{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T03:33:27Z","timestamp":1791862407003,"version":"4.3.4"},"reference-count":21,"publisher":"Galenos Yayinevi","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Facts Views Vis ObGyn"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:p>Background: A complete uterine septum, double cervix and vaginal septum is a complex and rare congenital genital tract anomaly. The diagnosis is often challenging and based on the combination of different diagnostic techniques and multiple treatment steps.\n\nObjective: To propose a combined one-stop diagnosis and an ultrasound-guided endoscopic treatment of complete uterine septum, double cervix, and longitudinal vaginal septum anomaly.\n\nMaterials and Methods: Stepwise demonstration with narrated video footage of an integrated approach management of a complete uterine septum, double cervix and vaginal longitudinal septum treated by expert operators combining minimally invasive hysteroscopy and ultrasound. The patient was 30 years old and was referred to our clinic because of dyspareunia, infertility and the suspicion of a genital malformation.\n\nResults: A one-stop complete evaluation of uterine cavity, external profile, cervix, and vagina was made through 2D, and 3D ultrasound combined with hysteroscopic assessment and a U2bC2V1 malformation (according to ESHRE\/ESGE classification) was diagnosed. The procedure consisted in a totally endoscopic removal of the vaginal longitudinal septum and the complete uterine septum, starting the uterine septum incision from the isthmic level, and sparing the two cervices, under transabdominal ultrasound guidance. The ambulatory procedure was performed in the Digital Hysteroscopic Clinic (DHC) CLASS Hysteroscopy in Fondazione Policlinico Gemelli IRCCS of Rome - Italy, under general anaesthesia (laryngeal mask).\n\nMain outcomes: Surgical time of procedure was 37 minutes; no complications occurred; patient was discharged three hours after the procedure; the hysteroscopic office control after 40 days showed a normal vagina and a normal uterine cavity with two normal cervices.\n\nConclusion: An integrated ultrasound and hysteroscopic approach allows an accurate one-stop diagnosis and a totally endoscopic treatment option for complex congenital malformations using an ambulatory model of care with optimal surgical results.<\/jats:p>","DOI":"10.52054\/fvvo.15.2.077","type":"journal-article","created":{"date-parts":[[2023,7,9]],"date-time":"2023-07-09T13:16:28Z","timestamp":1688908588000},"page":"167-170","source":"Crossref","is-referenced-by-count":15,"title":["Complete uterine septum, double cervix, and longitudinal vaginal septum: an integrated approach for one-stop diagnosis and ultrasound-guided endoscopic treatment"],"prefix":"10.52054","volume":"15","author":[{"given":"F","family":"Pozzati","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Mirandola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Topozouva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Parodi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Carla Testa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Scambia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U","family":"Catena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2811","published-online":{"date-parts":[[2023,6]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Bajka M, Badir S. Fundus thickness assessment by 3D transvaginal ultrasound allows metrics-based diagnosis and treatment of congenital uterine anomalies. Ultraschall Med. 2017;38:183-9.","DOI":"10.1055\/s-0034-1399701"},{"key":"ref1","unstructured":"Campo R, Santangelo F, Gordts S et al. Outpatient hysteroscopy. Facts Views Vis Obgyn. 2018;10:115-22."},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Carugno J, Grimbizis G, Franchini M et al. International Consensus Statement for recommended terminology describing hysteroscopic procedures. Facts Views Vis Obgyn. 2021;13:287-94.","DOI":"10.52054\/fvvo.13.4.037"},{"key":"ref3","unstructured":"Catena U. Surgical treatment of the septate uterus. Hysteroscopy Newsletter. 2022;8:2:15-9."},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Di Spiezio Sardo A, Manzi A, Zizolfi B et al. The step-by-step hysteroscopic treatment of patients with vaginal and complete uterine septum with double cervix (U2bC2V1). Fertil Steril. 2021;116:602\u20134.","DOI":"10.1016\/j.fertnstert.2021.04.011"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Di Spiezio Sardo A, Zizolfi B, Bettocchi S et al. Accuracy of hysteroscopic metroplasty with the combination of presurgical 3-dimensional ultrasonography and a novel graduated intrauterine palpator: a randomized controlled trial. J Minim Invasive Gynecol. 