Uterine septum is a congenital condition that affects the shape and size of the uterus. It occurs when the two tubes that form the uterus in the embryo do not fuse properly, leaving a wall of tissue that divides the uterine cavity into two parts. This wall of tissue is called the septum, and it can vary in length and thickness. Depending on how much it affects the uterine space, it can cause problems with pregnancy and fertility.
Symptoms and Diagnosis of Uterine Septum
Most women with uterine septum do not have any symptoms and may not even know they have this condition until they try to get pregnant or experience recurrent miscarriages. Some possible signs of uterine septum are:
- Painful periods
- Heavy bleeding
- Pelvic pain
- Difficulty conceiving
- Repeated pregnancy loss
How to Diagnose Uterine Septum
To diagnose uterine septum, your doctor may perform a pelvic exam, an ultrasound, a hysterosalpingogram (HSG), a sonohysterogram, a magnetic resonance imaging (MRI), or a hysteroscopy. These tests can help visualise the shape and size of your uterus and identify the presence and extent of the septum.
Treatment Options for Uterine Septum
The treatment for uterine septum depends on your symptoms and your reproductive goals. If you do not have any problems with your menstrual cycle or your fertility, you may not need any treatment at all. However, if you have difficulty getting pregnant or carrying a pregnancy to term, you may benefit from surgery to remove the septum.
The surgery to correct uterine septum is called hysteroscopic metroplasty. It is a minimally invasive procedure that involves inserting a thin instrument called a hysteroscope through your vagina and cervix into your uterus. The hysteroscope has a camera and a light that allows your doctor to see inside your uterus and locate the septum. Then, using a small scissors or a laser, your doctor cuts and removes the septum, creating a single uterine cavity.
The surgery usually takes less than an hour and does not require any incisions or stitches. You may have some cramping and bleeding after the procedure, but you can usually go home the same day. You will need to avoid sexual intercourse and tampons for a few weeks to allow your uterus to heal.
Risks and Benefits of Hysteroscopic Metroplasty
Hysteroscopic metroplasty is a safe and effective treatment for uterine septum. It can improve your chances of conceiving naturally or with assisted reproductive technologies (ART) such as in vitro fertilisation (IVF). It can also reduce your risk of miscarriage, preterm birth, breech presentation, and caesarean delivery.
However, like any surgery, hysteroscopic metroplasty has some potential risks and complications. These include:
- Infection
- Bleeding
- Perforation of the uterus
- Adhesions (scar tissue) inside the uterus
- Asherman's syndrome (a rare condition where the uterine walls stick together)
- Damage to nearby organs such as the bladder or bowel
To minimise these risks, you should choose an experienced surgeon who specialises in reproductive surgery. You should also follow your doctor's instructions before and after the surgery.
Conclusion
Uterine septum is a common cause of miscarriage and infertility in women. It is a congenital condition that results from incomplete fusion of the two tubes that form the uterus in the embryo. It creates a wall of tissue that divides the uterine cavity into two parts, reducing the space and blood supply for implantation and growth of an embryo.
Uterine septum can be diagnosed by various tests that visualise the shape and size of the uterus. The treatment for uterine septum is hysteroscopic metroplasty, a minimally invasive surgery that removes the septum and creates a single uterine cavity. This surgery can improve your chances of getting pregnant and having a healthy pregnancy.
If you have uterine septum or suspect you may have it, talk to our doctors about your options and expectations. With proper diagnosis and treatment, you can overcome this condition and achieve your reproductive goals.
Sources
[1] Debbo Africa: https://debbo.africa
[2] Cleveland Clinic. (n.d.). Septate Uterus (Uterine Septum): Symptoms & Treatment. Retrieved from https://my.clevelandclinic.org/health/diseases/22809-septate-uterus
[3] Wikipedia. (2021, October 25). Uterine septum. Retrieved from https://en.wikipedia.org/wiki/Uterine_septum
[4] TLC fertility. (2020, December 9). Uterine Septum, What it is, Diagnosis and Treatment. Retrieved from https://www.tlcfertility.com/blog/uterine-septum-diagnosis-and-treatment
[5] Healthline. (2018, March 2). Septate Uterus: How It Affects Pregnancy, Surgery Details. Retrieved from https://www.healthline.com/health/septate-uterus