Volume 9, Issue 4 (2025)
SJMR 2025, 9(4): 225-229 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Khandzad B, Mohammadian H, Nateghi M R. Introduction of a Case of Complete Uterine Septum and Its Management at Sarem Women’s Hospital: Surgical Challenges and Strategies. SJMR 2025; 9 (4) : 6
URL: http://saremjrm.com/article-1-351-en.html
URL: http://saremjrm.com/article-1-351-en.html
1- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran.
2- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran. & Sarem Cell Research Center (SCRC), Sarem Women’s Hospital, Tehran, Iran.
2- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran. & Sarem Cell Research Center (SCRC), Sarem Women’s Hospital, Tehran, Iran.
Abstract: (861 Views)
Introduction: A uterine septum is one of the most common congenital uterine anomalies, which can lead to infertility, recurrent miscarriages, or pregnancy complications. Optimal management of these patients, especially in cases of complete uterine septum, requires a multi-stage surgical approach accompanied by preventive interventions to avoid intrauterine adhesions. In this report, we present a successful case of uterine septum correction using minimally invasive laparoscopic and hysteroscopic techniques and the role of post-surgical IUD use at the Sarem Specialized Hospital in Tehran.
Case Presentation: A 35-year-old woman with a 7-year marriage history and no history of pregnancy visited the Sarem Specialized Hospital for pre-pregnancy evaluations. Initial evaluations, including three-dimensional transvaginal sonography (TVS 3D) and hysterosalpingography (HSG), indicated a uterus with a complete septum. The patient underwent two stages of laparoscopic and hysteroscopic surgery for uterine septum resection. Following each stage, an IUD was placed to reduce the risk of intrauterine adhesions. Postoperative evaluations showed a decrease in septum depth and correction of uterine anatomy. This case report demonstrates that the use of minimally invasive techniques combined with adhesion prevention strategies can improve surgical outcomes in patients with a complete uterine septum.
Conclusion: Management of a complete uterine septum is a significant challenge in treating congenital uterine anomalies that can affect fertility and pregnancy outcomes. In this report, the use of minimally invasive laparoscopic and hysteroscopic techniques accompanied by IUD placement was evaluated as an effective strategy to reduce the risk of adhesions and improve the anatomic structure of the uterus. The findings of this case indicate that a multi-stage surgical approach, meticulous postoperative monitoring, and preventive measures can lead to successful correction of the uterine septum and improved reproductive outcomes for patients.
Case Presentation: A 35-year-old woman with a 7-year marriage history and no history of pregnancy visited the Sarem Specialized Hospital for pre-pregnancy evaluations. Initial evaluations, including three-dimensional transvaginal sonography (TVS 3D) and hysterosalpingography (HSG), indicated a uterus with a complete septum. The patient underwent two stages of laparoscopic and hysteroscopic surgery for uterine septum resection. Following each stage, an IUD was placed to reduce the risk of intrauterine adhesions. Postoperative evaluations showed a decrease in septum depth and correction of uterine anatomy. This case report demonstrates that the use of minimally invasive techniques combined with adhesion prevention strategies can improve surgical outcomes in patients with a complete uterine septum.
Conclusion: Management of a complete uterine septum is a significant challenge in treating congenital uterine anomalies that can affect fertility and pregnancy outcomes. In this report, the use of minimally invasive laparoscopic and hysteroscopic techniques accompanied by IUD placement was evaluated as an effective strategy to reduce the risk of adhesions and improve the anatomic structure of the uterus. The findings of this case indicate that a multi-stage surgical approach, meticulous postoperative monitoring, and preventive measures can lead to successful correction of the uterine septum and improved reproductive outcomes for patients.
