Hysterosocpic Metroplasty: Complete Uterine Septum

The purpose of this educational video is to review the clinical implications of a uterine septum, to discuss how to frame this diagnosis for pediatric and adolescent patients and their families, and to demonstrate the technique of hysteroscopic metroplasty in which a uterine septum is surgically corrected in a minimally invasive fashion. Furthermore, this video reviews the diagnosis of a uterine septum including uterine embryology, discusses the obstetric and gynecologic issues related to a uterine septum and longitudinal vaginal septum, and reviews indications for surgical correction of a uterine septum with hysteroscopic metroplasty. The surgical portion of the video involves a 30 year old woman who was diagnosed with a complete uterine septum and vaginal septum at age 20 due to dyspareunia and difficulty with tampon insertion, underwent repair of the vaginal septum at the time, and decided to pursue surgery for the uterine septum prior to trying to conceive. The video demonstrates the surgical technique utilized to repair a complete uterine septum. This video is relevant to practitioners who provide pediatric and adolescent gynecologic services because a uterine septum is one of the most common uterine anomalies and is often an incidental finding when pelvic imaging is obtained. It is important for these practitioners to be able to explain this anomaly to patients and their parents, discuss the basics regarding gynecologic and reproductive implications, and understand the basics about how the anomaly can be surgically repaired.