Although longitudinal uterus is not a common disease, its incidence is not low, so its impact on women’s reproductive health should be taken seriously, but not all longitudinal uteruses have an impact on reproductive function, and the management of the disease should be individualized and treated on a case-by-case basis, not just hysteroscopy or combined hysteroscopy. First of all, it is important to understand what is going on in a longitudinal uterus. The uterus is initially formed by the fusion of two longitudinal tubes (Mullerian ducts). The lumen of the two ducts fuse to form a large cavity, the uterine cavity, and the walls of the two ducts become the uterine wall, forming a normal uterus. If there is a problem in the fusion of the two offs, a different degree of longitudinal uterus is produced. If the two tubes do not meet together at all, they form two separate cavernous organs, called double uterus, which is not two uteruses but two “half uteruses”; if the lower part of the two tubes are fused and the upper part is not fused, a double-horned uterus is formed; if the walls of the two tubes are not completely fused together, but the two tubes are fused together, the If the walls of the two tubes are not completely fused, but the shape of the two tubes fused together is similar to that of a normal uterus, it is called a completely longitudinal uterus, which means that the uterus is separated into two chambers; if the middle part of the septum is partially fused, it is called an incomplete longitudinal uterus. Of course, the thickness of the mediastinum and the length from top to bottom also vary from person to person, so there are various types of mediastinum, forming various types of longitudinal uterus and some uterine malformations, such as saddle-shaped uterus. It can be diagnosed by ultrasound, hysterosalpingography, CT, MRI, hysteroscopy, etc. Hysterosalpingography and hysteroscopy can reflect the morphology of longitudinal uterus more comprehensively. Because the uterine cavity is not normal anymore, it will have some effect on pregnancy and the growth of the fetus after pregnancy. However, not all women with longitudinal uterus are affected in their reproductive function. In 30% of cases of longitudinal uterus, fertility is not affected at all. The other 20% are basically unable to conceive, due to the combination of uterine dysplasia. 50% of the patients need surgical treatment to conceive and survive the birth of the fetus, of which 60% can be treated laparoscopically or with a combined hysteroscopy, while 40% require a caesarean section. If patients requiring a cesarean section are treated indiscriminately with a hysteroscope, the risk of pregnancy is increased and may even interfere with pregnancy. However, cesarean surgery is a last resort, as it takes a year and a half after surgery to prepare for pregnancy and the risks of early pregnancy are high. Therefore, patients with a longitudinal uterus should choose their treatment according to their specific situation, and not a one-size-fits-all approach. However, it is important to remember to visit a hospital experienced in treating this disease, or to visit several hospitals, because you do not know which one is better, and it is not reasonable to rely only on what the doctor says, or to ask friends of patients who have already been treated, if possible. In short, don’t treat it casually, once the treatment fails, it is very difficult to remedy.