Balloon technique for hysteroscopic correction of a complete septate uterus.
Hysteroscopic correction of septate uterusFigure 1. Balloon technique for hysteroscopic correction of a complete septate uterus. Table I. Pre-, intra- and postoperative data for six patients with complete uterine septum Age Past history Time of Postoperative pregnancy (years) surgery (min) 23 Primary infertility; 50 Term pregnancy longitudinal vaginal septum (Caesarean section) 28 Recurrent abortion 30 Term pregnancy (three abortions) 30 One abortion One preterm birth 25 – 23 Primary infertility, longitudinal vaginal septum 25 – 31 Recurrent abortions 30 Term pregnancy (three abortions) 24 Secondary infertility 20 – (one abortion)at 16 weeks gestation. Because of the prophylactic cervical uterus and septate vagina: report of a previously undescribed Mullerian¨ anomaly. Hum. Reprod., 11, 218–219.suture, the advantage of this technique of spared cervical Daly, D.C., Tohan, N., Walters, C. et al. (1983) Hysteroscopic resection ofincision could not be clearly demonstrated. Although Vercellini the uterine septum in the presence of a septate cervix. Fertil. Steril., 39,et al. (1989) could not show a positive effect of IUD insertion 560–563.and postoperative oestrogen administration, we used these two Ludmir, J., Samuels, P., Brooks, S. and Mennuti, M.T. (1990) Pregnancy outcome of patients with uncorrected uterine anomalies managed in a high-adjuvants with good results for the prevention of intrauterine risk obstetric setting. Obstet. Gynecol., 75, 906–910.adhesions after septal dissection. Perino, A., Chianchiano, N., Simonaro, C. and Cittadini, E. (1995) Endoscopic The described balloon technique offers the possibility of management of a case of complete septate uterus. Hum. Reprod., 10, 2171–2173.sparing the cervical septum during septum dissection in patients Rock, I. A., Murphy, A.A. and Cooper IV, W.H. (1987) Resectoscopicwith a complete uterine septum. The good clinical results of techniques for the lysis of a class V: complete uterine septum. Fertil. Steril.,our procedure lead us to favour this technique. Because a 48, 495–496.complete uterine septum is such a rare uterine malformation, Salle, B., Sergeant, P., Gaucherand, P., et al. (1996) Transvaginal hysterosonographic evaluation of septate uteri: a preliminary report. Hum.a deﬁnitive recommendation can be given only after a random- Reprod., 11, 1004–1007.ized multicentre study. In all cases of a uterine septum, an Vercellini, P., Fedele, L., Arcaini, L. et al. (1989) Value of intrauterineindication for dissection must be critically proven because, even device insertion and estrogen administration after hysteroscopic metroplasty. J. Reprod. Med., 34, 447–450.without intervention, term pregnancies have been reported. Vercellini, P., Ragni, G., Trespidi, L. et al. (1994) A modiﬁed technique for correction of the complete septate uterus. Acta Obstet. Gynecol. Scand., 73, 425–428.ReferencesAmerican Fertility Society (1988) The American Fertility Society Received on October 14, 1996; accepted on January 7, 1997 classiﬁcations of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies and intrauterine adhesions. Fertil. Steril., 49, 944–955.Balasch, J., Moreno, E., Martinez-Roman, S. et al. (1996) Septate uterus with cervical duplication and longitudinal vaginal septum: a report of three new cases. Eur. J. Obstet. Gynecol. Reprod. Biol., 65, 241–243Candiani, M., Busacca, M., Natale, A. and Sambruni, I. (1996) Bicervical 479