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Hysteroscopic resection of the septum
A uterine septum is an abnormal partition inside the uterine cavity that can affect fertility.
If it prevents embryo implantation or causes miscarriages, timely surgical intervention (hysteroscopic surgery of the uterine septum) is the solution to increase the chances of a successful pregnancy outcome.
Uterine septum (uterine cavity) or partitioned uterus is the most common deformity of the uterus and accounts for about 30% of all congenital deformities of the uterus. 2-3% of women have a uterine septum.
This separating septum is composed of muscle and mucosa-endometrium.
The endometrium covering the septum has a different cell structure than the endometrium of the uterine cavity.
The uterine septum gives no symptoms. It is most often detected during a regular ultrasound examination or during an examination of the cause of spontaneous abortions.
The uterine septum is formed before birth. The uterus is formed by the joining of the two Müllerian ducts. The central part of the two joined ducts disappears during embryonic development. If the central part of the two joined ducts does not disappear, a partition of the uterine cavity-septum is formed. The septum can be the entire length or only in one part of the uterine cavity.
- The patient fills out a detailed questionnaire about her health and has a blood count and her blood type done.
- Before the intervention, the patient is examined by an anesthesiologist.
- If there is any additional risk factor, an examination by a specialist in internal medicine is also carried out.
- The patient receives an antiseptic shampoo in the Clinic, which she uses to take a shower the night before and the morning before the surgery.
- Food and liquid should not be taken 6-8 hours before the intervention.
- The intervention is done on day 5-10 of the menstrual cycle.
- When taking contraceptive pills, the intervention can be done on any day of the cycle.
- Upon entering the operating room, the patient receives anesthesia.
- A metal instrument with a camera is inserted into the uterus through the cervix.
- After a detailed examination of the uterine cavity, the uterine septum is cut with hysteroscopic scissors or an instrument that uses bipolar energy.
- The intervention lasts for 15-20 minutes.
- The patient remains in the patient room for up to two hours after the surgery.
- The patient is given painkillers.
- She can eat and drink after the intervention.
- Light bleeding may occur up to two or three days after the surgery. Paracetamol, pills. 500 mg 2 pills. up to 4 times a day are advised against pain.
- Elevated temperature and infection are very rare, in which case it is necessary to contact the Clinic.
- Sexual intercourse, swimming and bathing should be avoided as long as the bleeding lasts.
- The patient can return to daily activities the day after the intervention, including physical training.
Uterine septum - diagnosis
In order to diagnose the uterine septum, it is necessary to visualize the inner and outer contours of the uterus. The uterine septum is diagnosed:
- by applying 3D ultrasound, with or without inserting a saline solution into the uterine cavity;
- magnetic resonance imaging,
- hysteroscopy.
A septum that is of the entire length can be with two cervixes and a septum-partition of the vagina, or the septum can extend along the entire length of the cervix and vagina.
Uterine septum and pregnancy
Women with a uterus septum usually have no problem getting pregnant, but they have an increased risk of spontaneous miscarriage and repeated spontaneous miscarriages.
Spontaneous abortion occurs in about 40-80% of pregnancies in women with a uterine septum compared to 12% after septum surgery.
Women with a uterine septum have an increased risk for premature placental abruption, preterm labor and a baby’s breech or transverse position.
If the woman does not want offspring, it is not necessary to treat this phenomenon.
Prognosis and chances of pregnancy after the septum removal
- Septal surgery reduces the risk of a miscarriage.
- After uterine septum surgery, the risk of spontaneous miscarriage decreases from 40-80% to only 12%, which significantly increases the chances of a healthy pregnancy.
Septum surgery in Gyn-Fertility Clinic Milenković
Septum surgery (partition in the uterine cavity) is performed hysteroscopically (a camera and the instruments are inserted through the cervix) under local or general anesthesia.
The patient is discharged immediately after the intervention.
Expert advice: frequently asked questions
Answered by: Milan Milenković, MD, PhD.
What is the uterine septum and is it dangerous?
The uterine septum is a congenital longitudinal partition in the uterine cavity that divides the uterine cavity into two parts. It can extend along the entire length or in only one part of the uterine cavity, in combination with the septum of the cervix and vagina. The uterine septum is not dangerous and is not a risk factor for the development of malignant diseases.
How is a uterine septum diagnosed?
The uterine septum is diagnosed by ultrasound examination (3D, hydrosonography), magnetic resonance and hysteroscopy. Hydrosonography is an ultrasound method when a saline solution is inserted into the uterine cavity after which an ultrasound examination is performed.
When is septum surgery needed?
Septum surgery is required if a woman has had one or more miscarriages. The septum is most often removed if it is diagnosed during an infertility test.
What does the hysteroscopic surgery procedure look like?
Hysteroscopic surgery is performed under local or general anesthesia. A metal instrument with a camera is inserted into the uterine cavity through the cervix. After a detailed inspection of the entire uterine cavity, the uterine septum is cut with hysteroscopic scissors or an instrument that uses bipolar energy. The intervention lasts for 15-20 minutes. The patient stays in the Clinic for 1-2 hours after the surgery.
How long does recovery take after the uterine septum surgery?
Hysteroscopic septum surgery is a minimally invasive surgery. A woman can return to her daily activities the very next day after surgery. Bleeding lasts for 2-3 days and it is not recommended for a patient to swim, take a bath and have sex while the bleeding lasts.
Is it possible to get pregnant after septum removal?
It is possible to achieve pregnancy after septum surgery. Septum surgery reduces the risk of spontaneous miscarriages and pregnancy complications.
Can the uterine septum be the cause of painful menstruations?
The uterine septum is not the cause of painful menstruations.
Is a uterine septum the same as a bicornuate uterus?
A uterine septum is not the same as bicornuate uterus. A uterus with a septum has a normal shape on the outside, while a bicornuate uterus has an indentation or "hollow" on the outside that divides the uterus into two parts. Bicornuate uterus is operated only in exceptional cases.
When can I try to get pregnant after the septum surgery?
1-2 months after the uterine septum surgery, you can try to get pregnant.
Contact
For all information about septum surgery and other gynecological procedures and questions, contact us on our phone numbers on weekdays from 9 a.m. to 7 p.m. or write us an email.
