אבקש לקבל הסבר על ניתוח הסרת מחיצה ברחם

הניתוח בד"כ מבוצע במסגרת אישפוז יום. זמן ההחלמה מהיר ואם אין סיבוכים ניתן לנסות שוב להרות כעבור חודש. Hysteroscopic resection of the uterine septum: is it always a necessity? Fatma Bahar Cebesoy M.D.a aObstetrics AND Gynecology Department, Gaziantep University Faculty of Medicine, Gaziantep, Turkey July 16, 2008. Available online 27 February 2009. Article Outline References To the Editor: The article by Mollo et al. reporting the benefit of hysteroscopic septum resection supports the recent literature about the topic 1 Mollo A, De Franciscis P, Colacurci N, Cobellis L, Perino A, et al. Hysteroscopic resection of the septum improves the pregnancy rate of women with unexplained infertility: a prospective controlled trial. Fertil Steril. Published online 19 June 2008 [Epub ahead of print].(1). We congratulate the authors for their contribution to the relevant literature. Uterine septum is a müllerian anomaly existing in differing degrees. Infertile patients (6.3%) had a significantly higher incidence of müllerian anomalies, compared with fertile (3.8%) AND sterile (2.4%) women. Septate (33.6%) AND arcuate (32.8%) uteri were the most common malformations observed (2). Previously, it has been documented that septate uterus could be related to spontaneous abortion, early miscarriage, AND recurrent fetal loss (3) AND (4). Early miscarriages (25%–38%) AND preterm deliveries (25%–47%) were quite common in müllerian anomalies (2). Especially in infertile patients AND those with a history of early miscarriages, hysterosalpingography is routinely performed to diagnose uterine anomalies AND pathologies. Because uterine septum was believed to be a cause of subfertility, surgical treatment was necessary. Recently, hysteroscopic resection of the uterine septum has become the most common surgical treatment modality. On the other hand, in patients for whom IVF-ET is indicated, septum resection is required before the beginning of the cycle to minimize the adverse effect of the septum on fecundity AND early pregnancy. It is also known, however, that many women with septate uterus are not infertile AND have term pregnancies AND deliveries without complications. Incidence of uterine septum in a fertile population was documented as 3%–4% (2). These women were diagnosed coincidentally during gynecologic evaluation (2) AND (5). Because some women have a normal obstetric history despite having a uterine septum, we are not sure about the effect of the septum on fertility. It must be mentioned, though, that many studies have reported the positive effect of surgical treatment of the septum in infertile women AND patients with a history of spontaneous abortion AND preterm delivery (3). In conclusion, uterine anomalies are relatively frequent in fertile women AND more frequent in infertile patients. Uterine septum is associated with both normal AND adverse reproductive outcomes, AND although women with uterine septum AND otherwise unexplained infertility might benefit from hysteroscopic septum resection, management in infertile women remains controversial (5). References 1 Mollo A, De Franciscis P, Colacurci N, Cobellis L, Perino A, et al. Hysteroscopic resection of the septum improves the pregnancy rate of women with unexplained infertility: a prospective controlled trial. Fertil Steril. Published online 19 June 2008 [Epub ahead of print]. 2 F. Raga, C. Bauset, J. Remohi, F. Bonilla-Musoles, C. Simón AND A. Pellicer, Reproductive impact of congenital müllerian anomalies, Hum Reprod 12 (1997), pp. 2277–2281. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (144) 3 N. Colacurci, G. De Placido, A. Mollo, C. Carravetta AND P. De Franciscis, Reproductive outcome after hysteroscopic metroplasty, Eur J Obstet Gynecol Reprod Biol 66 (1996), pp. 147–150. Abstract | Article | PDF (430 K) | View Record in Scopus | Cited By in Scopus (19) 4 L.D. Bradley, Complications in hysteroscopy: prevention, treatment AND legal risk, Curr Opin Obstet Gynecol 14 (2002), pp. 409–415. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (23) 5 B.W. Rackow AND A. Arici, Reproductive performance of women with müllerian anomalies, Curr Opin Obstet Gynecol 19 (2007), pp. 229–237. View Record in Scopus | Cited By in Scopus (4)