Hysteroscopy of the uterus
Are there suspected uterine fibroids or adenomyosis? The doctor does not exclude the possibility of endometrial polyps’ presence? Have you experienced multiple miscarriages? Do you want to influence the effectiveness of the IVF program?
All these problems can be solved with the help of hysteroscopy - a procedure that allows not only to study in detail the state of the uterine cavity, but also to immediately fix the detected disorders.
What is hysteroscopy?
Hysteroscopy is a procedure with a minimal invasion (that is, providing the least possible intervention into the body due to the absence of incisions), the purpose of which is a detailed study of the uterine cavity, as well as the treatment of discovered pathologies.
For the surgery, doctors use a hysteroscope - an endoscopic device equipped with a high-resolution optical system and a wide angle.
The hysteroscope is inserted through the patient's cervical canal and allows the doctor to examine the uterine cavity in great detail, as well as assess the state of its mucous membrane. A significantly enlarged image is displayed on the monitor screen.
Thus, hysteroscopy is a highly informative procedure that allows you to detect even the smallest pathologies of the uterine cavity and, if necessary, fix them immediately.
Types of hysteroscopy
Diagnostic hysteroscopy is usually performed to identify the causes of IVF failure and miscarriage. In addition, the procedure can be prescribed to monitor the effectiveness of hormone therapy.
The main advantages of office hysteroscopy in our reproduction center:
- no pain, since the use of the latest flexible small diameter hysteroscopes does not require the dilation of the cervical canal;
- absence of various complications associated with the use of anesthesia;
- the duration of the procedure is no more than half an hour;
- detailed examination of the uterine cavity and the possibility of targeted biopsy of the mucous membrane due to the high-quality optical system;
- a woman can observe the progress of the procedure on the screen and receive the necessary comments from the doctor.
This operation gives the doctor the opportunity not only to detect disorders and assess the extent of pathological processes, but also to treat them. For example, it is possible to remove endometrial polyps and dissect the intrauterine septa.
Indications for hysteroscopy
The surgery can be recommended for patients in a number of cases, including:
- irregular menstrual cycle;
- spotting from the genital tract after menopause;
- suspected anomalies in the development of the uterus;
- suspected pathologies such as internal endometriosis of the uterus (adenomyosis), submucous myoma, diffuse or focal hyperplasia of the endometrium, adhesions, perforation of the walls of the uterus during surgery, malignant tumors of the cervix or endometrium;
- infertility treatment by in vitro fertilization (at the preparation stage);
- there are several miscarriages in history;
- control over the state of the organ after surgery and hormonal therapy;
- the presence of a foreign body in the uterine cavity.
Thus, this operation can be prescribed in order to diagnose and monitor the effectiveness of previous treatment, and to correct various congenital or acquired intrauterine pathologies.
Separate diagnostic curettage is not always a complete curettage. This is the taking of any scraping, even a small one with the smallest curette.
It is important to keep in mind that in some cases the procedure is contraindicated. Among the restrictions are:
- inflammatory diseases of the genital organs (vaginitis, cervicitis, endometritis, colpitis, etc.);
- any acute infectious diseases (tonsillitis, flu, thrombophlebitis, etc.);
- exacerbation of chronic diseases;
- period of menstruation;
- dysfunctional uterine bleeding;
- widespread malignant process in the cervix;
- pathological narrowing (stenosis) of the cervix;
- III or IV degree of vaginal cleanliness based on smear results;
- serious condition of the patient due to pathologies of the cardiovascular system or parenchymal organs (kidneys or liver).
Contraindications for hysteroscopy can be absolute or relative. The absolute contraindications to the operation include pregnancy, since the procedure can provoke a miscarriage. But menstruation is a relative contraindication due to the fact that the presence of blood in the uterine cavity reduces the information content of the operation, but does not entail severe consequences.
Tests and research
For patient safety, tests before diagnostic hysteroscopy are mandatory.
Although hysteroscopy is a minimally invasive procedure, it requires careful preparation. In particular, the specialist will necessarily prescribe the following studies that will assess the woman's health status:
- a blood test to determine the blood group and Rh factor (has no expiration date);
- clinical blood test (valid for 15 days);
- biochemical blood test (valid for 15 days);
- blood test to detect syphilis (valid for 1 month);
- blood test to detect HIV, hepatitis B and C (valid for 2 months);
- coagulogram (valid for 15 days);
- general urine analysis (valid for 15 days);
- smear to determine the degree of cleanliness of the vagina (valid for 10 days);
- cytological examination from the surface of the cervix and cervical canal (valid for six months);
- ultrasound of the pelvic organs (valid for 1 month);
- resting ECG (valid for 2 weeks);
- chest x-ray (valid for 1 year);
- conclusion of the therapist on the absence of surgery contraindications (it is possible to visit the therapist at "Nova Clinic", the certificate is valid for 2 weeks).
Please pay attention that only original documents are accepted at Nova Clinic!
Preparation for hysteroscopy
Before the procedure, there is no special preparation required. The surgery is performed on an empty stomach (at least 6 hours after the last meal and water).
As a rule, hysteroscopy can be done on an outpatient basis; hospitalization is not required.
Usually the procedure is carried out on the 5-10th day of the cycle, since during this period the thickness of the endometrium and the state of the uterine cavity are optimal.
If the indication is a suspected mucosal hyperplasia or fibroids, the study can be conducted on any day of the cycle.
In case if there is an adhesions in the uterine cavity, the surgery is performed approximately on the 20-24th day of the cycle (in the middle of the luteal phase).
Thus, the indications determine the optimal interval of the menstrual cycle for the procedure.
You can do hysteroscopy:
- without anesthesia (office hysteroscopy using a flexible hysteroscope);
- with local anesthesia, when the doctor is numbing the cervix;
- under general anesthesia (operative hysteroscopy).
First of all, the doctor checks the patency of the cervical canal of the cervix, its direction and the length of the uterine cavity, and then inserts a hysteroscope.
Saline is infused into the uterine cavity, due to which the walls move apart, contributing to good visualization.
The doctor carefully examines the state of the cervical canal and uterine cavity (walls, tubal corners, orifices of the fallopian tubes).
It is necessary to carefully assess the condition of the mucous membrane: its thickness, relief, color, vascular pattern and other significant characteristics.
If a pathology is detected during the procedure, it can be repaired:
- by scraping the uterine cavity;
- using special tools. In particular, they are used to remove large polyps of the endometrium and myomatous nodes, coagulatuion of the active foci of adenomyosis, dissect adhesions and intrauterine septa.
During the diagnosis, if there are no visible changes, an endometrial biopsy is performed.
A histological examination of a tissue allows to accurately diagnose pathology and develop optimal treatment tactics.
The duration of the procedure can vary from 5 to 40 minutes.
Recommendations after surgery
For some time after the procedure (2-5 days), women may experience bloody discharge. In addition, minor cramps in the lower abdomen (like during menstruation) are possible.
After the procedure, the doctor may recommend taking antibiotics and painkillers for 5-7 days.
To minimize the possibility of inflammation and infection, tampons should not be used after hysteroscopy (both operative and office).
Women should give up intimate contact:
- for 2 days after diagnostic hysteroscopy;
- for 2 weeks after surgical hysteroscopy.
Only the attending physician, who takes into account the scope of the intervention, the individual characteristics of each patient and other parameters, can give more detailed recommendations.
Strict compliance with all the doctor's prescriptions will let you to recover as quickly as possible and avoid the development of any complications. For more detailed information about hysteroscopy costs, the prices of tests, to make an appointment and do an operative or office hysteroscopy in Moscow, please use the contact form on the website.