Dr Dimple Doshi

HYSTEROSCOPIC SEPTAL RESECTION

What is HYSTEROSCOPIC SEPTAL RESECTION

Hysteroscopic Septal Resection (surgical removal of the septum) improves the odds of a live birth in women with a septate uterus.

Septate uterus is an important cause of miscarriages and is easily diagnosable by routine ultrasound. Septal resection done by hysteroscopy is a daycare procedure to improve pregnancy outcomes.

ICD-10 Code:

  • ICD-10-PCS Code for Hysteroscopic Septal Resection:
    0UDB7ZZ – This code is used for the resection of the uterine septum through a hysteroscopic approach.

The breakdown:

    • 0: Medical and Surgical Section
    • U: Female Reproductive System
    • D: Resection
    • B: Uterus
    • 7: Via natural or artificial opening, endoscopic
    • Z: No device
    • Z: No qualifier

CPT Code:

  • 58561 – Hysteroscopy, surgical; with removal of leiomyomata or septum.

 

  1. Any woman who is diagnosed to have a septate uterus and is planning pregnancy
  2. History of miscarriage(s)
  1. You will be asked to carry all your investigation reports which include your complete blood count; liver , thyroid; kidney function tests and other preoperative tests, and the x-ray chest.
  2. You will be asked to stop the medications like estrogen-containing medicines a month prior to surgery and also blood thinners like aspirin at least a week prior to surgery.
    At the same time you will be asked to continue your thyroid; blood pressure and diabetes medications.
  3. You will be asked to report any signs of illness in case you have it prior to surgery.
  1. This procedure is done under general anesthesia in the operating room.
  2. Your gynecologist will distend your uterus with normal saline
  3. The whole uterine cavity is visualized; the septum is located and is cut using hysteroscopic scissors. If the septum is too thick;  an electric current may be used.
  • You will be in the recovery room for 2 hrs after you wake up from anesthesia. You may feel sleepy for the next few hours after which you will be shifted to your room.

    You may have some discomfort in the area or you may feel tired for a few days after the procedure but with each passing day, you feel better.

    Contact your doctor immediately if the pain does not go away or if it is associated with nausea and vomiting or any other problems.

You will be asked to start taking clear liquids 2 hrs after the surgery followed by a light diet. You may be asked to walk around after 2 hrs.

Once your doctor is sure that you have recovered well after the procedure; you will be discharged the same done.

Conservative treatment:

If the adnexal mass is small and you have no symptoms, then it may not require treatment at all. However, your gynecologist will monitor you with regular pelvic exams and ultrasounds.

Surgery will be needed if:

  • The mass begins to grow
  • You develop symptoms
  • A cyst develops solid elements or any finding that is suggestive of cancerous nature of the mass.

Q: WHAT IS HYSTEROSCOPIC SEPTAL RESECTION?

A: Some women have a septum or a fibrous band inside the uterine cavity that is responsible for abortions or recurrent miscarriages. This septum can be excised using a Hysteroscope. It is called hysteroscopic septal resection.

Q: HOW LONG DOES UTERINE SEPTUM SURGERY TAKE?

A: Uterine septum surgery using hysteroscopy takes 7 to 8 minutes.

Q: CAN YOU GET PREGNANT WITH THE UTERINE SEPTUM?

A: Yes, it is possible to get pregnant with a uterine septum but the chances of abortion or miscarriage are high.

Q: HOW DO I GET RID OF MY UTERINE SEPTUM?

A: Uterine septum can be treated only by surgical excision. There are no medicines to dissolve that.

Q: WHAT ARE THE CHANCES OF UTERINE SEPTUM RESECTION PREGNANCY?

A: The chances of successful pregnancy till the term are very high after septal resection.

Q: HOW IS THE RECOVERY AFTER UTERINE SEPTUM RESECTION?

A: You can be discharged the same day after septum resection surgery and resume your daily activities from the very next day.

Q: WILL MY SYMPTOMS IMPROVE AFTER HYSTEROSCOPIC SEPTUM RESECTION SURGERY?

A: Usually uterine septum does not cause symptoms but is responsible for abortions and recurrent miscarriages. This will definitely be taken care of by hysteroscopic septum resection surgery.

Q: HOW MUCH IS THE COST OF UTERINE SEPTUM RESECTION?

A: Uterine septum resection surgery cost ranges from 20000 to 60000.