Hysteroscopy is surgical. Hysteroscopy technique

When examining the uterine cavity, a special device is often used - a hysteroscope. This process is called hysteroscopy. This device can be described as endoscopic, i.e. with its help you can look inside an organ that has some kind of cavity.

Also endoscopic devices are, for example, a gastroscope, a sigmoidoscope. All these devices have one feature, namely, that when working with them, you do not need to make any cuts, you can examine the inner surface of the organ through the natural openings in the human body. Hysteroscopy, for example, is performed through the vagina and cervical canal.

Why is a hysteroscopy necessary?

A gynecological smear must be good, because the presence of any inflammatory process in the vagina or cervix can cause inflammation in the uterine cavity or fallopian tubes after the procedure is performed. Other additional tests may be required depending on the indications.

Hysteroscopy is performed on certain days menstrual cycle. Usually this is from the fifth to the tenth day from the onset of menstruation. True, each specific case has options.

Types of hysteroscopy

There are several types of hysteroscopy. Standard hysteroscopy is performed in a one-day hospital under short-term intravenous anesthesia. And office hysteroscopy is performed without anesthesia right at the outpatient appointment.

Hysteroscopy is divided into diagnostic and therapeutic-diagnostic. During diagnostic hysteroscopy, the uterine cavity is examined and, if necessary, a biopsy is taken. And then, upon receipt of all the examination data, a diagnosis is made.

To diagnostic hysteroscopy, you can add diagnostic curettage of the uterine cavity, as well as the cervical canal, if there are polyps or endometrial hyperplasia, suspicion of cancer, bleeding.

Therapeutic and diagnostic hysteroscopy is also called resectoscopy. It is carried out not only for the purpose of clarifying the diagnosis, but also for surgical treatment identified diseases. Excision of large polyps, submucosal myomatous nodes is carried out, adhesions in the uterine cavity and intrauterine septa are removed, endometriosis foci are coagulated.

The hysteroresectoscope can also be used for endometrial ablation - removal of the endometrium in the presence of precancerous diseases of the uterine cavity. Hysteroscopy is contraindicated in acute infectious diseases, in a serious condition of the patient due to diseases of the heart, blood vessels, as well as inflammatory changes in the smear on the flora.

All materials on the site are prepared by specialists in the field of surgery, anatomy and specialized disciplines.
All recommendations are indicative and are not applicable without consulting the attending physician.

Hysteroscopy is one of modern methods diagnosis and treatment, successfully used in gynecology since the end of the last century. For the first time, hysteroscopic intervention was carried out back in the 19th century, but the technical capabilities only made it possible to penetrate into the uterine cavity, while examination with magnification, the introduction of a light guide and a video camera, and, moreover, medical manipulations were impossible due to the lack of the necessary endoscopic equipment. The doctor could only rely on the data obtained when examining the endometrium through the lens system with his own eye.

Today, specialists have high-precision equipment, optical systems, video cameras, instruments for microsurgical manipulations in their arsenal. Endometrial hysteroscopy is actively replacing invasive procedures and curettage of the uterus - traumatic and dangerous interventions, which, however, are still performed, especially in countries with insufficient medical care.

Endoscopic procedures require the availability of appropriate equipment, which costs a lot of money, as well as trained and qualified personnel. Not every hospital, even of an average level, can fulfill these conditions, but in the outback one can only dream of it.

hysteroscopy

Economic conditions prevent the widespread introduction of hysteroscopy into the practice of ordinary obstetrician-gynecologists, but the technique is already available to a wide range of patients, especially in large medical institutions. This is one of the most frequent endoscopic examinations in gynecology.

Through hysteroscopy, it is possible to examine the uterine cavity from the inside, diagnose a variety of pathological processes and treat them. In the latter case, the procedure from the category of diagnostic becomes therapeutic. Endoscopic manipulations are highly accurate, but do not require open surgery, which reduces the likelihood of adverse effects to a minimum, making such diagnostics and treatment very attractive.

With hysteroscopic intervention, the diagnosis of hyperplastic processes in the endometrium, tumors of the uterus, developmental anomalies occurs, the causes of infertility are established, pathological formations and foreign bodies are removed. A targeted biopsy is another undoubted advantage of the procedure, because the doctor can take exactly that part of the mucous membrane or pathological focus that causes the greatest concern.

