Abstract
Video Objective Demonstrate innovative approach of hysteroscopically-guided myomectomy in a woman with a septate uterus. Setting 49 y/o with abnormal uterine bleeding secondary to a submucosal fibroid and presumed uterine didelphys who was found to have a partial septate uterus and duplicated cervix. Interventions Diagnostic hysteroscopy, dilation and curettage, with hysteroscopically-guided myomectomy under direct visualization by the hysteroscope by inserting the hysteroscope into one cervix while preforming instrumentation of the fibroid through the other cervix. Conclusion Uterine anomalies may be challenging to characterize based on exam or ultrasound alone. Surgical management of gynecological pathology, such as fibroids, requires understanding of normal and anomalous anatomic landmarks and innovative application of common instrumentation. This patient's unique anatomy allowed intrauterine instrumentation normally preformed blindly to be directly visualized by hysteroscopy. This allowed safe and effective treatment in a technically challenging case.
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