What should I do if a uterine septum is detected?

A uterine septum is a congenital anomaly resulting from incomplete cavity formation during uterine development. Specific treatment options include cold scissor separation under hysteroscopic and laparoscopic guidance, as well as hysteroscopic resection using cold instruments or plasma electro-needles.

① Cold Scissor Separation Under Hysteroscopic and Laparoscopic Guidance

Hysteroscopic septal resection avoids the excessive intraoperative bleeding associated with traditional open surgery. Utilizing specialized techniques, this minimally invasive procedure results in minimal intraoperative and postoperative bleeding, reduced tissue trauma, shorter recovery time, and a lower risk of intrauterine adhesions. Particularly, cold scissor technique maximally preserves uterine integrity and fertility potential, without compromising natural conception postoperatively. Following septal resection, effective anti-adhesion strategies are implemented to prevent postoperative adhesion formation.

② Hysteroscopic Resection Using Cold Instruments or Plasma Electro-Needles

The uterine septum is incised using cold instruments or a plasma electro-needle under hysteroscopic visualization. In contrast, resection with a conventional electrosurgical loop may cause cicatricial contraction and fail to effectively enlarge the uterine cavity. Performing the procedure under laparoscopic monitoring enhances both safety and precision. A biodegradable anti-adhesion membrane is placed intrauterinely following surgery. For larger septa, complete resection in a single session is not mandatory; staged procedures are acceptable. Over-resection (“overcorrection”) must be avoided, as it may result in excessive scarring at the uterine fundus, thereby impairing fertility.