Hysteroscopic metroplasty

My hysteroscopic metroplasty took place last Thursday.  I must confess that I had some misgivings about my surgeon…  Could he be 100% sure that my fundus is convex based on the sonohysterogram?  What if he accidentally perforated my uterus during the metroplasty?  Without the help of concurrent laparoscopy, would he stop short of the fundal myometrium, necessitating a second surgery to complete the septum resection?   Why didn’t he schedule the surgery during the first half of my menstrual cycle or prescribe a gonadotropin-releasing hormone agonist to thin my endometrial lining prior to the surgery?  Just how many septum resections has he done?

I was hoping that these questions would be answered at my pre-op appointment on Wednesday afternoon.  Unfortunately, I only met with the nurse practitioner at that appointment.  She was able to answer some of my questions, but she was not the surgeon, and she was not present during the sonohysterogram that delineated my unique anatomy.

I suppose I could have quizzed Dr. Clark on his surgical techniques when I saw him before my surgery on Thursday, but it somehow didn’t feel like the best time as I lay on my gurney, dressed in a hospital gown, IV in arm, minutes away from surgery.  At that point, I just wanted my doctor to do the surgery as best he knew how.  I told him as much, and he chuckled.  “My mother used to tell me that, and it always made me laugh.  Of course I’m going to do my best!  Why would I do any less?”

Oddly, the one thing that did reassure me as I waited to go into surgery was when Dr. Clark confused my case with that of another patient.

We’re going to resect the septum and remove two fibroids, right?

I was not aware of any fibroids.

Dr. Clark apologized, explaining that he had read through the cases of 5 patients the previous evening and confused mine with a very similar case.  He was going to operate on the other woman on Friday.  I felt reassured that my case was not particularly unique; septum resections really are old-hat for Dr. Clark.

My memory goes blank as I was being wheeled into the OR at 10:45 a.m.  I hoped that the surgery would be done by noon as promised.  I didn’t want a repeat of my D&C.  (The D&C was supposed to take only a few minutes, but after working for 3 hours and recruiting the help of 2 doctors, my OB gave up.  I had to spend the night alone in the hospital expelling the products of conception with the help of misoprostol.)

I don’t know what time I woke up, but I felt sick and achy.  I rolled to my side and slept some more, unwilling to face the world.

Happily, the metroplasty was done at about noon.  Dr. Clark told Son and Peter that the procedure went as predicted.  I was left with a Foley catheter in my uterus to help minimize scarring.  I knew beforehand that this was a possibility, depending upon how large my septum was.  And since my septum was larger than average, I expected the balloon.

What I didn’t expect was the nausea.  I thought the hysteroscopy would leave me in a state similar to the D&C – forgetful and weak, but not in much pain.  I had no issues with the general anesthesia post-D&C, but this time around, they gave me every antiemetic they could, and I still felt nauseous.  At first, it was difficult to distinguish the nausea from the pain associated with the surgery, but the nausea wore off by 4 p.m., leaving only an achy abdomen.  The way the nurse practitioner had described the surgery on Wednesday, I didn’t think I would need the pain relievers she prescribed, but when I got home, I was glad to have them.

By 6 p.m., I was feeling fairly good; I was just weak from fasting all day long.  Now, 3 days post-op, I’m still slightly achy, and I know better than to take Peter for a long walk in the baby carrier, but 800 mg Ibuprofen is more than sufficient to keep me feeling good.

The Foley catheter is going to be taken out on Wednesday.  I’m afraid it will be like reopening an old wound; I hope my imagination is worse than what it will actually be like.  I’ll have to wait 2 cycles for another sonohysterogram to verify that the resection was complete.  Fingers crossed!

Update:  Feeling good.  Catheter removal was quick and (nearly) painless.

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8 Responses to Hysteroscopic metroplasty

  1. Diana says:

    Thanks for posting. I have the same surgery coming up and have felt so alone. It’s so nice to hear from a women who has had the procedure explain it.

  2. kristinlena says:

    Glad you found the post helpful. Let me know if you have any questions. I finally had follow-up imaging last week, and everything looked good. My once 4-5 cm septum had been reduced to a 0.5-cm ridge.

    Good luck with your surgery!

  3. EH says:

    Hello, thanks for the informative post Can you kindly share the email/contact details for Dr Clark as I think I will be needing the same surgery.

    Thank you!

  4. nikki says:

    Thank you so much for posting this. I had this surgery 3 days ago and was feeling quite “alone.” It’s .comforting to know someone else went through the sane thing.

  5. Bethany Rhoten says:

    I’m not sure if anyone is still reading this thread, but I am waiting for my period to start so that I can schedule the septate uterus repair. I will be so glad to have it over and done with. I had a missed miscarriage in October 8w7d, and never knew I had a septate uterus until I had an ultrasound to check for fetal viability. This is one of the most “alone” experiences I have ever had – I am a big people person, but I just can’t connect with my friends who have gotten pregnant easily within a couple of months of trying. Thanks for sharing your story.

    • Kelli says:

      I am patiently awaiting my cycle to start so I can schedule my hysteroscopic metroplasty to repair my septate uterus. I have had three mc over the past two years and after seeing an infertility specialist, I finally was given hope that I can one day carry a baby if we fix the septum. Did your docs recommend specific days during your cycle that the procedure could be performed? Also, what were your recovery times? My work is not very flexible so I am planning on taking 2-3 days off. However, I will have the foley left in for a week after so I am curios if that causes more discomfort? Thank you all for sharing your stories, and any feedback is greatly appreciated!

      • kristinlena says:

        My surgeon didn’t care what point I was at in my cycle. Some surgeons prefer for you to be at the beginning of your cycle so that your endometrium is thinner and visualization is easier. Since I had hysteroscopy only – no laparoscopy – recovery was quick for me. I only really felt bad the day of the surgery; I probably could have returned to work the next day if it were a desk job. The Foley became slightly uncomfortable for me after a few days, but it was never painful. Sort of like wearing a tampon when you aren’t on your period. Good luck with your surgery!

  6. Kelli says:

    Thank you for your reply, I appreciate your input. I have my surgery scheduled two days from now so I will be relieved to get it over with. Thank you again!

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