The septate uterus is the result of a failure in the process of resorption of the medial septum that can range from a minimal septum in the uterine fundus to a complete one dividing the uterine cavity completely or even asociating double cervix and vaginal septum. The proposed mechanism by which the uterine septum regresses is apoptosis, the presence of Blc-2 protein protects from apoptosis. The absence of Blc-2 in the embryonal uterine septum may indicate a lack of protection from apoptosis in this area. On the other hand different studies have allowed the identification of several genes that can be implicated in the development of uterine malformations
In an interesting study comparing the use of resectoscope to VersaPoint in 63 women for the treatment of septum (Resectoscope or Versapoint for hysteroscopic metroplasty. Int J Obstet Gynaecol 2008 Apr; 101 (1):39-42) Dr. Litta concludes that the VersaPoint system does not require cervical dilation, avoiding potential cervical incompetence, cervical lacerations and uterine perforation related to the dilation process. The use of VersaPoint is a safe alternative to the use of resectoscope, especially in nulligravid or patients with cervical stenosis.