The Technique of Vaginal Septum as Uterine Septum: A New Approach for the Hysteroscopic Treatment of Vaginal Septum

Abstract

Study objective: To evaluate the outcomes of a new hysteroscopic technique for the treatment of a longitudinal vaginal septum.

Design: A retrospective study.

Setting: Arbor Vitae Center for Endoscopic Gynecology, Rome, Italy.

Patients: Thirty women who underwent hysteroscopic treatment for a vaginal septum.

Intervention: All enrolled patients underwent pelvic examination, hysteroscopy, and 2-dimensional ultrasound. In case of a diagnosis of a partial or complete uterine septum, magnetic resonance imaging or 3-dimensional ultrasound were performed, and surgical procedures were performed after diagnostic laparoscopy was used to better visualize the uterine fundus. All patients were treated with the technique using vaginal septum as uterine septum or the same methodology applied for a uterine septum.

Measurements and main results: The procedure was successfully accomplished in all patients, and longitudinal vaginal septa were totally resected. There were no perioperative complications, and in only 1 case, vaginal bleeding occurred because of an erroneous identification of the excision line that was easily remedied with coagulation by resectoscope. Dyspareunia has improved or completely disappeared in all patients.

Conclusion: The technique of vaginal septum as uterine septum for the resectoscope of a longitudinal vaginal septum appears to be safe and effective with good outcomes, even in terms of dyspareunia.

Keywords: Dyspareunia; Hysteroscopy; Longitudinal vaginal septum; Mullerian abnormalities; Vaginal septum as uterine septum.