What is Uterine Septoplasty?
Uterine septoplasty or metroplasty is a surgical procedure employed for the correction of a septate uterus or uterine septum using an operative hysteroscope to create a normal uterine cavity.
Septate uterus or uterine septum is a congenital condition characterized by deformity of the uterus that happens at the time of fetal development before birth. The septum is a fibrous or muscular wall that splits the inside of the uterus, forming two cavities (a septate uterus).
The instances of congenital uterine malformations have been reported to be as high as 3 to 4 percent in the general female population. Women with a septate uterus are at increased risk of recurrent pregnancy loss.
Indications of Uterine Septoplasty
Some of the indications of uterine septoplasty include:
- Recurrent miscarriage
- Pelvic pain
- Preterm delivery
- Obstruction phenomenon
Diagnosis of Uterine Septum
Your doctor will review your medical history and conduct a thorough pelvic exam. In order to obtain additional details and confirm the diagnosis, your doctor may order tests, such as:
- 2-D and 3-D pelvic ultrasound
- MRI scan
- Saline infusion sonohysterography (SIS or SHG)
Uterine Septoplasty Procedure
Uterine septoplasty procedure is commonly performed by operative hysteroscopy. A hysteroscope is a thin, flexible fiberoptic tube with a camera and a light attached at the end that allows internal viewing of the structures. The hysteroscopic method enables your surgeon to carry out corrective procedures within the uterus without the need for an outer abdominal incision.
The procedure is conducted under general or spinal anesthesia and involves the following steps:
- After cervical dilation, a hysteroscope is inserted into the uterus via the cervix.
- Another instrument is also inserted to cut away and remove the septum.
- The uterine cavity is distended with fluid (carbon dioxide and low viscosity fluids) to clearly visualize the internal structures and fluid control is carefully monitored to avoid overload.
- Your surgeon then excises the septum using electrosurgery, microscissors, or laser with the aid of images displayed on a television monitor by hysteroscope.
Post-Procedure Care and Instructions
You should be able to go home shortly after the procedure. You may experience some mild cramping or pain. You may also experience watery discharge or spotting. You may be given medications to alleviate pain and other symptoms. You might also experience bloating due to the gas used to distend the cavity that may last for a day. You must avoid sex for at least two weeks post procedure. If you experience excessive bleeding, cramping, chills, fever, pelvic or abdominal pain, you should seek immediate medical care. A follow-up appointment should be made to monitor your progress.
Risks and Complications of Uterine Septoplasty
As with any surgery, there may be certain risks and complications associated with uterine septoplasty, such as:
- Postprocedural pain
- Excess fluid accumulation
- Puncture of the cervix or uterus
- Damage to nearby organs
- Intrauterine adhesions
- Pelvic inflammatory disease
Benefits of Uterine Septoplasty
Some of the benefits of uterine septoplasty include:
- Improvement in live-birth rates
- Improved pregnancy rates
- Decreased miscarriage rates