Article number: 6
Article Type: Case Report |
Subject:
Women Diseases
Received: 2025/01/7 | Accepted: 2025/02/12 | Published: 2025/03/16
Received: 2025/01/7 | Accepted: 2025/02/12 | Published: 2025/03/16
References
1. Pfeifer SM, Attaran M, Goldstein J, Lindheim SR, Petrozza JC, Rackow BW, et al., ASRM müllerian anomalies classification 2021. Fertil Steril, 2021. 116(5): 1238-1252. [DOI:10.1016/j.fertnstert.2021.09.025] [PMID]
2. Ludwin A, Ludwin I, Banas T, Knafel A, Miedzyblocki M, Basta A, Diagnostic accuracy of sonohysterography, hysterosalpingography and diagnostic hysteroscopy in diagnosis of arcuate, septate and bicornuate uterus. J Obstet Gynaecol Res, 2011. 37(3): 178-86. [DOI:10.1111/j.1447-0756.2010.01304.x] [PMID]
3. Rikken J, Leeuwis-Fedorovich NE, Letteboer S, Emanuel MH, Limpens J, van der Veen F, et al., The pathophysiology of the septate uterus: a systematic review. Bjog, 2019. 126(10): 1192-1199. [DOI:10.1111/1471-0528.15798] [PMID]
4. Uterine septum: a guideline. Fertil Steril, 2016. 106(3): 530-40. [DOI:10.1016/j.fertnstert.2016.05.014] [PMID]
5. Ludwin A, Martins WP, Nastri CO, Ludwin I, Coelho Neto MA, Leitao VM, et al., Congenital Uterine Malformation by Experts (CUME): better criteria for distinguishing between normal/arcuate and septate uterus? Ultrasound in Obstetrics & Gynecology, 2018. 51(1): 101-109. [DOI:10.1002/uog.18923] [PMID]
6. Jacquinet A, Millar D, Lehman A, Etiologies of uterine malformations. Am J Med Genet A, 2016. 170(8): 2141-72. [DOI:10.1002/ajmg.a.37775] [PMID]
7. Blanco-Breindel MF, Kahn J, Singh M, Septate Uterus, in StatPearls [Internet]. 2023, StatPearls Publishing.
8. Daniilidis A, Papandreou P, Grimbizis GF, Uterine septum and reproductive outcome. From diagnosis to treatment. How, why, when? Facts Views Vis Obgyn, 2022. 14(1): 31-36. [DOI:10.52054/FVVO.14.1.002] [PMID] []
9. Homer HA, Li T-C, Cooke ID, The septate uterus: a review of management and reproductive outcome. Fertility and Sterility, 2000. 73(1): 1-14. [DOI:10.1016/S0015-0282(99)00480-X] [PMID]
10. Hua M, Odibo AO, Longman RE, Macones GA, Roehl KA, Cahill AG, Congenital uterine anomalies and adverse pregnancy outcomes. American Journal of Obstetrics & Gynecology, 2011. 205(6): 558.e1-558.e5. [DOI:10.1016/j.ajog.2011.07.022] [PMID]
11. Ahmed NHA, Sabr NS, Bapir R, Hiwa DS, Hasan AH, Salih RQ, et al., Hysteroscopic management of complete septate uterus with septate cervix, and longitudinal vaginal septum: a case report. Journal of Surgical Case Reports, 2024. 2024(4): rjae238. [DOI:10.1093/jscr/rjae238] [PMID] []
12. Ludwin A, Ludwin I, Banas T, Knafel A, Miedzyblocki M, Basta A, Diagnostic accuracy of sonohysterography, hysterosalpingography and diagnostic hysteroscopy in diagnosis of arcuate, septate and bicornuate uterus. Journal of Obstetrics and Gynaecology Research, 2011. 37(3): 178-186. [DOI:10.1111/j.1447-0756.2010.01304.x] [PMID]
13. Rikken J, Leeuwis‐Fedorovich N, Letteboer S, Emanuel M, Limpens J, van der Veen F, et al., The pathophysiology of the septate uterus: a systematic review. BJOG: An International Journal of Obstetrics & Gynaecology, 2019. 126(10): 1192-1199. [DOI:10.1111/1471-0528.15798] [PMID]
14. Valle RF, Ekpo GE, Hysteroscopic metroplasty for the septate uterus: review and meta-analysis. Journal of minimally invasive gynecology, 2013. 20(1): 22-42. [DOI:10.1016/j.jmig.2012.09.010] [PMID]
15. Chan YY, Jayaprakasan K, Zamora J, Thornton JG, Raine-Fenning N, Coomarasamy A, The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review. Human reproduction update, 2011. 17(6): 761-771. [DOI:10.1093/humupd/dmr028] [PMID] []
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
