Leiomyoma on the septum of a septate uterus with double cervix and vaginal septum: a challenge to manage Eray Caliskan, M.D., Yiğit Cakiroglu, M.D.,

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Leiomyoma on the septum of a septate uterus with double cervix and vaginal septum: a challenge to manage Eray Caliskan, M.D., Yiğit Cakiroglu, M.D., Erkan Turkoz, M.D., Aydin Corakci, M.D. Fertility and Sterility Volume 89, Issue 2, Pages 456.e3-456.e7 (February 2008) DOI: 10.1016/j.fertnstert.2007.03.045 Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions

Figure 1 Hysterosalpingography of the case showing two endometrial cavities (thick arrows) and superimposed double cervices (thin arrows). Fertility and Sterility 2008 89, 456.e3-456.e7DOI: (10.1016/j.fertnstert.2007.03.045) Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions

Figure 2 Magnetic resonance imaging of the uterus. Right cavity (thick horizontal arrow), left cavity (thin horizontal arrow), and leiomyoma of the septum (thin vertical arrow). Fertility and Sterility 2008 89, 456.e3-456.e7DOI: (10.1016/j.fertnstert.2007.03.045) Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions

Figure 3 Real-time three-dimensional ultrasound image of the case after myomectomy and vaginal septum resection. Thick arrows show the cavities and the two cervices; thin arrow shows the uterine septum and the fundus. Fertility and Sterility 2008 89, 456.e3-456.e7DOI: (10.1016/j.fertnstert.2007.03.045) Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions

Figure 4 Illustration of the second operation. Horizontal view shows the wedge resection and unification of the cervices (shaded area). Coronal view shows the resection of the remaining septum, which was performed with fine scissors up to the level of cervical isthmus. Fertility and Sterility 2008 89, 456.e3-456.e7DOI: (10.1016/j.fertnstert.2007.03.045) Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions

Figure 5 Transvaginal view of the cervix at the 26th week of gestation; the cervix was measured at this time to be 35 mm. Fertility and Sterility 2008 89, 456.e3-456.e7DOI: (10.1016/j.fertnstert.2007.03.045) Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions