Ultrasound-guided unification of noncommunicating uterine cavities

Abstract

Background: The benefits of ultrasound-guided hysteroscopic metroplasty have been well described in the management of the partial septate uterus. The use of ultrasonography at the time of hysteroscopy provides visualization of the intrauterine instruments within the uterine cavity. This report describes a case where ultrasound-guidance was used to enter a noncommunicating uterine cavity hysteroscopically.

Methods: A 22-year-old female after her third miscarriage experienced worsening dysmenorrhea. The patient underwent a laparoscopy and hysteroscopy to further evaluate the cause of pelvic pain and to treat the Müllerian anomaly. Under ultrasound-guidance, the 2 uterine cavities were unified by hysteroscopic metroplasty.

Results: Postoperative sonohysterography demonstrated unification of the 2 cavities.

Conclusions: This unique application of ultrasound-guidance in hysteroscopic surgery may aid the surgeon in entering a noncommunicating uterine cavity.

Figure 1.

Preoperative sonohysterographic image of the 2 uterine cavities.

Figure 2.

Hysteroscopic view at resection of the uterine septum. The image was taken immediately after the ipsilateral uterine cavity was entered in the lower uterine segment. The septum is identified in the midline.