Uterine septum

Uterine septums are the most common congenital anomaly of the uterus. The congenital anomalies of the uterus do not constitute a certain or the only factor of subfertility, though they may affect the pregnancy.

Various phases of hysteroscopic section of the uterine septum.
Various phases of hysteroscopic section of the uterine septum.

In the past, their surgical treatment included laparotomy, section of the uterus and the septum and suture of the uterus with the Strassmann and Jones techniques etc. Nowdays, the section of the septum is performed with hysteroscopic surgery which is a treatment of choice in order to create a uniform cavity in the septate (double) uterus. The creation of a normal uniform cavity after surgery is impressive and the development of epithelium is exceptional. Post-operative check includes hysterosalpingography and hysteroscopy.

In some cases of bicornuate uterus that the development of a pregnancy may be affected, plastic surgery of the uterus according to the Strassmann-Jones techniques that are performed with laparotomy may be decided. An alternative solution for such cases may be the limited hysteroscopic section of the point of connection of the two horns, in order to achieve a limited extension of the uterus.

This section takes place under laparoscopic guidance and the results are checked after three months with hysterosalpingography and hysteroscopy.

Bicornuate uterus
Bicornuate uterus:
Α. Hysteroscopic appearance of the point of connection of the two horns.
Β. Commencing limited section with Versapoint-Twizzle.
C. Final result.

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