National Taiwan University Hospital yesterday said that its novel method of hysteroscopic metroplasty has simplified the surgical procedure for people with a septate uterus and increased the success rate.
A septate uterus — the most common congenital uterine anomaly — is a condition in which a thin tissue membrane runs down the middle of the uterus and divides it into two parts.
A 33-year-old woman surnamed Chen (陳) said she had never had menstrual cramps and did not know she had a congenital uterine anomaly until she had difficulty getting pregnant and sought medical assistance.
Photo: Chiu Chih-jou, Taipei Times
She was found to have a complete septate uterus (CSU), with the thin septum running down the entire length of the uterus and the cervix, extending to the vagina, separating them into two, so she was transferred to a hospital, Chen said.
She received a cervix-preserving hysteroscopic metroplasty procedure at the hospital, and gave birth to a baby and is pregnant again, Chen said.
National Taiwan University Hospital Department of Obstetrics and Gynecology attending physician Yang Po-kai (楊博凱) said congenital uterine anomalies occur when an embryo is developing, and about 5 percent of all women have the condition.
A septate uterus is the most common congenital uterine anomaly, and it increases the risk of miscarriage, he said.
Although laparotomy (open abdominal surgery) is the conventional procedure for the condition, hysteroscopic metroplasty, a minimally invasive surgical procedure that involves cutting and removing the septum from the uterus, has become the most common treatment in the past few years years, Yang said.
CSU is a relatively rare condition, he said.
A hysteroscopic metroplasty for treating CSU is more difficult than other septate uterus cases, as an initial perforation needs to be made between the non-communicating cavities above the cervix to preserve the cervical architecture, he said.
The hospital said that Reproductive Endocrinology and Infertility Divison, led by Department of Obstetrics and Gynecology director Yang Jehn-hsiahn (楊政憲) performed hysteroscopic metroplasty on 58 CSU patients over the past 16 years and developed a new method with an increased success rate of initial perforation.
The team found that by applying progressively larger dilators into each of the bifurcated cervical canals, spontaneous perforations — progressive thinning of the cervical stroma, which causes the weaker portion of the septum to spontaneously tear — are applied to the uterine septum, Yang Po-kai said.
The novel surgical method improves the cervix-preserving hysteroscopic metroplasty by avoiding the need to make sharp incisions, he said.
The procedure has a higher success rate, which makes it a safer first option for all women with CSU, he added.
The team’s novel method was published in the Journal of Minimally Invasive Gynecology in September last year.
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