2016;23:557-66.","DOI":"10.1016\/j.jmig.2016.01.020"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Fascilla FD, Resta L, Cannone R et al. Resectoscopic metroplasty with uterine septum excision: a histologic analysis of the uterine septum. J Minim Invasive Gynecol. 2020;27:1287-94.","DOI":"10.1016\/j.jmig.2019.11.019"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Grimbizis GF, Gordts S, Di Spiezio Sardo A et al. The ESHRE\/ESGE consensus on the classification of female genital tract congenital anomalies. Hum Reprod. 2013;28:2032\u201344.","DOI":"10.1093\/humrep\/det098"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Grynberg M, Gervaise A, Faivre E et al. Treatment of twenty-two patients with complete uterine and vaginal septum. J Minim Invasive Gynecol. 2012;19:34-9.","DOI":"10.1016\/j.jmig.2011.08.726"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Ignatov A, Costa SD, Kleinstein J. Reproductive Outcome of Women with Rare M\u00fcllerian Anomaly: Report of 2 Cases. J Minim Invasive Gynecol. 2008;15:502\u20134.","DOI":"10.1016\/j.jmig.2008.04.003"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Lin K, Zhu X, Xu H et al. Reproductive outcome following resectoscope metroplasty in women having a complete uterine septum with double cervix and vagina. Int J Gynecol Obstet. 2009;105:25\u20138.","DOI":"10.1016\/j.ijgo.2008.11.018"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Louden ED, Awonuga AO, Gago LA et al. Rare M\u00fcllerian Anomaly: Complete Septate Uterus with Simultaneous Longitudinal and Transverse Vaginal Septa. J Pediatr Adolesc Gynecol. 2015;28:e189-91.","DOI":"10.1016\/j.jpag.2015.04.012"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Ludwin A, Ludwin I, Pity\u0144ski K et al. Differentiating between a double cervix or cervical duplication and a complete septate uterus with longitudinal vaginal septum. Taiwan J Obstet Gynecol. 2013;52:308-10.","DOI":"10.1016\/j.tjog.2013.04.034"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Noventa M, Spagnol G, Marchetti M et al. Uterine Septum with or without Hysteroscopic Metroplasty: Impact on Fertility and Obstetrical Outcomes-A Systematic Review and Meta-Analysis of Observational Research. J Clin Med. 2022;11:3290.","DOI":"10.3390\/jcm11123290"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Parodi L, Hoxhaj I, Dinoi G, et al. Complete uterine septum, double cervix and vaginal septum (U2b C2 V1): hysteroscopic management and fertility outcomes-A systematic literature review. J Clin Med. 2022;12:189.","DOI":"10.3390\/jcm12010189"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Parsanezhad ME, Alborzi S, Zarei A et al. Hysteroscopic metroplasty of the complete uterine septum, duplicate cervix, and vaginal septum. Fertil Steril. 2006;85:1473-7.","DOI":"10.1016\/j.fertnstert.2005.10.044"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Rikken JFW, Kowalik CR, Emanuel MH et al. Septum resection versus expectant management in women with a septate uterus: an international multicentre open-label randomized controlled trial. Hum Reprod. 2021;36:1260\u20137.","DOI":"10.1093\/humrep\/deab037"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Seet MJ, Lau MSK, Chan JKY et al. Management of complete vagino-uterine septum in patients seeking fertility: Report of two cases and review of literature. Gynecol Minim Invasive Ther. 2015;4:140\u20135.","DOI":"10.1016\/j.gmit.2015.06.002"},{"key":"ref18","unstructured":"Sejelfot EB, Nytun OE, Kjotrod SB et al. A septate uterus with double cervix during two pregnancies: pregnancy outcome before and after cervix sparing metroplasty. A case report. Fact Views Vis ObGyn. 2020;12:149-52."},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Toma\u017eevi\u010d T, Ban-Frange\u017e H, Virant-Klun I et al. Septate, subseptate and arcuate uterus decrease pregnancy and live birth rates in IVF\/ICSI. Reprod Biomed Online. 2010;21:700\u20135.","DOI":"10.1016\/j.rbmo.2010.06.028"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Wang JH, XU KH, Lin J et al. Hysteroscopic septum resection of complete septate uterus with cervical duplication, sparing the double cervix in patients with recurrent spontaneous abortions or infertility. Fertil Steril. 2009;91:2643\u20139.","DOI":"10.1016\/j.fertnstert.2008.04.009"}],"container-title":["Facts, Views and Vision in ObGyn"],"original-title":[],"language":"en","deposited":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T05:55:51Z","timestamp":1739512551000},"score":1,"resource":{"primary":{"URL":"https:\/\/fvvo.eu\/articles\/doi\/FVVO.15.2.077"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6]]},"references-count":21,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,6]]},"published-print":{"date-parts":[[2023,6]]}},"URL":"https:\/\/doi.org\/10.52054\/fvvo.15.2.077","relation":{},"ISSN":["2684-4230","2032-0418"],"issn-type":[{"value":"2684-4230","type":"electronic"},{"value":"2032-0418","type":"print"}],"subject":[],"published":{"date-parts":[[2023,6]]}}}