Septum Removal: Everything to Know About Your Uterine Health

A septum uterus consists of membranous boundaries dividing the uterine chamber. It causes no discomfort until a woman gets pregnant, leading to frequent miscarriages. It is a congenital female reproductive issue that develops within the female foetus.

Fortunately, uterine septum removal surgery can successfully treat and remove this membranous barrier. However, most women only learn about it when undergoing gynaecological observation in the event of pregnancy failure.

Women born with a uterus septum must have it removed before conceiving to prevent additional pregnancy complications.

Septum removal: Overview

A septum is a membranous boundary that separates the uterine cavity in the uterus, often extending to the vagina. The human uterus is an inverted, pear-shaped hollow organ. The presence of a septum separates it into two cavities.

The uterine septum is formed when reproductive development happens in the female foetus. Septum removal is the surgical treatment to remove this uterine membrane.

While a uterine septum does not inhibit women from conceiving naturally, it frequently does cause miscarriages due to implantation issues. Even if pregnancy is successful, it often causes complications, hindering a natural birth.

How does a septate uterus affect pregnancy?

The septate uterus is usually asymptomatic and does not bother unless a woman is pregnant. This condition is typically there from birth and can be fixed through surgical intervention only. A woman affected by a septate uterus may experience some complications during pregnancy. Some of the common complications are- 

• Frequent miscarriages
• Preterm birth 
• Low birth weight of the baby
• Premature birth 

Spotting a uterine septum: Symptoms

A uterine septum shows no symptoms up until the point a woman is set to conceive. Thus, you must visit a gynaecologist if you have experienced the following:

• History of miscarriage in your family
• Lower-back spasm (pelvic pain)
• Frequent miscarriages and difficulty in getting pregnant
• Painful menstruation (dysmenorrhea)

How does a uterine septum form?

A uterine septum is nothing but the remnants of the unfused Mullerian duct in the embryonic phase. It fuses to form the intra-uterine cavity along with the associated reproductive organs.

Around the 8th week of pregnancy, the Mullerian ducts fuse to form the uterovaginal duct, which on further development leads to the formation of the uterus and vagina. Upon failure, its remnants transform into the uterine septum. This membrane-like structure further divides the uterus into distinct parts.

Diagnosing a uterine septum: Methods and techniques

It is impossible to determine the underlying uterus septum without using diagnostic tools (X-ray, MRI, CT scan, USG, etc.).

When you visit a gynaecologist, they may ask you a few questions before performing a scan. They will begin with a pelvic exam (a physical examination would not be fruitful if the septum has not extended to the vagina). Next, they will perform:

• a 2D USG scan
• an MRI scan
• a hysteroscopy (insertion of an optical instrument to observe the uterine cavity through the vagina)

Post-observation, the gynaecologist may describe one of the following observations:

• The membranous partition extends from the uterine wall until the cervix and, sometimes, till the vagina (complete uterine septum)
• The partition stays limited to the uterine region (partial uterine septum)

Uterine septum: Potential complications

Having a uterine septum can wreak havoc on pregnancy plans.

While there are instances of women giving birth with this membranous uterine obstruction, it tends to enhance the chances of frequent miscarriage. Besides, women who have not undergone septum removal tend to experience issues such as:

• Painful menstruation (dysmenorrhea)
• Chronic back pain (in the abdominal region)

Treating uterine septum: Surgical methods

The only treatment to remove a uterine septum is a surgical procedure called hysteroscopic metroplasty. This uterine septum removal surgery happens under local anaesthesia. It is a minimally invasive operation.

Upon successful surgery, the membranous wall gets severed from the uterine wall, unifying the uterine cavity. The severed septum is removed from the uterus.

Uterine metroplasty takes around an hour to perform. Patients undergo surgery on the same day of admission and return home by nightfall, provided the patient has met all post-operative parameters.

What happens after septum removal surgery?

Post-operative care is crucial to ease the pain after uterine septum removal, ensuring gradual healing.

While you can resume usual business within a few days after the operation, it may take a couple of weeks for complete recovery. Your physician may prescribe analgesic medications if you are prone to post-operative trauma.

Besides, your reproductive system must heal, meaning you cannot engage in any sexual intimacy for a month or two to prevent unwanted harm to the operative wound.

Outcomes of septum removal surgery

Women with pre-existing conditions reported the following post-uterine septum removal:

• Reduced cases of dysmenorrhea
• Problems related to abdominal pain from the uterine septum reduced
• Women could conceive naturally
• Fewer cases of miscarriage

Furthermore, there’s a stringent need to take proper care to prevent the following complications:

• Abnormal spotting
• Post-operative infection
• Damage to the uterine wall (seriously hampers implantation)
• Abrasion to the cervical wall (during operation)

Preventing uterine septum: How to keep your reproductive system free from hiccups?

Since a uterine septum is a congenital condition, there are no preventive techniques since the girl child born with it is not responsible for her genes.

However, if your maternal family has a history of uterine septums, it is best to undergo a gynaecological examination after menarche (onset of puberty).

All women planning pregnancy should also consult a gynaecologist. It is the safest way to check that there are no underlying complications that can make your pregnancy risky.

Conclusion

An underlying uterine septum causes more than just physical trauma when you are failing to conceive or are getting frequent miscarriages.

While it is silent enough to be mistaken for just another bout of painful menstruation, getting regular gynaecological check-ups can prevent such traumatic experiences. Besides, most women have reported successful pregnancy after septum removal.

Experiencing painful menstruation lately? Unable to get pregnant? Visit your nearest Birla Fertility and IVF clinic or book an appointment with Dr. Shobhna to receive the best gynaecological advice.

FAQs:

1. Is having a uterine septum a common gynaecological issue?

The presence of a septum in your uterus includes you among 4% of the female population worldwide. However, it accounts for nearly 50% of inheritable uterine issues.

2. Why do my periods get affected because of the uterine septum?

The septum leads to more surface area around the uterine wall, meaning more formation of the endometrium. During menstruation, painful bleeding happens because the uterine wall churns out the excess wall that exists because of the membranous ridge.

3. Can a uterine septum regenerate after surgery?

No. There’s no chance of regeneration of dead tissue (removed uterine septum) after surgery. After the uterine metroplasty, it gets removed from the uterus like the placenta after giving birth.

4. Can I get pregnant after the septum removal surgery?

Most patients undergo uterine septum removal because it is a barrier to conceiving naturally. There are countless cases of successful pregnancy after septum removal, making it a safe technique to neutralise miscarriage chances.