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Metroplasty for the complete septate uterus: does cervical sparing matter?
P Vercellini1, O De Giorgi, I Cortesi
1Clinica Ostetrica e Ginecologica "Luigi Mangiagalli," dell'Universita di Milano, Via Commenda 12, 20122 Milan, Italy.
Summary
Hysteroscopic metroplasty for complete septate uterus is facilitated by incising the cervical septum. This safe and rapid technique reduces operative time and avoids obstetric complications.
Area of Science:
- Reproductive Medicine
- Minimally Invasive Gynecologic Surgery
Background:
- A complete septate uterus can impact reproductive outcomes.
- Hysteroscopic metroplasty is a common surgical approach.
Purpose of the Study:
- To evaluate the efficacy and safety of incising the cervical septum during hysteroscopic metroplasty for complete septate uterus.
- To assess intraoperative bleeding and postoperative obstetric complications associated with this technique.
Main Methods:
- Prospective, observational study involving ten women with a complete septate uterus.
- Surgical technique involved hysteroscopic incision of the cervical septum with Metzenbaum scissors and corporeal septum with microscissors.
Main Results:
- The mean operating time was 24 ± 7 minutes with a mean distention fluid deficit of 480 ± 190 ml.
- No significant intraoperative bleeding occurred during cervical septum incision.
- Follow-up hysteroscopy confirmed competent cervices, with no instances of second-trimester abortion or premature delivery.
Conclusions:
- Sectioning the cervical septum is a simple, rapid, and safe adjunct to hysteroscopic metroplasty.
- This technique effectively corrects a completely septate uterus and may improve obstetric outcomes.