Histologic architecture and vascularization of hysteroscopically excised intrauterine septa.

STUDY

OBJECTIVE

To investigate histologic structures of intrauterine septa resected hysteroscopically.

DESIGN

Prospective, consecutive study (Canadian Task Force classification II-2).

SETTING

University-affiliated hospital.

PATIENTS: Seventy-six women evaluated for uterine septa and infertility.

INTERVENTIONS: All patients with diagnosis of uterine septum detected by transvaginal color Doppler (TVCD) underwent operative hysteroscopy in which the most prominent part of the septum was encircled with a hysteroscopic loop electrode and removed. Specimens were sent for histopathologic evaluation. The rest of the septum was divided by monopolar needle electrode until the uterine cavity assumed a globular shape.

MEASUREMENTS AND MAIN

RESULTS

In 63 women (82.8%) preoperative TVCD revealed septal vascularity typical for radial arteries with mean resistance flow of 0.64 +/- 0.06, and enlarged sunusoidal and capillary spaces. Histopathologic results revealed fibromuscular tissue with moderately more connective tissue in 55 cases (72.3%) and myometrial tissue in 21 (27.6%). There was no statistically significant difference (p >0.05) in frequency of septa between patients with primary and secondary infertility.

CONCLUSION

Intrauterine septa consisted of the same type of tissue as normal myometrium, with many muscular fibers. We suspect that muscular tissue within the uterine septum is a potential cause of irregular contractility and consequently increased abortion rate in these patients. (J Am Assoc Gynecol Laparosc 8(1):111-116, 2001)