Last week, we started a discussion on Septate Uterus. We defined septate uterus and explained the types, causes, symptoms and septate uterus with its correlation with fertility. This week we will continue with septate uterus and fertility, diagnosis and treatment.
SEPTATE UTERUS AND FERTILITY
It is crucial to remember that not all septate uteri will impair fertility or result in miscarriage, and the chance of miscarriage can change based on how severe the condition.
DIAGNOSIS OF SEPTATE UTERUS
This will usually start with a pelvic exam. However, unless the septum extends into the vagina, a pelvic exam will not show the depth or position of the septum. Instead, the healthcare provider will use imaging tools to get the best picture of the septum, its thickness and its exact position in the uterus. To diagnose a septate uterus, one or more of the following methods may be used –
If any of these tests indicate the presence of a septate uterus, further testing may be recommended or treatment to address any related issues, such as infertility or recurrent miscarriage.
TREATMENT OF SEPTATE UTERUS
The treatment of a septate uterus depends on various factors such as the severity of the septum, symptoms experienced by the patient, and the desire for fertility.
There are two main surgical approaches for treating a septate uterus:
Hysteroscopic metroplasty is a minimally invasive procedure performed using a hysteroscope, which is a thin tube with a camera attached to it. During this procedure, the surgeon inserts the hysteroscope through the vagina and cervix into the uterus to visualize the septum. Surgical instruments are then used to remove or resect the septum, creating a normal uterine cavity.
Open surgery, also known as metroplasty, is another surgical option for treating a septate uterus. This procedure is performed through an abdominal incision, typically a low transverse or vertical incision. The surgeon accesses the uterus and removes or resects the septum to create a normal uterine cavity. Open surgery may be recommended for patients with a large or complex septum that cannot be adequately treated hysteroscopically.
After surgical intervention for a septate uterus, postoperative care is essential to ensure proper healing and reduce the risk of complications. This may include pain management, antibiotics to prevent infection, and follow-up appointments to monitor progress.
CONCLUSION
Women who are having trouble getting pregnant or who are experiencing repeated miscarriages may face difficulties due to a septate uterus. A Gynaecologist /Fertility Specialist’s advice and recommendation is essential for precise diagnosis and individualized treatment plan. Patients can make informed decisions regarding their reproductive health if they are aware of the causes, symptoms, diagnosis, and available treatment options.