Objective: To demonstrate a systematic approach for the hysteroscopic management of a patient with uterine septum with double cervix and a nonobstructive longitudinal vaginal septum (Class U2bC2V1 of the ESHRE/ESGE classification).
Design: A step-by-step demonstration of the technique with narrated video footage of three different cases.
Setting: University Hospital.
Patient(s): We present three patients diagnosed with uterine septum with double cervix and a nonobstructive longitudinal vaginal septum (Class U2bC2V1 of the ESHRE/ESGE classification). Case 1 is a 31-year-old woman with class U2bC2V1 müllerian anomaly and primary infertility. Case 2 is a 29-year-old patient with class U2bC2V1 müllerian anomaly, infertility, and dyspareunia. Case 3 is a 32-year-old patient with class U2bC2V1 müllerian anomaly, infertility, and abnormal uterine bleeding. She also was diagnosed with a submucous leiomyoma.
Intervention(s): Hysteroscopic management of this complex müllerian anomaly using miniaturized hysteroscopic instruments, including the mini-resectoscope, was performed. All three procedures were performed in the operating room with the patient under general anesthesia. No complications were encountered. Patients were discharged home the same day of the procedure after a short period of observation. The critical aspects of the procedure are highlighted.
Main Outcome Measure(s): Description of the systematic approach with a detailed demonstration of the critical steps of the procedure.
Result(s): Complete resolution of the vaginal septum with creation of a single uterine cavity was obtained in all three cases. Absence of intrauterine adhesion formation was confirmed.
Conclusion(s): Due to the recent innovations in hysteroscopic equipment and improved surgical techniques, the hysteroscopic management of patients with complex müllerian anomalies using miniaturized instruments is a feasible and effective treatment option.
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This is the case of a 30-year-old nulliparous patient with a complete uterine septum, double cervix and non- obstructive longitudinal vaginal septum (Class U2bC2V1 according to the ESHRE/ESGE classification). The patient presented with severe dyspareunia and dysmenorrhea. Imaging revealed a complex Müllerian anomaly and hysteroscopic treatment was agreed.
View Article and Find Full Text PDFHysteroscopic Management of Complete Vaginal and Uterine Septum with Double Cervix: Tips & Tricks for a Safe Surgery.
J Pediatr Adolesc Gynecol
August 2024
Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero - Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
Background: The septate uterus is the most common uterine abnormality, comprising 35% of all identified uterine malformations. According to the ESHRE/ESGE 2013 classification, the class U2bC2V1 is a rare congenital malformation characterized by a complete septate uterus with double cervix and nonobstructive longitudinal vaginal septum.
Study Objective: to share the decision-making process, the preoperative ultrasonographic assessment and our step-by-step hysteroscopic surgery technique to manage this complex malformation: including how to access the septate uterine cavity, the resection of the septum and its postoperative management.
Background: A complete uterine septum, double cervix and vaginal septum is a complex and rare congenital genital tract anomaly. The diagnosis is often challenging and based on the combination of different diagnostic techniques and multiple treatment steps.
Objective: To propose a combined one-stop diagnosis and an ultrasound-guided endoscopic treatment of complete uterine septum, double cervix, and longitudinal vaginal septum anomaly.
Step-by-Step Hysteroscopic Treatment of Complete Uterine Septum Associated or Not with Cervical Anomalies.
J Minim Invasive Gynecol
June 2023
Department of Public Health (Drs. Brunella, Alessandra, Chiara, and Attilio).
Study Objective: To demonstrate our hysteroscopic technique using the mini-resectoscope for the treatment of complete uterine septum with or without cervical anomalies.
Design: A step-by-step video demonstration of the technique with the use of an educational video.
Settings: We present 3 patients diagnosed as having complete uterine septum (U2b according to the ESHRE/ESGE classification) with or without cervical anomalies (C0, normal cervix; C1, septate cervix; C2, double "normal" cervix"), 2 of them with a longitudinal vaginal septum (V1).
The step-by-step hysteroscopic treatment of patients with vaginal and complete uterine septum with double cervix (U2bC2V1).
Fertil Steril
August 2021
First Department of Obstetrics and Gynecology, Papageorgiou University Hospital, Aristotle University of Thessaloniki Thessaloniki, Greece.
Objective: To demonstrate a systematic approach for the hysteroscopic management of a patient with uterine septum with double cervix and a nonobstructive longitudinal vaginal septum (Class U2bC2V1 of the ESHRE/ESGE classification).
Design: A step-by-step demonstration of the technique with narrated video footage of three different cases.
Setting: University Hospital.
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