Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy.
Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
Fertil Steril. 2021 Aug;116(2):602-604. doi: 10.1016/j.fertnstert.2021.04.011. Epub 2021 May 8.
To demonstrate a systematic approach for the hysteroscopic management of a patient with uterine septum with double cervix and a nonobstructive longitudinal vaginal septum (Class U2bC2V1 of the ESHRE/ESGE classification).
A step-by-step demonstration of the technique with narrated video footage of three different cases.
University Hospital.
PATIENT(S): We present three patients diagnosed with uterine septum with double cervix and a nonobstructive longitudinal vaginal septum (Class U2bC2V1 of the ESHRE/ESGE classification). Case 1 is a 31-year-old woman with class U2bC2V1 müllerian anomaly and primary infertility. Case 2 is a 29-year-old patient with class U2bC2V1 müllerian anomaly, infertility, and dyspareunia. Case 3 is a 32-year-old patient with class U2bC2V1 müllerian anomaly, infertility, and abnormal uterine bleeding. She also was diagnosed with a submucous leiomyoma.
INTERVENTION(S): Hysteroscopic management of this complex müllerian anomaly using miniaturized hysteroscopic instruments, including the mini-resectoscope, was performed. All three procedures were performed in the operating room with the patient under general anesthesia. No complications were encountered. Patients were discharged home the same day of the procedure after a short period of observation. The critical aspects of the procedure are highlighted.
MAIN OUTCOME MEASURE(S): Description of the systematic approach with a detailed demonstration of the critical steps of the procedure.
RESULT(S): Complete resolution of the vaginal septum with creation of a single uterine cavity was obtained in all three cases. Absence of intrauterine adhesion formation was confirmed.
CONCLUSION(S): Due to the recent innovations in hysteroscopic equipment and improved surgical techniques, the hysteroscopic management of patients with complex müllerian anomalies using miniaturized instruments is a feasible and effective treatment option.
展示宫腔镜处理子宫纵隔伴双宫颈和非梗阻性阴道纵隔（ESHRE/ESGE 分类 U2bC2V1 类）患者的系统方法。
分步演示技术，并附有三个不同病例的解说视频。
大学医院。
我们介绍了 3 名被诊断为子宫纵隔伴双宫颈和非梗阻性阴道纵隔（ESHRE/ESGE 分类 U2bC2V1 类）的患者。病例 1 是一名 31 岁的女性，患有 U2bC2V1 型米勒管畸形和原发性不孕。病例 2 是一名 29 岁的患者，患有 U2bC2V1 型米勒管畸形、不孕和性交困难。病例 3 是一名 32 岁的患者，患有 U2bC2V1 型米勒管畸形、不孕和异常子宫出血。她还被诊断出患有黏膜下肌瘤。
使用微型宫腔镜器械（包括迷你电切镜）对这种复杂的米勒管畸形进行宫腔镜处理。所有三个手术均在手术室中进行，患者全身麻醉。没有遇到并发症。患者在观察一段时间后当天出院。突出了该手术的关键步骤。
系统方法的描述，详细演示手术的关键步骤。
所有 3 例均成功切除阴道纵隔，形成单一子宫腔。确认不存在宫内粘连形成。
由于宫腔镜设备的最新创新和手术技术的改进，使用微型器械对复杂米勒管畸形患者进行宫腔镜处理是一种可行且有效的治疗选择。
