Histologic architecture and vascularization of hysteroscopically excised intrauterine septa

Study Objective. To investigate histologic structures of intrauterine septa resected hysteroscopically. Design. Prospective, consecutive study (Canadian Task Force classification II-2). Setting. University-affiliate hospital. Patients. Seventy-six women evaluated for uterine septa and infertility. Interventions. All patients with diagnosis of uterine septum detected by tr ansvaginal color Doppler (TVCD) underwent operative hysteroscopy in which t he most prominent part of the septum was encircled with a hysteroscopic loo p electrode and removed. Specimens were sent for histopathologic evaluation . The rest of the septum was divided by monopolar needle electrode until th e uterine cavity assumed a globular shape. Measurements and Main Results. In 63 women (82.8%) preoperative TVCD reveal ed septal vascularity typical for radial arteries with mean resistance flow of 0.64 +/- 0.06, and enlarged sunusoidal and capillary spaces. Histopatho logic results revealed fibromuscular tissue with moderately more connective tissue in 55 cases (72.3%) and myometrial tissue in 27 (27.6%). There was no statistically significant difference (p >0.05) in frequency of septa bet ween patients with primary and secondary infertility. Conclusion. Intrauterine septa consisted of the same type of tissue as norm al myometrium, with many muscular fibers. We suspect that muscular tissue w ithin the uterine septum is a potential cause of irregular contractility an d consequently increased abortion rate in these patients.