Uterine Septum Correction
A septum is a dividing wall between two chambers in animals and structures. You expect to have a septum in your nose to separate both halves and each nostril from the other. The heart has septums too, separating each chamber within the organ.
But there isn’t supposed to be a septum in your uterus. If there is, then it will be nearly impossible for you to get pregnant or carry a baby to term. If you did get pregnant, the odds of a normal delivery are close to nil. Uterine septum, also called a septate uterus, is a congenital defect, meaning that you are born with the deformity. Unfortunately, many women don’t realize they have a uterine septum until they experience infertility issues or have repeated miscarriages.
Essentially, a uterine septum, also called a Mullerian anomaly, is fibrous tissue that forms a horizontal dividing wall within your uterus. The formation of a female in the womb includes the creation of Mullerian tissue that absorbs into the body after it forms the uterus, which is a triangular, open shape. When the tissue doesn’t completely absorb, it can leave the septum.
The septum may be small and just dangle from the top of your uterus or the hard tissue can extend all the way to the uterine floor, basically creating two chambers. If you have a uterine septum, you won’t have any symptoms and unless your OBGYN notices it during a pelvic exam, you won’t even know it’s there until you try to conceive. The condition is a formative abnormality with no known causes.
Most women never know they have a septum in their uterus until their first pelvic exam or when they try to get pregnant. One possible symptom, however, can occur. If the septum blocks the vaginal septum, it may cause menstrual blood to collect in the upper vagina and not pass through and out.
Some symptoms that may alert your OBGYN to the possibility of a uterine septum include:
- Recent infertility issues
- Multiple miscarriages
- Early labor
- Incorrect positioning of the fetus during pregnancy
- Extreme pain during your period
- Pain inserting a tampon
- Unusual pain during sexual intercourse
Tests that can confirm the existence of the abnormality include:
- 3D Ultrasound, a common test performed during the early part of a pregnancy. Images are made from the inside of your vagina rather than through your belly and are projected onto a computer screen for immediate diagnosis.
- MRI, or magnetic resonance imaging, is a test that relies on radio waves and magnets to create a clear picture of your uterus from the inside. You cannot be pregnant when you get an MRI. MRI is probably the most accurate for diagnosing any uterine abnormalities.
- Hysterosalpingogram, a test during which your doctor inserts dye into your cervix, which then shows up on X-rays. The uterus pictures allow your OBGYN to view your fallopian tubes, cervix and uterus. Again, though, you must be sure that you aren’t pregnant for this test.
- Sonohysterogram, another test for which you must sure you’re not pregnant. During this test, salt water is inserted in the uterus through your cervix and a vaginal ultrasound is performed. The salt water helps produce a clearer image of your uterus from the inside than a regular ultrasound.
Uterine Septum Surgery
Many infertility issues are treated with medication, but because the uterine septum is a structural issue, correction requires surgery. Uterine septum surgery, sometimes referred to as hysteroscopic septoplasty or hysteroscopic resection, is a minimally invasive outpatient treatment performed with a hysteroscope. The procedure doesn’t leave any scars that you can see, because no incisions are required.
- You’re put under with general anesthesia or local anesthesia with light sedation. So even though you don’t have to spend the night in the hospital, you do need to have someone with you to drive you home when you’re finished.
- Your cervix is dilated with a sterile saline solution to give the surgeon room to view your entire uterus and the space in which to move around without interfering with any other nearby organs.
- A long thin tube with a camera and light on the end is then inserted through the vagina to your uterus, meaning no incisions are needed to reach the uterus.
- Through the tube, another thin device is inserted that holds the instruments needed to cut or resect the septum.
- Any extra tissue is pulled back or scraped out to open the uterus for egg implanting and fertilization.
Recovery and Potential Risks
After a couple hours in recovery, you’ll be able to leave with your driver. You’ll be given pain pills to help you get through any discomfort or cramping you may feel for the first day, although you may not need to use them after 24 hours, which is when you can expect to resume your normal activities.
A little bit of bloody discharge is normal for a couple days following the surgery, for which you can wear a pad. You’ll want to avoid any heavy lifting and refrain from rigorous exercise and sexual intercourse for at least two weeks or until your doctor releases you after a follow-up exam.
Call your doctor immediately if you experience:
- Shortness of breath
- Difficulty urinating
- Heavy bleeding
- Severe abdominal cramps
- Chills or fever
According to a 2010 study reported in the journal Reproductive Biology and Endocrinology, women who struggled with fertility due to a uterine septum were successful at getting pregnant 60 percent of the time following the corrective surgery.
Complications from the procedure were found in only 1.7 percent of patients, while six percent needed to have a second correction of vaginal and uterine septum surgery. Hysteroscopic surgery is painless and rarely leads to complications. For example:
- Only one percent of patients who underwent hysterscopic surgery had a puncture of the uterus or cervix.
- The bladder or bowel may be punctured in rare cases, and surgical repair can be provided if that happens.
- There always is the potential for anesthesia complications.
- The fluid used to dilate your cervix can seep into your system and lead to low sodium levels.
- And while infection is possible, it’s very rare with this procedure.
All symptoms should always be evaluated with a thorough consultation and examination by your gynecologist for an accurate diagnosis and treatment plan to exclude any underlying serious condition. The uterine septum correction procedure, indications, options and risks should always be discussed with your gynecologist.
Important Reminder: This information is only intended to provide guidance, not a definitive medical advice. Please consult ob/gyn doctor about your specific condition. Only a trained, experienced board certified gynecologist can determine an accurate diagnosis and proper treatment.
Do you have questions about Uterine Septum Correction procedure? Would like to schedule an appointment with the top NYC GYN specialist, Dr. Pedram Bral of Manhattan Women’s Health and Wellness, please contact our office for OBGYN consultation.
Dr. Pedram Bral, Gynecologist (Gynecologist NYC, Midtown OB GYN)
New York, NY10010
(Between Madison Ave & Park Ave)
☎ (212) 533-4575