Extended resectoscopic versus sequential cold knife-resectoscopic excision of the unclassified complete uterocervicovaginal septum: a randomized trial

Abstract

Objective: To determine if resectoscopic sectioning of complete uterocervicovaginal septum is as effective as cold knife excision of the vaginal part followed by resectoscopic cutting of the cervicouterine part in symptomatic patients.

Design: Randomized controlled clinical trial.

Setting: University hospital.

Patient(s): Thirty-two women with a diagnosis of complete uterocervicovaginal septum who had a history of pregnancy wastage or infertility. They were randomized into two groups: Group A underwent resectoscopic excision of the complete septum starting from the vaginal interoitus; group B underwent cold knife excision of the vaginal part followed by resectoscopic excision of the cervical and uterine parts.

Intervention(s): Hysteroscopic metroplasty alone or preceded by cold knife excision of the vaginal part.

Main outcome measure(s): Operating time, perioperative bleeding, complications, reproductive outcome, and patient and husband satisfaction.

Result(s): Patients in group A showed significantly less operative time and scar-related dyspareunia. There were no significant differences in the reproductive outcome in the two groups.

Conclusion(s): Resection of the vaginal part of symptomatizing complete vaginocervicouterine septum using resectoscopic metroplasty makes the procedure faster with less possibility of scar-related dyspareunia than cold knife excision.