Indications and contraindications for intervention

Hysteroscopy of the uterus is indicated for a variety of pathologies:

Hyperplastic changes in the endometrium (diffuse hyperplasia, polyposis); endometriosis of the internal genital organs;
Defects and anomalies on the part of the uterus and tubes, intrauterine adhesions, septa;
In obstetrics - suspicion of the remains of embryonic fragments, chorion, placenta after an undeveloped pregnancy, medical abortion, miscarriage, inflammation after childbirth, caesarean section;
Submucosal myoma nodes;
Determination of the position of the intrauterine device and the exclusion of perforation of the uterus;
Infertility and disorders monthly cycle, unsuccessful attempts at in vitro fertilization;
Suspicion of malignancy;
With postmenopausal bleeding (absolute indication);
Control revision of the uterus after surgical or hormonal treatment.

Office hysteroscopy is performed on an outpatient basis, and a medical operation becomes when, during its implementation, the doctor removes submucous myoma, endometrial polyp, septum or adhesions, foci of endometrial hyperplasia. Manipulation is accompanied by resection of pathologically altered formations and is called hysteroresectoscopy.

Reproductologists often resort to hysteroscopy before IVF for accurate diagnosis of the causes of infertility and gentle treatment of the detected pathology. Endoscopy involves a careful attitude to the walls of the uterus, so the risk of subsequent adhesions and chronic inflammation extremely small, which is very important for women planning to become pregnant soon.

There are also obstacles to hysteroscopy of the uterus. These include:

Endoscopy in gynecology has a number of advantages over "blind" curettage and invasive interventions:

Low trauma and minimal complication rate;
Diagnostic accuracy reaching 100%;
Possibility of outpatient treatment, in the hospital - the duration of stay is a maximum of two days;
Short rehabilitation period, quick and painless recovery after manipulation;
The possibility of taking a targeted biopsy, visual control and magnifying optics of all manipulations, the possibility of treating the pathology immediately after its endoscopic diagnosis.

Preparation for the procedure

Preparation for hysteroscopy includes a number of standard studies that can be done at your clinic before the planned procedure:

General and biochemical analyzes blood, urine, coagulation test, - no longer than two weeks before the scheduled date of the operation;
Test for syphilis, HIV, hepatitis, determination of blood type, Rh-affiliation;
Smear on the flora from the genital tract, oncocytology;
ECG (valid for no more than a month);
Ultrasound of the pelvic organs, colposcopy;
Fluorography or an overview of the lungs;
Therapist's consultation.

The specified list of examinations is mandatory before hysteroscopy. Based on the data received, the therapist gives his consent to the intervention, which will be considered safe for the patient.

If you are taking any drugs, you should notify the specialists about this, blood-thinning agents, anticoagulants, non-steroidal anti-inflammatory drugs that can provoke bleeding are subject to cancellation. If indicated, examined internal organs, comorbidity should be brought to such a state that the risks of complications from other systems are excluded.

Endoscopic intrauterine interventions are carried out in the first phase of the cycle, on the 6-9th day from the beginning of the last menstruation. With infertility, to assess the functional state of the mucosa, hysteroscopy of the endometrium is indicated in the secretory phase of the cycle.

If there is a possibility of infectious complications, antibacterial and antifungal drugs for preventive purposes. The risk group for infectious complications includes women with diabetes, chronic foci of infection, obesity. Excessive emotional experiences in connection with the upcoming procedure are eliminated by taking sedatives.

Types of hysteroscopy

Hysteroscopy of the uterus always consists in examining the inner lining of the organ with the help of optical instruments and visually assessing the existing changes. Depending on the goal pursued, it happens:

diagnostic;
Medical;
Control.

The duration of the operation is usually no more than half an hour, and the diagnostic procedure may be limited to 10-15 minutes. With polyposis or large nodules of fibroids, hysteroscopy becomes surgical and takes up to an hour or more, while prophylactic antibiotic therapy is mandatory, and intervention involves general anesthesia.

