Hysteroscopic metroplasty of the complete uterine septum, duplicate cervix, and vaginal septum.
OBJECTIVE
To determine if sectioning of the cervical septum in hysteroscopic metroplasty of the complete uterine septum is associated with intraoperative bleeding, cervical incompetence, and secondary infertility.


METHODS
Multicenter, randomized, controlled clinical trial.


METHODS
University hospitals.


METHODS
Twenty-eight women with a diagnosis of complete uterine septum who had a history of pregnancy wastage or infertility. They were randomized into two groups: group A underwent metroplasty including section of the cervical septum; group B underwent the same procedure with preservation of the cervical septum.


METHODS
Hysteroscopic metroplasty was performed for all patients in the two groups.


METHODS
Operating time, distending media deficit, total distending media used, intraoperative bleeding, complications, and reproductive outcome.


RESULTS
Operating times were 36.40 +/- 10.67 minutes and 73 +/- 14.40 minutes in group A and group B, respectively. Distending media deficit was 456.66 +/- 165.68 mL in group A, while in group B it was 673.84 +/- 220.36. Two cases of pulmonary edema and three cases of significant bleeding (> 150 mL) were seen in group B. The cesarean section rate was significantly higher in group B. There were no significant differences in the reproductive outcome in the two groups.


CONCLUSIONS
Resection of the cervical septum during hysteroscopic metroplasty of complete uterine septum makes the procedure safer, easier, and less complicated than the procedure with preservation of the cervical septum. This procedure is recommended for all cases of complete uterine septum.
Parsanezhad
Mohammad Ebrahim
ME
Referral GYN Endoscopy Centers, Department of Obstetrics and Gynecology, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran. parsame@sums.ac.ir
Alborzi
Saeed
S
Zarei
Afsoun
A
Dehbashi
Sedigheh
S
Shirazi
Lila Ghasempour
LG
Rajaeefard
Abdolreza
A
Schmidt
Ernst Hienrich
EH
D000328:Adult; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data*; D002584:Cervix Uteri / Q000002:abnormalities / Q000601:surgery; D005260:Female; D005836:Genitalia, Female / Q000002:abnormalities* / Q000601:surgery*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015907:Hysteroscopy / Q000706:statistics & numerical data*; D015994:Incidence; D007247:Infertility, Female / Q000453:epidemiology*; D007492:Iran / Q000453:epidemiology; D009095:Mullerian Ducts; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016896:Treatment Outcome; D002581:Uterine Cervical Incompetence / Q000453:epidemiology*; D014592:Uterine Hemorrhage / Q000453:epidemiology*; D014599:Uterus / Q000002:abnormalities / Q000601:surgery; D014621:Vagina / Q000002:abnormalities / Q000601:surgery