Description:
Correction of uterine anomalies involves various surgical and minimally invasive procedures aimed at treating structural abnormalities of the uterus. These anomalies can be congenital, such as a double or bicornuate uterus (uterus didelphys or uterus bicornis), or they can result from acquired conditions such as fibroids, adhesions, or scar tissue (Asherman’s syndrome). These anomalies may lead to fertility issues, recurrent miscarriages, abnormal bleeding, and other gynecological problems. The goal of correction is to restore the normal structure and function of the uterus, thereby improving the chances of a successful pregnancy or alleviating symptoms.
Indications:
- Congenital uterine anomalies such as septate uterus (divided uterus), bicornuate uterus (two-horned uterus), or uterus didelphys (double uterus)
- Acquired anomalies such as intrauterine adhesions (Asherman’s syndrome) or fibroids that deform the uterine cavity
- Recurrent miscarriages or infertility due to uterine anomalies
- Abnormal menstrual bleeding or chronic pelvic pain associated with uterine anomalies
- Women seeking improvement in uterine anatomy for future pregnancies or symptom relief
Procedure:
- Pre-Procedure Assessment and Diagnosis: Before correcting a uterine anomaly, a thorough gynecological examination is performed, including imaging studies such as ultrasound, magnetic resonance imaging (MRI), or hysterosalpingography (HSG). These studies help determine the exact type and location of the anomaly and guide the selection of the appropriate treatment method.
- Surgical Techniques:
- Hysteroscopic Surgery: This minimally invasive technique is commonly used to correct intrauterine anomalies such as septa (dividing walls) or adhesions. A hysteroscope, a thin, lighted instrument, is inserted through the vagina and cervix into the uterus. Under direct visualization, surgical instruments are guided through the hysteroscope to remove septa, release adhesions, or correct other anomalies. This method requires no abdominal incisions and offers a quicker recovery time.
- Laparoscopic Surgery: This method is used to correct anomalies requiring external visualization of the uterus, such as a bicornuate uterus or removal of fibroids. Several small incisions are made in the abdomen, and a laparoscope is inserted to visualize the uterus and surrounding structures. Surgical instruments are inserted through the other incisions to correct the anomalies.
- Abdominal (Open) Surgery: This method is rarely used and reserved for complex or extensive anomalies that cannot be addressed through minimally invasive techniques. A larger incision is made in the lower abdomen to provide direct access to the uterus. This method may require a longer recovery time and leaves a larger scar.
- Aftercare: After surgery, the patient is closely monitored for possible complications such as infections, bleeding, or adhesions. The doctor provides specific postoperative care instructions, including avoiding strenuous physical activity and attending regular follow-up appointments to monitor the healing process. Women who have had uterine anomaly correction to improve fertility may be closely monitored to maximize the chances of success in future pregnancies.
Benefits:
- Improvement in uterine structure and function, increasing the chances of a successful pregnancy
- Relief from symptoms such as abnormal bleeding and pelvic pain
- Minimally invasive techniques offer shorter recovery times and less postoperative pain
- Reduction in the risk of recurrent miscarriages and fertility problems
- Enhancement of quality of life through targeted treatment of uterine anomalies