Diagnostic hysteroscopy aimed at examining the endometrium and identifying visible to the eye changes. When using flexible endoscopes, there is no need for anesthesia. At therapeutic endoscopy the doctor excises the altered tissues, violating their integrity with the help of a resectoscope. Control hysteroscopy helps to evaluate the result surgical treatment or hormone therapy.

hysteroscope

Modern hysteroscopes, equipped with magnifying optics, make it possible to make an overview examination of the uterus from the inside, as well as to examine the structure of epithelial cells, glandular formations with high magnification - microhysteroscopy.

Flexible fibrohysteroscopes have high resolution, thanks to which the doctor evaluates the state of the cytoplasm and nuclei of cells, and also give a very clear image with minimal trauma to the mucous membrane, so they are the most promising for widespread use.

Today, hysteroscopy using very thin flexible endoscopes can be performed on an outpatient basis, in a antenatal clinic or a medical center - office hysteroscopy. Such a study takes no more than a quarter of an hour, does not require preparation, is safe and highly informative.

By the time of execution, hysteroscopy happens:

planned - with a polyp, myoma, adenomyosis;
emergency - with bleeding;
preoperative - usually diagnostic;
postoperative - to control the result of the operation.

Often, gynecologists resort to hysteroscopy after scraping the body of the uterus and cervical canal. If a non-developing pregnancy, a hyperplastic process, polyposis is diagnosed as a consequence of an ultrasound examination, the doctor can immediately refer the woman to curettage.

Since the mechanical removal of the pathology is performed almost blindly, the risk of leaving altered tissues, polyps, retention of fetal fragments, non-radical removal of hyperplastic mucosa is quite large. Endoscopy in these cases will help both identify and effective elimination complications.

To conduct an endoscopic examination or treatment in gynecology, a hysteroscope (hard or soft), a video camera, a light source (the most modern - xenon lamps with a power of at least 150 W), devices for supplying liquid or gas into the uterus are required. The hysteroscope itself can be equipped with biopsy forceps, scissors, electrodes for tissue coagulation, a laser and power tools. The laser is usually used for tissue dissection (unions, septa), destruction of a pathologically altered focus.

An overview of the inner layer of the uterus is possible only with the introduction of a means that expands it. It can be a gas (carbon dioxide) or a liquid. In the first case, they talk about gas hysteroscopy, in the second - about liquid. Liquid media for expanding the uterine cavity - dextrans, glycine, saline, sorbitol, the choice depends on the specific clinical case and the purpose of the procedure, but sterility is a prerequisite.

Hysteroscopy technique

Immediately before the procedure, the surgeon lubricates the genitals and thighs of the woman being examined from the inside with antiseptic solutions, the cervix is fixed in mirrors and treated with ethanol. Next, a probe is inserted into the cavity of the organ and its length is measured, then the cervical canal expands and the washing and outflow of the discharge is established. Fibrohysteroscopy does not involve the expansion of the cervical canal due to the small diameter of the endoscope.

The hysteroscope, connected to a light source and a device for supplying gas or liquid, is placed in the uterus, after which an examination of the mucous membrane begins, an assessment of the shape of the cavity, the relief of the membrane, its thickness, color, and the state of the mouths of the fallopian tubes. The direction of movement of the hysteroscope is clockwise.

The normal uterine cavity looks like an oval, the thickness and vascular pattern of the mucous membrane depend on the day of the cycle when the study is performed. The endometrium is low with an abundance of blood vessels before ovulation, gradually thickens and becomes folded after ovulation, on the eve of menstruation - with hemorrhages, thickened, velvety.

What does hysteroscopy show?

The most common problems that become the subject of endoscopic diagnosis can be considered uterine myoma, hyperplasia, polyps, endometrial glandular cancer, endometriosis.

myoma nodes

Detection submucosal myomatous nodes presents no difficulty. These tumors are round, light pink, have clear boundaries and protrude into the uterine cavity. The nodes located in the thickness of the myometrium are visible in the form of a thickening or protrusion of the muscle layer.

When diagnosing fibroids in the submucosal layer during hysteroscopy, the question of the possibility of its removal by resection is decided, which depends on the size of the tumor, the presence of a vascular pedicle, and the localization of the neoplasm. Removal of the tumor through endoscopic resection is called hysteroresectoscopic myomectomy.

Hysteroscopy uterine polypand diffuse hyperplasia shows an increase in the thickness of the mucous membrane of the body of the uterus, the presence of outgrowths of the endometrium, the formation of folds. Polyps are single or numerous, they are pale pink, hang down inside the uterus, with an increase, you can see the vessels that feed them. With liquid hysteroscopy, the outgrowths of the mucosa move with the current of the liquid medium.

