Hysteroscopic resection of uterus septus versus abdominal metroplasty

The new hysteroscopic approach toward pregnancy loss associated with uterine septum offers several advantages over abdominal metroplasty. However, several safeguards should be taken: laparoscopic or sonographic guidance should accompany hysteroscopic metroplasty; postoperative HSG or hysteroscopy is recommended; there is no advantage of IUD insertion postoperatively; sequential estrogen-progesterone therapy postoperatively is optional, but of no proved benefit; a hysteroscopic approach toward uterine septum is the preferred procedure, even when laparotomy for treatment of pelvic endometriosis or intrapelvic adhesions is indicated, and, although its value is not established, a short perioperative cause of prophylactic antibiotics seems to be warranted.