RE: New Here. Please help! Septum surgery didn't work???

July 17, 2004

Ami

My daughter seems to have the same thing. She had an MRI & ultrasound (after 4

M/Cs) which showed bicornuate uterus. She was sent to a specialist who did

surgery, removing a large septum 3/4 down. He said her uterus was very broad

and the septum large. Her dr. did not do an HSG before or after the surgery.

She got pregnant 5 months later and delivered two months early to a placental

abruption. She started trying to have another child 4 years ago and has two more

M/Cs. She just had an HSG done, which the technician says looks bicornuate. The

outside of her uterus is normal & smooth. We don't know if there is still a

septum or if she has some sort of bicornuate uterus as well. We were told that

a bicornuate uterus usually does not cause very early M/C. I do know that

sometimes a second surgery is required, in order to remove the entire septum.

We are waiting for another specialist to review her HSG and make a

recommendation on what to do next. We do not know if she needs a second surgery

or if there is something else causing her M/Cs.

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July 20, 2004

Hi Ami,

Sorry that I am so far behind on posts. I am so very sorry for your

loss. Your post spoke loudly to me...I was in your shoes a few years

back and still remember that horrible feeling when you see the HSG

fill up and look EXACTLY the same as before surgery!

For background, I had a 12 wk m/c in Dec 01 where I found out by u/s

that I had an MA...ob said it was BU w/out further testing. I pushed

for the HSG and she still insisted it was BU. Luckily I found this

group and knew there was just as good a chance it was SU. Found a

surgeon in Chicago that was a specialist in MAs. Lap/hys confirmed I

was SU - it was very broad reaching from tube to tube and about 1/3

the length of the uterus. A month later at my f/u HSG it was EXACTLY

the same. In fact, you can see my before and " after surgery #1 "

HSGs in the Photos folder, see Our Uteri, Sara SU.

I freaked, the big jerk said everything looked fine and wished me

godspeed ttc. He couldn't run out of that room fast enough and

refused to meet w/ dh in the waiting room to explain the HSGs. I

frantically booked 3 appts with other REs in the area. I went to 2

of them and they agreed the big ugly thing was still there - they

offered no explanation of why, but agreed that it should be taken

out. I had a 2nd surgery by a VERY compassionate RE that did an HSG

during surgery to prove that he got it all out. I waited a month

after surgery to ttc and had a chemical pg on the first try, then did

meds/IUI to get pg and on finally got pg w/ dd who was born Oct 03.

We are now expecting #2 in Jan 05.

When you have the time, please use the search function to look for

old posts on SU resection. There is a wealth of info in here. There

are (unfortunately) quite a few that have had a 2nd surgery. For the

reasons others have mentioned (sometimes it is cut, but the cut edges

adhere during healing, sometimes RE did not cut enough out to make a

difference, sometimes the septum is vascular and therefore takes on

more of a BU and is safe for sustaining a pg, etc.)

You are right that a smooth exterior is indictive of SU, but some

women have found when the dr goes in w/ the hys that the septum has

some BU-properties that make it risky to remove entirely - i.e. it is

vascular and muscular like a BU. We affectionately call this

the 'combo platter' here ) But you don't sound like you have this

b/c the dr said the septum just melted away...hmmmm.

> Is this a case of incompetence?

No, I don't think it's incompetence. I think that like all surgeries

it is not an exact science. Sometimes they think they got it all,

but the post op test shows it is still there. It sounds trivial to

you at this point, but later you will realize how fortunate it is

that you had this f/u HSG. Some women have found out the hard way

later after another m/c. I learned to be grateful that at least the

jerk I had did f/u testing...I would not have been so disappointed in

him if he would have immediately followed it up with the necessary

2nd surgery and recognition of the septum that was clearly staring at

us on the HSG.

I hope by now you have spoken to your dr. You must be an anxious

bundle of nerves! I would base my next decision on her reaction to

the situation. If she has experience in resection and recognizes

that the septum is still there and should be removed, I would be

inclined to stay with her. Give her the chance to finish the job, so

to speak. But if she is too egotistical to admit that " maybe " her

work was not perfect, then I would run to another specialist with

copies of my HSGs and medical records in hand.

I'm really sorry you are in this mess right now. It really sucks, I

know. But there are lots of women that will support you through

this. It has been an immensely informative and compassionate group

and I hope that they give you some direction.

Welcome again and let us know what your dr says.

Sara

36, SU resected x2, dd 9 mos, #2 12w4d

July 20, 2004

Sara,

Thank you so much for your response. It does feel so much better to

know that I'm not alone in this. I just never imagined the

possiblity that the surgery might not work, but from what I've seen

here, it looks like that happens much more often than it should!

I'm so sorry that you had such a terrible experience. Awful that

your surgeon wouldn't acknowledge that there even was a problem! My

surgery was performed by my OB ... I have not been able to get her

to call me back since the HSG test on Friday. I think it's time to

get myself and my records to an RE.

I'm also SO encouraged to hear that you've been sucessful since

then! It is nice to know there may really be some hope for me!

I'm worried about the " combo platter " that you mentioned ... if

that's the case, then a resection probably wouldn't be possible,

right? And with the outside of the uterus being all there, then is

the uterus not able to stretch and move that middle section up, like

BU's sometimes do? I don't think that my doc actually cut the

septum at all. I don't know what " melted away " , but I don't think

it was the septum.

I had my lap/hyst done late in my cycle -- cd 24. Could that have

made a difference? My doc said that the timing during the cycle

didn't matter, but I think I've seen others on here who say that it

has to be early in the cycle (I still need to keep reading the back

posts).

Thank you SO much for your response. I really appreciate the help.

I'm starting to feel like maybe it's not totally hopeless afterall.

-Ami.

July 20, 2004

Hi Ami,

I do think having the lap/hyst done on CD24 may have been a problem and maybe

the " melted away " comment was just the endometrial lining? I know for my

lap/hsyt, I had to be on BC pills so my lining wouldn't build up alot. As it

turns out my surgery was on cd6. I think if you need surgery again, I would try

to schedule it early in your cycle. To make sure you are not pregnant as well as

allowing the doc to see clearly the inside of your uterus.

SU

Resected 06/25

ariwash2 wrote: