What should I do if a uterine septum is detected?

Uterine septum is a manifestation of incomplete uterine cavity formation during congenital uterine development. Specific treatment options include cold scissor separation under hysteroscopic-laparoscopic guidance, as well as hysteroscopic cold instrumentation and plasma electrode needle therapy.

① Cold Scissor Separation Under Hysteroscopic-Laparoscopic Guidance

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

② Hysteroscopic Cold Instrumentation and Plasma Electrode Needle Therapy

The uterine septum is incised using hysteroscopic cold instruments or a plasma electrode needle; however, resection using an electrosurgical loop may lead to cicatricial contraction rather than beneficial expansion of the uterine cavity. Performing the procedure under laparoscopic monitoring enhances safety and precision. Postoperatively, a biodegradable anti-adhesion membrane is placed within the uterine cavity. For larger septa, complete resection in a single session is not mandatory—multiple staged procedures may be performed. Over-resection (“overcorrection”) must be avoided, as it may result in excessive scarring at the uterine fundus, thereby impairing fertility.