopic resection of the septum improves the. Onehundred ninety cases of patients with uterine septum who were diagnosed and treated at our hospital during 20072011. Uterine rupture after hysteroscopic septum resection is a rare complication, and its frequency is reported to be approximately 12. You may experience some cramping similar to period pain for 24 to 48 hours after this procedure. Surgical treatment in patients with this rare malformation includes resection of the vaginal septum with or without hysteroscopic resection of the uterine septum. I had a bit of doms type soreness the next day and for the better part of a week and that was it.
Shes told me that nothing can be done about my uterine septum i have uterus didelphys. Uterine rupture after hysteroscopic resection of uterine septum. Resection of uterine septum using gynaecoradiological techniques. Assessment of hysteroscopic metroplasty in women with a uterine septum and a history of miscarriage. However, if a patient has a history of uterine rupture during previous pregnancies, the risk of uterine rupture may increase for earlier gestational ages in subsequent. Dan gehlbach employs a minimally invasive technique to correct a uterine septum one often undetected cause of female infertility and recurrent miscarriage is a uterine septum. Other forms of uterine malformation need to be considered in the workup for uterine septum. Uterine septum surgery improving infertility minimally. Hysteroscopic resection of uterine septum improves. Educational videos the hinsdale center for reproduction. There is no convincing evidence concerning its effectiveness and safety. Hysteroscopic resection surgery of fibroids london fibroids.
Initial procedures, such as the jones metroplasty, described resection and removal of the uterine septum with subsequent uterine closure. This larger study verifies the findings of smaller studies, that iud placement andor estrogen treatment play no role in the prevention of intrauterine adhesions or the maintenance of pregnancy after hysteroscopic uterine septum resection. Nov 04, 2008 recently, hysteroscopic resection of the uterine septum has become the most common surgical treatment modality. Conclusionuterine rupture may occur in pregnancies after hysteroscopic resection of the uterine septum.
This instrument relays video to a monitor, where the doctor can inspect the organs in the pelvic area. The resection is performed using an operative hysteroscope with monopolar cutting current and a straight blade collins. Brought to you by video clip showing transvaginal hysteroscopic resection of uterine septum. Hysteroscopy is an outpatient procedure in which the doctor inserts a small and lighted instrument called the hysteroscope into the patients vaginal opening. Uterine rupture after hysteroscopic resection of uterine. The patient may only have one kidney, which may not be a problem unless the patients kidney function is strained.
Licciardi performing surgery to repair uterine septum. Uterine septum is the most common uterine malformation and is associated with the worst reproductive outcome. Uterine septum are a significant cause of both infertility and recurrent pregnancy loss. The video shows a hysteroscopic morcellation myosure of an endometrial polyp together with morcellation of a uterine septum which developed after previous polypectomy. A uterine septum may result in fi rst or second trimester fetal loss, preterm delivery, presentation anomalies, intrauterine growth restriction, and infertility. Laparoscopically monitored hysteroscopic resection of a. Sometimes patients will be asked to stay overnight to recover from general anaesthetic. Miscarriage rates with a uterine septum are as high as 90%. Hysteroscopic resection of uterine septa has replaced metroplasty through laparotomy as the surgical treatment of choice in the management of uterine septum associated with recurrent pregnancy loss. Reproductive outcomes after uterine septum resection. Dr singhals uterine septum resection surgery expert in indore.
A uterine septum is the condition where the uterus has a wedge of extra tissue, called the septum, hanging from the top. A uterine septum is a form of a congenital malformation where the uterine cavity is partitioned by a longitudinal septum. However, the procedure is occasionally complicated by uterine perforation. Dr singhals uterine septum resection surgery expert in. All septum were successfully resected with no hysteroscopic or anesthetic complications. Hysteroscopy septum resection by dr rajeev agarwal youtube. The mean age of the patients at the time of septum resection was 33. Endometrial resection is a procedure involving the removal of a womans endometrium the lining of the uterus with an electrosurgical wire loop to prevent excessive bleeding during menstruation. May 21, 2010 septate uterus, one of the most common forms of congenital uterine malformations, negatively affects female reproductive health. Resection of the cervical septum during hysteroscopic metroplasty of complete uterine septum makes the procedure safer, easier, and less complicated than the procedure with preservation of the.
This study aims to assess whether hysteroscopic septum resection improves reproductive outcome in women with a. I hope you have a very speedy recovery and we hope to see you over here very soon. Septum resection is the surgical removal of the uterine septum, which is one of the most common congenital malformations birth defect. Mar 03, 2007 or the ducts fuse, but the area where they joined does not dissolve, leaving a dividing wall inside the uterine cavity a uterine septum. A few weeks later i had the septum removed with a hysteroscopy under anesthesia. Oct 04, 2019 a uterine septum is a congenital anomaly of the uterus. According to several studies, treating a uterine septum is associated with an improvement in livebirth rates for women with prior. They scanned me again 3 months after giving birth to see the septum more clearly and confirmed the septum. This septum can be small or can extend all the way from the top of the uterus to the cervix, functionally dividing the uterus into two cavities. Septate uterus with double cervix and longitudinal vaginal septum represents one of the mullerian anomalies without a classification.
Hysteroscopy minor surgery procedure utilizing a thin. The major indications for surgery were primary infertility n 41, 33. A vaginal septum is a wall of tissue in the vagina that can cause a range of symptoms, including pain during intercourse and long periods. This video presents uterine septum hysteroscopic resection. Complete uterine septum hysteroscopic metroplasty by y.