New approach for T-shaped uterus: Metroplasty with resection of lateral fibromuscular tissue using a 15 Fr miniresectoscope. A step-by-step technique

• Published in: Facts, views & vision in ObGyn Vol. 13; no. 1; pp. 67 - 71
• Main Authors: Catena, U, Campo, R, Bolomini, G, Moruzzi, M C, Verdecchia, V, Nardelli, F, Romito, I, Camolo, F, La Manna, V, Ianieri, M M, Scambia, G, Testa, A C
• Format: Journal Article
• Language: English
• Published: Wetteren, Belgium Universa Press 31.03.2021
• Subjects: Video
• ISSN: 2032-0418; 2684-4230
• DOI: 10.52054/FVVO.13.1.003

T-shaped uterus is a congenital uterine malformation (CUM), only recently defined by the ESGE ESHRE classification as Class U1a. The uterus is characterised by a narrow uterine cavity due to thickened lateral walls with a correlation 2/3 uterine corpus and 1/3 cervix. Although the significance of this dysmorphic malformation on reproductive performance has been questioned, recent studies reported significant improvement of life birth rates after surgical correction in patients with failed in-vitro fertilisation (IVF) or recurrent miscarriage. The classical surgical technique to treat a T-shaped uterus is by performing a sidewall incision with the micro scissor or bipolar needle, resulting in a triangular cavity. In this video article, we describe a new surgical technique with a step-by-step method combining three- dimensional ultrasound (3D-US) and hysteroscopic metroplasty in an office setting, using a 15 Fr office resectoscope (Karl Storz, Tuttlingen, Germany), to treat a T-shaped uterus by resecting the lateral fibromuscular tissue of the uterine walls. No complications occurred and the postoperative hysteroscopy showed a triangular and symmetrical uterine cavity without any adhesions.