Hysteroscopy of the uterine polyp with resection

If a polyp was detected endoscopically, then its targeted removal is required - resection. The vascular pedicle is necessarily excised, and the resulting fragment is sent for histological examination. With diffuse hyperplasia, microhysteroscopy makes it possible to suspect malignancy in individual fragments of the overgrown endometrium, to sample suspicious areas for histological examination and remove the entire pathologically altered layer of the mucous membrane.

internal endometriosis (adenomyosis)

Diagnostic difficulties are not uncommon in internal endometriosis (adenomyosis). Hysteroscopy in such patients requires considerable experience on the part of a specialist, often the result is erroneous. Endometrioid passages during endoscopy are viewed as white color spots from which blood is released.

In addition to the above pathological changes, endoscopy allows you to see and eliminate the remnants of the tissues of the fetus or placenta inside the uterus, dissect partitions or adhesions, remove intrauterine contraceptives.

Surgical endoscopic operation is aimed at eliminating the pathology of the body of the uterus:

Hysteroscopy of the uterus with removal of the polyp - endoscopic polypectomy;
Myomectomy for uterine myoma with submucosal growth of nodes;
Removal of pathological contents when fragments of the fetus or membranes are retained in the uterus;
Dissection of adhesions, partitions in the body of the uterus;
Extraction of intrauterine foreign bodies, including - spirals;
Destruction of the endometrium with recurrent hyperplasia, atypical changes in the mucous membrane;
Sterilization by hysteroscopy.

Postoperative period and rehabilitation

The absence of tissue incisions endoscopic surgery less traumatic, so rehabilitation and recovery are easy, and complications are rare. Diagnostic (office) hysteroscopy does not involve hospitalization and is performed on an outpatient basis, patients do not need special monitoring, and the next day a woman can return to her usual life and work.

Antibiotic prophylaxis in the postoperative period is indicated for women at risk of infectious complications, who may be offered observation during the first 1-2 days in a hospital setting. Surgical hysteroscopy is performed with the mandatory prescription of broad-spectrum antibiotics, metronidazole, antifungal agents.

Within a few days after hysteroscopy, bloody issues from the genital tract and sensations of painful spasms in the pelvis. On the first day, the discharge is moderate, and then their intensity decreases. AT postoperative period do not use tampons and douching, as this can provoke infection. Sexual contact should also be avoided.

If necessary, uterotonics are used to accelerate the contraction of the body of the uterus - oxytocin, hemostatic agents - dicynone, etamsylate. At severe pain immediately after the intervention, analgesics (baralgin, ketorol) are indicated. After surgical hysteroscopy, the restriction of sexual life may last for several weeks, depending on the nature of the operation, and the doctor may also prohibit visiting the pool and bath.

The results of hysteroscopy depend on the initial pathological process and the technical possibilities of its elimination. With polyps, hyperplasia, adhesions, myoma, it is possible to achieve complete removal of pathologically altered tissues without traumatic surgery, skin incisions and subsequent scars. In case of infertility, finding out the cause of the pathology may require repeated endoscopies, but, unfortunately, it is not always possible to find out why pregnancy does not occur or miscarriages occur.

Hysteroscopy is considered a safe measure, complications with it occur in no more than 1% of cases. Possible bleeding, infection, trauma to the internal genital organs with rigid endoscopes.

Most young women are worried about whether they will be able to conceive after a hysteroscopy procedure. Since the manipulation is minimally invasive, does not injure the inner layer of the uterus, and often treats the existing pathology, pregnancy is quite possible. In the case of infertility, hysteroscopy is generally carried out in order to achieve it.

The period when you can plan conception depends on the purpose and result of hysteroscopy of the uterus. So, if the procedure was carried out for diagnosis (office hysteroscopy), and there were no obstacles to pregnancy, then there will be no contraindications to having children in the near future.

Pregnancy after hysteroscopy can occur in the next cycle, if there is no pathology that prevents it, but still doctors advise to wait a month or two. In the treatment of diseases of the body of the uterus by endoscopic method, it may take up to six months to restore the endometrium and the correct menstrual cycle, and it will be possible to become pregnant when the doctor is convinced that this event is safe for both the woman and the future embryo.

