Sunday, February 14, 2016

Uterine Septum is the most common uterine anomaly. This condition is common in patients  who have difficulty getting pregnant or may have miscarriages. 

It is  usually diagnosed by an ultrasound evaluation. In some cases the diagnosis may be confirmed by an MRI. 

Uterine Septum consists of tissue which divides the uterus into two parts. It is difficult for the pregnancy to continue if the embryo implants on the uterine septum. This condition can be easily and safely treated by hysteroscopy. A operative hysteroscope is placed into the uterine cavity and the uterine septum is easily divided thus opening up the uterine cavity and creating enough space for the pregnancy to develop.  Normal saline (Sodium Chloride solution ) is used to distend the uterine cavity during hysteroscopy so that the cavity is well visualized.

This is an outpatient procedure. The septum is usually partial and the resection can be completed in one sitting unless there is bleeding or rapid fluid absorption. The surgical time is usually 20 minutes. Sometimes the procedure is aided by the use of ultrasound or laparoscopy during surgery depending on the ultrasound / MRI findings. The patients go home the same day and resume routine activities in a couple of days after a hysteroscopic procedure. 

The uterine lining heals by itself in about 2 months after which the patient can try for pregnancy. 

Please click on the link below to view the video for hysteroscopic septum resection:

Please contact me at with any questions! 

Hysteroscopy is a very commonly used procedure in Gynecology. It helps evaluate the cavity of the uterus for any problem( pathology). The cavity of the uterus is like a room and the lining of the uterus thickens and sheds every month during the menstrual cycle. If there is a problem in the lining of the uterus in the form of a polyp, fibroid or thickened lining, it can manifest as heavy periods, irregular bleeding or bleeding after menopause.

Hysteroscopic procedure involves placement of a camera in the uterus through the vagina using a 4mm hysteroscope. Since this does not involve making any incisions, the procedure is well tolerated and can be done in the office setting with local anesthesia in many patients. 

Hysteroscopy is used in patients with irregular bleeding, uterine polyps, uterine fibroids, bleeding after menopause, uterine septum, adhesions/bands in the endometrial cavity and other conditions to help diagnose and treat them

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Different types of abnormal bleeding in women may include irregular bleeding between periods, heavy bleeding during periods, postmenopausal bleeding etc.

Hysteroscopic evaluation can be done in the office with and without anesthesia. Some patients may need hysteroscopic evaluation and treatment in the hospital depending on the pathology. 

Patients with irregular bleeding or bleeding after menopause usually undergo a pelvic ultrasound to evaluate the cavity for polyps, fibroids or thickened lining of the uterus. If these conditions are suspected on ultrasound, we then recommend a hysteroscopic evaluation to confirm the diagnosis and help treat them. 

Hysteroscopic procedure helps remove the polyps, fibroids, areas of endometrial thickening or endometrial lining to help treat  abnormal bleeding patterns. It also provides a tissue sample which can be assessed under the microscope by a pathologist to rule out any changes which may become cancer later on. 

Women who may experience difficulty getting pregnant may also have conditions like uterine polyp, fibroid, septum or adhesions within the uterine cavity. These conditions prevent the embryo from implanting in the uterine cavity and hence decrease pregnancy rates. These conditions can be treated using hysteroscopic techniques.