Histeroscopy and laprascopy with diode laser as a treatment for septate uterus

Background:Septate uterus is the most common congenital uterine malformation in women with infertility and is the most common, resulting from incomplete resorption of the medial septum after fusion of the Mullerian ducts. however, there is insufficient evidence that a uterine septum is associated with infertility. The introduction of hysteroscopy to diagnose and treat intrauterine conditions, specifically to divide the uterine septum, or metroplasty, has replaced the traditional laparotomy approach, and objective results demonstrate its salutary effects in women treated Methods: we performed systematic review of literature with related keywords in PubMed,Science direct and Google scholar to gather information in articles published since 2016 and summarized here. RESULTS: 18 patients were treated for septate uterus between 2013 and 2016. The indications for hysteroscopic metroplasty were recurrent abortion in 11 of the women and primary infertility in the other seven. We used a 5mm-office hysteroscope with a diode laser fibre. After exploration of the cavity, the septum was divided with use of the laser fibre.Operating time was 13,16±1,33min. Intraoperative pain was 3,05±0,72. No intraoperative or postoperative complications were observed. Follow-up performed 2 months after the hysteroscopic metroplasty confirmed the complete removal of the septum and no evidence of intrauterine synechiae CONCLUSION: Hysteroscopy and laparoscopy is a useful method for the diagnosis and treatment of asymmetric uterine septum. we believe that vaporization of the septum with a diode laser could reduce the formation of adhesions and consequently reduce the occurrence of septum persistence.The skill and experience of the laparoscopic surgeon is another important factor to identify and manage unusual uterine malformations

Keywords:

Hysteroscopy , laprascopy , Uterine septum