Thus, hysteroscopy provides a huge amount of information that cannot be obtained with ultrasound, separate curettage of the uterine cavity and cervical canal, and even with their combination. In addition, therapeutic hysteroscopy is one of the most effective and, at the same time, very safe methods surgical gynecology, when the risk to the patient is minimal. These undoubted advantages make hysteroscopy the gold standard in the diagnosis and treatment of a variety of obstetric and gynecological pathologies.

Video: hysteroscopy - medical animation

Video: hysteroscopy - indications, preparation, conduct

Sometimes one examination in the gynecological chair is not enough, and the doctor sends the woman for additional examinations. One of these is hysteroscopy of the uterus. This method is informative and efficient. It can be used both for the diagnosis and treatment of various diseases.

Collapse

What is a hysteroscopy of the uterus?

This procedure in gynecology involves the introduction of a mini-camera into the organ, which is located on a special probe. The hysteroscope (this is what the device is called) also has LEDs, with the help of which all the mucous membranes are visible.

There is a surgical and diagnostic hysteroscopy. If the doctor's goal is to examine the endometrium of the uterus to confirm or clarify the diagnosis, this is a diagnostic procedure. If you need to remove neoplasms without incisions and punctures, then surgical hysteroscopy is done.

In what cases is the operation performed?

If you need to clearly find out the diagnosis of the patient, an examination of the uterus is performed, namely:

when it is impossible to get pregnant;
if intermenstrual bleeding is present;
after systematic spontaneous abortions;
with organ defects;
if there is a suspicion of endometriosis, polyps, oncology.

Also performed for surgical purposes, for:

elimination of placental remains after delivery;
removal of neoplasms in the form of polyps, fibroids or adhesions;
elimination of intrauterine rings, spirals, etc.

Types of hysteroscopy

As mentioned above, the procedure is of two types. Surgical and diagnostic. Let's consider in more detail.

Surgical

During this procedure, both optical and surgical equipment are used. Pathologies of the organ are treated in a radical way, while injuries are minimal. Here you need anesthesia for hysteroscopy of the uterus.

Diagnostic

When carrying out such manipulation, the integrity of the mucous membranes is not violated. The doctor examines the entire uterine cavity in detail. After this diagnosis, it is possible to confidently say whether a woman has a benign or malignant formation.

Contraindications for surgery

Cannot be used if present:

an infectious disease;
pregnancy;
inflammation in the pelvic organs;
stenosis of the uterine neck;
bleeding.

Preparation for the procedure

How to prepare for a hysteroscopy of the uterus? Prior to the operation, the doctor must examine the patient in the gynecological chair using mirrors. This is necessary in order to study the condition of the vaginal walls and partially the cervix. In parallel with this, a bacteriological smear is taken, which will exclude various infections. If there are inflamed areas or the presence of infection, then hysteroscopy is not performed.

The woman herself needs:

for one, two days to forget about sex;
give up intimate gels and aromatic bath foams for a week;
do not douche 5-7 days before the manipulation;
wait for 5 days using vaginal tablets, suppositories, creams, etc.;
an enema should be given the day before the procedure;
empty the urethra immediately before the procedure;
in the morning it is forbidden to eat anything (if the procedure will be anesthetized).

Also without fail, a woman undergoes tests before hysteroscopy of the uterus:

general (blood, urine);
HIV research;
Wasserman reaction.

Apart from laboratory research preparation for hysteroscopy of the uterus includes an examination by a therapist. After that, she does fluorography, ultrasound diagnostics of the genital organs and ECG. All the data obtained will help the gynecologist determine the auxiliary drug that is used during hysteroscopy. All preparatory measures before surgery are mandatory. Based on them, the postoperative treatment and the drug used in anesthesia will be selected.

Anesthesia for hysteroscopy

Before the operation, the doctor must decide on the choice of anesthesia. His choice will directly depend on the planned intervention and on the results of the preliminary examination.

Types of anesthesia

Used for hysteroscopy of the uterine cavity anesthesia:

Local. An injection with an anesthetic drug is injected into the uterine cervix. Useful for diagnosis.
General. Introduction intravenously. During medical sleep, the doctor performs all the manipulations.
Regional. This concept refers to epidural anesthesia. The medicine must be injected into the region of the spine. At present this species the most popular.

