Department of Public Health (Drs. Brunella, Alessandra, Chiara, and Attilio).
Department of Neuroscience, Reproductive Sciences and Dentistry (Dr. Alfonso), School of Medicine, University of Naples "Federico II," Naples, Italy.
J Minim Invasive Gynecol. 2023 Jun;30(6):441-442. doi: 10.1016/j.jmig.2023.02.015. Epub 2023 Mar 3.
To demonstrate our hysteroscopic technique using the mini-resectoscope for the treatment of complete uterine septum with or without cervical anomalies.
A step-by-step video demonstration of the technique with the use of an educational video.
We present 3 patients diagnosed as having complete uterine septum (U2b according to the ESHRE/ESGE classification) with or without cervical anomalies (C0, normal cervix; C1, septate cervix; C2, double "normal" cervix"), 2 of them with a longitudinal vaginal septum (V1). The first case is a 33-year-old woman with history of primary infertility diagnosed as having a complete uterine septum with normal cervix (class U2bC0V0 according to the ESHRE/ESGE classification). Case 2 is a 34-year-old woman with infertility and abnormal uterine bleeding, diagnosed as having complete uterine and cervical septum and a partial nonobstructive vaginal septum (class U2bC1V1). Case 3 is a 28-year-old woman with infertility and dyspareunia, diagnosed as having a complete uterine septum, double "normal" cervix, and nonobstructive longitudinal vaginal septum (class U2bC2V1) Still 3. The procedures were performed in a tertiary care university hospital.
The 3 procedures were performed in the operative room using a 15 Fr continuous flow mini-resectoscope and bipolar energy with the patient under general anesthesia Still 1 and Still 2. No complications were encountered in any of the 3 cases. After all procedures, a gel based on hyaluronic acid was applied to minimize postoperative adhesion formation. Patients were discharged home the same day of the procedure after a short period of observation.
Hysteroscopic treatment of patients with uterine septa associated or not with cervical anomalies using miniaturized instruments is a feasible and effective option for the management of patients with these complex müllerian anomalies.
展示使用迷你型宫腔镜切除系统治疗完全性子宫中隔伴或不伴宫颈异常的技术。
使用教育视频分步演示技术。
我们呈现了 3 例经诊断为完全性子宫中隔（ESHRE/ESGE 分类 U2b）伴或不伴宫颈异常（C0，正常宫颈；C1，纵隔宫颈；C2，双“正常”宫颈）的患者，其中 2 例伴有阴道纵隔（V1）。第 1 例是 33 岁的原发性不孕妇女，诊断为完全性子宫中隔伴正常宫颈（ESHRE/ESGE 分类 U2bC0V0）。第 2 例是 34 岁的不孕和异常子宫出血患者，诊断为完全性子宫和宫颈中隔伴部分非梗阻性阴道纵隔（U2bC1V1）。第 3 例是 28 岁的不孕和性交困难患者，诊断为完全性子宫中隔、双“正常”宫颈和非梗阻性纵向阴道纵隔（U2bC2V1）。这些手术都是在三级护理大学医院进行的。
这 3 例手术都是在手术室使用 15Fr 连续流迷你型宫腔镜切除系统和双极电流在全麻下进行（Still 1 和 Still 2）。这 3 例患者均无并发症。所有手术完成后，使用基于透明质酸的凝胶来减少术后粘连形成。患者在手术当天观察一段时间后出院。
使用微型器械治疗伴或不伴宫颈异常的子宫中隔患者是一种可行且有效的方法，可用于治疗这些复杂的米勒管畸形患者。
