Vaginal Septoplasty in Septate Uterus with Double Cervix

Abstract

Fusion defects of the Müllerian ducts occur frequently and they have been described by the American Fertility Society. However, septate uterus with cervical duplication and longitudinal vaginal septum is not described by this classification and has suggested a change in the classical theory of fusion of the Müllerian ducts. This paper describes a rare case report of a patient with complete septate uterus with double cervix and longitudinal vaginal septum, submitted to the vaginal septoplasty for dyspareunia, progressing to clinical improvement. The description of this case is to contribute with all uncommon cases of Müllerian anomalies reports and clinical treatment protocols, which is not yet established.

Complete Uterine Septum with Cervical Duplication and Longitudinal Vaginal Septum: An Anomaly Supporting Alternative Embryological Development

“…A number of similar cases have come into literature in the last three decades. [ 1 4 5 6 ] All these support the alternative embryological hypothesis. While the AFS classification left many anomalies nonclassified, the ESHRE-2013 classification can incorporate this and many other anomalies.…”

“…The complete diagnosis is possible only with a combination of MRI and diagnostic hysterolaparoscopy. [ 5 ] The septate uterus (U2) is associated with a number of obstetric complications such as second-trimester abortions, preterm labor pains, malpresentations, and infertility. [ 2 ] However, in this case, a trial for normal conception was planned.…”

“…Further procedure was planned in case of future pregnancy complications. [ 5 ] Ribeiro et al . reviewed those with a complete uterine septum, double cervix, and a vaginal septum.…”

Determinants of Pregnancy Outcomes after Assisted Reproductive Therapy: A Sample from the West Bank, Palestine

“…Several factors can cause disturbance at any step, whether due to female or male reasons. Female reasons leading to infertility included: hormonal disorders [6], polycystic ovarian syndrome [7], premature ovarian failure [8], endometriosis [9], fallopian tube obstruction [10], congenital uterine anomalies [11], or due to complication of medical diseases (diabetes and hypothyroidism) [12,13]. Male infertility is usually due to sperm abnormalities or hormonal imbalance [2,14].…”

Role of three dimensional ultrasound in uterine anomalies - 3D assessment of cervix in septate uteri

“…Both may be seen in combination with or without a vaginal septum. 4,[15][16][17] With the help of 3D ultrasound the cervical os can be visualised as per speculum examination (Figure 4). This is extremely useful in patients with vaginal septum where despite insertion of a speculum the cervix is inadequately visualised.…”