: BU/SU (pg & baby ment)

[Guest guest]

<<From talking with others and reading your post, I'm beginning to think I

may be BU/SU. Does this mean you have a heart shape uterus and a septum?>>

Hi . My uterus looks mostly normal and is not dented deeply enough

on the outside to look really heart shaped . . . just a little, which is not

inconsistent with a septate uterus, either. The thing that makes my RE and

OB call it partially BU is that the top part of the septum is made of

muscle, meaning that my uterus did not fuse together quite right. From an

embryological perspective, an SU fuses together okay, but the septum fails

to dissolve. In a BU, the uterus fails to fuse together thoroughly, but

there is usually no fibrous septum in there that failed to dissolve.

Uterine development takes place in 3 stages: first the müllerian ducts

*descend*, then they *fuse*, then the middle wall *dissolves* away.

<<Can you have a BU and a septum or is the septum only seen with an SU? I'm

confused. >>

I think a BU and septum is possible, but less common. With the three stages

of uterine development, anyting can go wrong at any point, giving an

infinite variety of anomalies, which we try to categorize rather rigidly.

But I believe we get combinations, which is why women like and

have a total SU with two cervices (failure to dissolve and fuse) and

others can have a BU but with a rudimentary horn (fusion and partial descent

failure). Just a little bit differently and the BU with rudimentary horn

would have been a UU (total descent failure). Sometimes we get stuck with

subtle classifications that defy the usual categories.

<< The reason I ask is because after my 1st m/c (I've had 3 to date), they

did a lap/hys and removed what they could of a septum. I had an MRI after

the 2nd m/c and it showed a BU.>>

Well, assuming that they are not misusing the term BU (which sometimes is

used as a blanket term for BU and SU), you'll probably do fine with a BU

remainder. I sure did.

<<Also, when you say you resected x 2, does this mean they went in and

removed the septum or did that metroplasty surgery where they make two wedge

shape incisions and unify the uterus?>>

The former, a.k.a " hysteroscopic metroplasty. " Metroplasty does not solely

mean the abdominal sort that you describe.

I used to refer to it as septoplasty but then it gets confused with surgery

to repair the septum in a nose.

For my first surgery they went in and looked with a laparaoscope and a

hysteroscope, then resected with hand scissors, because he couldn't get

started on the septum with the scope's scissor. He said it came down too

far. (But most competent surgeons *can* handle this). With the hand

scissors he resected the middle segment of the septum, perforated the fundus

and left the lowest segment of the septum intact above my cervix. (Yes I am

still mad about this poor judgment, but since I have my baby I am trying to

mellow out about it).

I then went back and he resected the remaining fibrous septum at the top of

my uterus, leaving the muscular part intact. He looked for but did not see

the septum left in the lower segment of the uterus.

So I guess my resections are not the most orthodox of surgeries. The first

removal of a septum was done in the 1880s with hand scissors, just like mine

.. . . but I am the only one I know of today who had it done that way!

Hope you have a smooth pregnancy, and soon, now that your septum is gone.

Be sure to ask them why they think your ute is BU (if you haven't already).

--

Beth

SU/BU, resected x 2