Ferla Stefano, Virgilio Agnese, Arena Alessandro, Raimondo Diego, Raffone Antonio, Seracchioli Renato, Casadio Paolo
Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero - Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero - Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
J Pediatr Adolesc Gynecol. 2025 Apr;38(2):180-183. doi: 10.1016/j.jpag.2024.08.012. Epub 2024 Aug 24.
The septate uterus is the most common uterine abnormality, comprising 35% of all identified uterine malformations. According to the ESHRE/ESGE 2013 classification, the class U2bC2V1 is a rare congenital malformation characterized by a complete septate uterus with double cervix and nonobstructive longitudinal vaginal septum.
to share the decision-making process, the preoperative ultrasonographic assessment and our step-by-step hysteroscopic surgery technique to manage this complex malformation: including how to access the septate uterine cavity, the resection of the septum and its postoperative management. The goal of the surgical treatment is to restore the regular morphology of the vaginal canal and the uterine cavity with the right amount of myometrium.
we present video footage of a hysteroscopic approach at a tertiary care academic medical center for managing a 21-year-old patient with a symptomatic uterine septum with double cervix and nonobstructive longitudinal vaginal septum.
Both the intraoperative and postoperative periods were uneventful: a complete resolution of the vaginal septum and creation of a single uterine cavity were obtained.
Due to the significant anatomic variability of this condition, this type of surgery can be challenging. The goal of this video is also educational, aiming to illustrate a reproducible technique that can be utilized by younger or less experienced surgeons. In our experience, this hysteroscopic technique appears to be a valid option for patients with symptomatic Mullerian malformation or those with a history of recurrent miscarriages or unexplained infertility.
纵隔子宫是最常见的子宫异常，占所有已确诊子宫畸形的35%。根据ESHRE/ESGE 2013分类，U2bC2V1类是一种罕见的先天性畸形，其特征为完全纵隔子宫、双宫颈和非阻塞性纵向阴道纵隔。
分享针对这种复杂畸形的决策过程、术前超声评估以及我们的分步宫腔镜手术技术：包括如何进入纵隔子宫腔、切除纵隔及其术后管理。手术治疗的目标是恢复阴道管和子宫腔的正常形态，并保留适量的肌层。
我们展示了在一家三级医疗学术中心采用宫腔镜方法治疗一名21岁有症状的双宫颈纵隔子宫且伴有非阻塞性纵向阴道纵隔患者的视频资料。
术中和术后过程均顺利：阴道纵隔完全消除，形成了单一子宫腔。
由于这种情况存在显著的解剖变异，此类手术具有挑战性。该视频的目的还具有教育意义，旨在展示一种可被年轻或经验不足的外科医生采用的可重复技术。根据我们的经验，这种宫腔镜技术对于有症状的苗勒管畸形患者或有复发性流产或不明原因不孕病史的患者似乎是一种有效的选择。
