Hysteroscopy

 

 

Hysteroscopy is a surgical procedure during which the gynecologist uses a small telescopic instrument with lighting (hysteroscope) for diagnosing and treating uterine pathologies. Hysteroscopy is one of the leading methods in the modern endoscopic technology. The hysteroscope with the help of the fiber optic technology sends the image of the cervical channel and the uterine cavity to the monitor which helps the gynecologist to correctly insert the instrument into the uterus.

 

There are two types of the hysteroscopy. The diagnostic hysteroscopy is conducted to examine the uterus and make conclusions on whether the uterus has any pathologies. The diagnostic hysteroscopy allows to detect availability of septum, commissure, polyps and myomas in the uterine cavity and thus to find out the reason of dysfunctional uterine bleeding, infertility and miscarriage. The operative hysteroscopy is conducted for the correction of detected pathologies. During the operative hysteroscopy additional instruments are inserted though the hysteroscope allowing the doctor to conduct different treatment manipulation. The surgical hysteroscopy allows to remove polyps, commissures and cut septum. Endoscopic methods also allow to remove the uterine myomas. The diagnostic and operative hysteroscopy can be conducted simultaneously or as two different procedures depending on the conditions of the specific patient.

 

In difference to the abrasion of the uterine cavity the hysteroscopy allows the gynecologist to visually examine the uterus and detect the reason of the disease.

 

Indication for hysteroscopy

 

Pathologies which can be diagnosed and treated with the hysteroscopy:

 

• Infertility conditioned with commissures at the entrance of the fallopian tubes;
• Dysfunctional uterine bleeding;
• Very painful menstruations;
• Bleeding after the end of the menstruation;
• Irregular or strange menstruations;
• Pathologies of the uterine cavity, including the uterine septum;
• Habitual miscarriage;
• Pain in and around pelvic minor;
• Removal of small submucous myomas or polyps.

 

Hysteroscopy description

 

The diagnostic hysteroscopy can be conducted without any anesthesia, but the medicinal hysteroscopy is conducted with the narcosis. Anesthesiologist examines the patient before the anesthesia and selects the optimal portion of anesthesia for the given patient.

 

During the hysteroscopy no incisions are made. After the gradual dilatation of the cervical channel the hysteroscope is inserted into the uterus through the neck, which is a long and very thin nail equipped with the camera and light.

 

The diagnostic hysteroscope is 3-4 mm in diameter; the operative hysteroscope is broader – 8-10 mm in diameter to enable the insert of appropriate surgical instruments, e.g. small scissors or laser.

 

At the same time CO2 or liquid (saline) may be injected into the uterus to dilate the uterine cavity. This helps the gynecologist to examine the uterus in details.

 

Depending on the type of the procedure the hysteroscopy may last from 5 minutes to more than an hour. However, the diagnostic hysteroscopy takes less time that the operative one.

 

As the surgeon doesn’t see the uterine cavity in details until the moment of the hysteroscope insert, the decision on conducting operative hysteroscopy may be made during the operation.

 

Post-operational period after the hysteroscopy

 

Women usually experience spasms and insignificant bloody discharges during 1-2 days after the hysteroscopy. Your doctor may prescribe anesthetics. The most of patients can start working on the next day after the operation.

 

To minimize the risk of infection or development of inflammatory processes you should avoid using tampons and syringing during 1-2 days. After the diagnostic hysteroscopy patients are recommended to avoid sexual intercourses during the next 1-2 days.

 

Complications of hysteroscopy

 

The hysteroscopy is comparably a safe procedure. Complications, such as cervical channel or uterine traumas, infection, severe bleeding and side effects of anesthesia are observed in 1% of cases.

 

Although complications after the hysteroscopy are observed rarely, the patient should immediately contact her doctor, if she has started experiencing abundant bleeding or if there are signs of infection, such as painful spasms, high temperature or shiver.

 

As was mentioned above the hysteroscopy is a surgical operation without any incisions. Independent of the type of the hysteroscopy you can be sure that this operation is not dangerous.

 

It’s important to remember that each patient is individual and indications for the hysteroscopy, as well as the results depend on the conditions of the patient. If you have any additional questions regarding the hysteroscopy you can discuss them during the reception by the endoscopist.