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Hysteroscopic septoplasty is a minimally invasive surgical procedure that involves the correction of a uterine septum—a condition in which there is a wall-like structure (septum) inside the uterus that partially or completely divides the uterine cavity. This procedure is performed to improve fertility, reduce the risk of pregnancy complications, and alleviate menstrual symptoms caused by the septum pain.

When it is Performed

Hysteroscopic septoplasty is typically performed when a uterine septum is diagnosed and is believed to be contributing to infertility, recurrent pregnancy loss, or menstrual problems.

Purpose of the Procedure

The primary purposes of hysteroscopic septoplasty are:

Uterine Septum Correction

To remove or reshape the uterine septum, creating a more normal uterine cavity.

Fertility Improvement

To enhance fertility by providing a suitable environment for embryo implantation.

Reduction of Pregnancy Complications

To reduce the risk of miscarriages or preterm births associated with uterine septum.

What is expected to be performed

Here is an overview of the procedure:

Anesthesia

Hysteroscopic septoplasty is typically performed under general anesthesia, although in some cases, regional or local anesthesia may be used.

Hysteroscope Insertion

A hysteroscope, a thin, lighted tube with a camera, is inserted through the cervix and into the uterus, allowing the surgeon to visualize the septum.

Septum Correction

Specialized instruments are introduced through the hysteroscope to remove or resect the septum. This can involve cutting and reshaping the septum until a more normal uterine cavity is achieved.

Tissue Removal

Any removed tissue or septal fragments are typically aspirated or flushed out of the uterus.

End of Procedure

Once the septum has been adequately corrected, the hysteroscope is removed.

Incisions

Hysteroscopic septoplasty involves no external incisions. The hysteroscope is inserted through the cervix, minimizing trauma to surrounding tissues.

Surgical Instruments and Equipment

The main instruments used during hysteroscopic septoplasty are the hysteroscope itself and specialized instruments for tissue removal and septum correction.

Duration of Surgery

The length of hysteroscopic septoplasty can vary but is typically relatively short, ranging from 15 minutes to an hour, depending on the complexity of the septum.

Intraoperative Monitoring

Standard monitoring equipment, such as vital sign monitors, may be used to ensure the patient's safety during the procedure.

Potential Complications

Potential complications of hysteroscopic septoplasty may include:

  • Uterine perforation (a small hole in the uterine wall).
  • Bleeding.
  • Infection.
  • Reaction to anesthesia.

Expected Outcomes

Hysteroscopic septoplasty is expected to result in a more normal uterine cavity, which can improve fertility outcomes and reduce the risk of pregnancy complications associated with a uterine septum.

– Alternatives to Surgery

Practically, no alternative option w.r.t. pain. 

– Scarring

Hysteroscopic septoplasty typically does not result in external scarring, as it involves no external incisions.

Post-operative Care

Post-operative care may include:

  • Rest and recovery.
  • Monitoring for any unusual symptoms.
  • Follow-up appointments to assess uterine healing and discuss fertility or pregnancy plans.

– Hospital Stay

Hysteroscopic septoplasty is often performed as an outpatient procedure, meaning that patients can usually return home on the same day without the need for a hospital stay.

Recovery Time

Recovery time is relatively short for hysteroscopic septoplasty. Patients may experience mild cramping and light bleeding for a few days. Most individuals can return to their regular activities within a few days, but it's essential to follow the post-operative care instructions provided by the healthcare provider. Full recovery typically occurs within a few weeks.

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