Is uterine septum surgery successful?

The current treatment methods for the occurrence of uterine septum are relatively mature. The choice of treatment method will also affect the success rate, but the method should be selected according to the patient's physical condition. Hygiene care and dietary care after treatment also need attention.

Surgical treatment:

1. Uterine anastomosis

Patients with bicornuate uterus and recurrent miscarriage, excluding other causes of miscarriage not caused by uterine malformations, can undergo uterine anastomosis. A transverse incision is made from one uterine horn to the other uterine horn and the uterine cavity is cut into (the horns on both sides should be more than 0.5 cm away from the interstitial part of the fallopian tube). If there is a septum, it should be removed. The incision can be sutured longitudinally with absorbable sutures in the seromuscular layer without passing through the endometrial layer. The apexes of the incisions on both sides of the uterine horns are brought together to form a longitudinal suture so that the corrected uterus has a complete uterine cavity. If the distance between the two sides of the uterine cavity is far, a "V"-shaped incision can be made at the fundus of the uterus and the suturing method is the same as above.

2. Uterine septum resection

It can be done through abdominal surgery or hysteroscopy. At present, many hospitals in China use hysteroscopic removal of the uterine septum under laparoscopic monitoring, which improves the safety of the operation and achieves a success rate of about 75%. The operation should be performed 5 to 10 days after menstruation, using 5% glucose as the uterine distension fluid and laser or electric knife resection, with the uterine septum cut open from bottom to top. To prevent postoperative intrauterine adhesions, an IUD can be inserted. The recurrent miscarriage rate after surgery is reduced, and the full-term pregnancy rate and delivery rate are increased.

3. Rudimentary horn hysterectomy

In cases of rudimentary horn pregnancy, rudimentary horn with functional endometrium causing menstrual blood retention, and those diagnosed with rudimentary horn during the non-pregnancy period (unless the rudimentary horn is solid, without endometrium, and asymptomatic), the rudimentary horn should be removed, and the fallopian tube on the same side should be removed at the same time to avoid ectopic pregnancy in the future. After the above corrective surgery, contraception must be continued for more than one year before pregnancy can be achieved, and cesarean section is the preferred method of delivery.

Those with congenital uterine hypoplasia and ovarian hypoplasia who have difficulty getting pregnant can first undergo endocrine treatment to promote function and then undergo surgery, which will increase the pregnancy rate.