Catena Ursula, Bernardini Federica, La Fera Eleonora, Fedele Camilla, Bonetti Emma, Pozzati Federica, Scambia Giovanni, Grimbizis Grigoris F
Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy.
Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali Civili, Brescia, Italy.
Facts Views Vis Obgyn. 2025 Mar 28;17(1):84-89. doi: 10.52054/FVVO.2024.13721.
The presence of complete uterine septum, cervical septum and longitudinal vaginal septum (class U2bC1V1 according European Society of Human Reproduction and Embryology/European Society for Gynaecological Endoscopy classification) is a rare congenital anomaly of the female genital tract. The diagnosis of this anomaly is very challenging, significantly influencing the type of treatment to be performed.
We propose a one-stop diagnosis through the combined use of 2D-3D ultrasound (US) and hysteroscopy and the minimally invasive endoscopic treatment of this anomaly, emphasising the diagnostic and therapeutic differences compared to U2bC2V1 anomaly.
Stepwise demonstration with video footage of an integrated approach in the management of a patient with a class U2bC1V1 anomaly. The patient was 23 years old and presented with dyspareunia and a previous miscarriage. We performed a one-stop diagnosis through the combined use of diagnostic hysteroscopy and 2D-3D pelvic US and a minimally invasive endoscopic treatment with a 15Fr bipolar miniresectoscope.
Hysteroscopic control performed 40 days after the procedure showed a regular vagina, a normal single cervix and a normal uterine cavity. No intra- or postoperative complications occurred. The patient was discharged 3 hours after the procedure. The total operation time was 24 minutes.
Making an accurate diagnosis of a single cervix with cervical septum and a double cervix is crucial in the management of patients with complex genital anomalies. An accurate diagnosis is possible when combining hysteroscopy and US. Minimally invasive endoscopic treatment of U2bC1V1 anomaly with a 15 Fr bipolar miniresectoscope is an effective and safe procedure, easier when compared to the treatment of U2bC2V1 anomaly.
WHAT IS NEW?: This video article describes the hysteroscopic criteria for the differential diagnosis between single cervix with cervical septum and double cervix.
完全性子宫纵隔、宫颈纵隔和阴道纵隔的存在（根据欧洲人类生殖与胚胎学会/欧洲妇科内镜学会分类为U2bC1V1类）是一种罕见的女性生殖道先天性异常。这种异常的诊断极具挑战性，对所实施的治疗类型有重大影响。
我们建议通过联合使用二维-三维超声（US）和宫腔镜检查进行一站式诊断，并对这种异常进行微创内镜治疗，强调与U2bC2V1异常相比的诊断和治疗差异。
通过视频片段逐步展示对一名U2bC1V1类异常患者进行综合治疗的方法。患者23岁，有性交困难和既往流产史。我们通过联合使用诊断性宫腔镜检查和二维-三维盆腔超声进行一站式诊断，并使用15Fr双极微型电切镜进行微创内镜治疗。
术后40天进行的宫腔镜检查显示阴道正常、宫颈单一且正常、子宫腔正常。未发生术中或术后并发症。患者术后3小时出院。总手术时间为24分钟。
准确诊断单一宫颈合并宫颈纵隔和双宫颈对于复杂生殖器异常患者的管理至关重要。联合宫腔镜检查和超声可以做出准确诊断。使用15Fr双极微型电切镜对U2bC1V1异常进行微创内镜治疗是一种有效且安全的手术，与治疗U2bC2V1异常相比更容易。
新内容是什么？：本文视频描述了单宫颈合并宫颈纵隔和双宫颈鉴别诊断的宫腔镜标准。
