Successful treatment of complete septate uterus with longitudinal vaginal septum:a case report.

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  • 腟中隔合併の完全中隔子宮に対して腹腔鏡・子宮鏡下手術を行った一例 －頸部中隔切断の試み－

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A 38-year-old woman was referred to our department for bicornuate or septate uterus and primary infertility. Pelvic examination revealed a longitudinal vaginal septum and a doubled uterine cervix. Magnetic resonance imaging revealed a smooth fundus with a complete uterine septum and cervical duplication. Incision of the complete longitudinal vaginal septum was performed, followed by hysteroscopic complete dissection of the whole uterine septum with laparoscopic assistance. Intraoperative monitoring was performed using laparoscopy and transabdominal ultrasound. No intra- or postoperative complications were encountered. After surgery, no adhesions were found in the uterine cavity. She achieved pregnancy through in vitro fertilization after 8 months. She delivered a healthy baby at 39 weeks and 1 day of gestation. Hysteroscopic surgery is a promising method to treat a septate uterus. In this case, we performed a "septum section" by only cutting the septum without its complete resection from the uterus. Moreover, we incised not only the corporal portion but also the cervical portion of the septate uterus. These modified techniques are simple, rapid, and safe. Examination of more cases is needed to conclude the effectiveness of these methods.

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