Management of Complete Vagino-uterine Septum in Patients Seeking Fertility: Report of Two Cases and Review of Literature

Publication date: Available online 26 June 2015 Source:Gynecology and Minimally Invasive Therapy Author(s): Meei Jiun Seet , Matthew Lau , Jerry.K.Y. Chan , Heng Hao Tan Septate uterus is the most common congenital uterine anomaly encountered clinically. It is associated with infertility and adverse pregnancy outcomes including miscarriages and preterm births. Over the past few decades, the diagnosis and surgical management of uterine septum has changed significantly. Here, we present two women with complete vagino-uterine septum presenting with infertility. The diagnoses of septate uterus were made through three-dimensional (3D) ultrasound and magnetic resonance imaging (MRI) and they were treated with thin-gauge bipolar electrocautery (VERSAPOINTTM) through hysteroscopy. A literature review of the approach to managing complete vagino-uterine septum suggests the use of combinatorial imaging modalities such as hysterosalpingography (HSG), 3D ultrasonography and MRI to accurately define the anatomy. Furthermore, compared to open surgery, treatment through hysteroscopic approaches are associated with shorter operating time and good fertility outcomes. With the use of concomitant laparoscopic and ultrasound monitoring, the incidence of uterine perforation and visceral injury may be reduced. However, referral to a centre with such expertise is essential.
Source: Gynecology and Minimally Invasive Therapy - Category: OBGYN Source Type: research