Sometimes anesthesia is not used. The reason for this allergic reactions and other contraindications.

Let's consider each separately.

Local anesthesia

With the help of this type, only diagnostic hysteroscopy of the uterus is done. Under local anesthesia The procedure is performed on an outpatient basis. Before placing a hysteroscope in the uterine cavity, a specialist cuts off the uterine cervix with painkillers. After you need to withstand 10-15 minutes and carry out hysteroscopy. The most optimal medicine for local anesthesia is lidocaine.

Keep in mind! After such anesthesia, severe pain will not be felt, but some discomfort will remain.

General anesthesia

Hysteroscopy under such painkillers is carried out in a hospital. If you need to remove a polyp, cyst, fibroid, adhesions or scrape the uterine cavity, local anesthesia can be used.

The drugs enter the body intravenously or maskally, after which the patient falls asleep. Preparations in the form of Propofol and Midazolam for injection into a vein and Sevoflurane and Isoflurane for inhalation can be used. They are the safest. After a woman comes out of drug sleep, she feels nausea, muscle soreness, weakness and dizziness. It all goes away within 24 hours.

Regional anesthesia

AT modern world regional anesthesia (spinal or epidural) is most preferable. The medicine is injected into the region of the spine. At the same time, the woman does not fall asleep, is in her right mind, but the lower part of her body loses sensitivity. To achieve normal (complete) anesthesia, you need to perform several manipulations. The hardest part is the insertion of the epidural tube.

Procedure technique and how long does it take?

Where and how is a hysteroscopy of the uterus performed? A woman enters the office and sits in a gynecological chair. Then comes the turn of the anesthesiologist. The specialist introduces a solution prepared in advance and monitors the patient's condition.

Then everything happens as follows:

The doctor makes the treatment of the vagina, vulva and cervix with an antiseptic preparation.
Produces an expansion of the cervical canal. For this, special metal expanders are used.
He introduces a special tube on which there is a light source and a video camera. With the help of these devices, the organ cavity is examined. During the passage of the instrument through the neck, the organ is filled with air. This is necessary so that the uterine walls straighten out, and everything can be inspected without hindrance.
After that, the specialist gradually examines all parts of the uterus. The image is displayed through the camera on the monitor. The picture is enlarged several times and this makes it possible to draw appropriate conclusions and make a clear diagnosis.
If necessary, a tissue sample is taken for further laboratory testing.
At the end, the uterus is cleaned of the auxiliary solution and the patient is taken out of anesthesia.

The duration of the session will take half an hour, sometimes 10-15 minutes more. It all depends on the complexity of the process.

If hysteroscopy is performed for surgical purposes, then the procedure is performed under general anesthesia. After the operation, the woman will stay in the hospital for another two or three days.

First, the surgeon will examine the organ, then remove the endometrial polyp or other formation. Video operation is very popular nowadays. Hysteroscopy allows you to remove a pathological neoplasm without violating the integrity of the skin.

If hysteroscopy with curettage is performed, then general anesthesia and a hospital stay of 2-3 days are also desirable.

During diagnostic procedure no pain, but women with high pain threshold minor pain and discomfort may be present. During surgical hysteroscopy, an anesthetic is usually used. In this case, the woman does not feel anything. If there is no anesthesia (for example, when taking a biopsy), then there are quite noticeable painful sensations.

On what day of the cycle is the manipulation done? Hysteroscopy is performed from the sixth to the tenth day of the menstrual cycle. During this period, the uterine membranes thin out, and this contributes to better visibility. If the procedure needs to be carried out urgently, then this happens on any day.

Recovery period after the procedure

In the postoperative period, a woman may feel pain in the lower abdomen of a pulling nature. It resembles menstrual pain. With severe pain, you can take any painkiller or antispasmodic.

Discharge after hysteroscopy of the uterus is also a frequent occurrence. It is ok if they are not more than five days old. If the bleeding continues more and every day increases, and does not decrease, you should immediately seek medical help.

Practice shows that surgical hysteroscopy affects the menstrual cycle. The first time there are failures.

The patient cannot be for recovery period douching, putting tampons or suppositories in the vagina, taking hot baths or going to baths and saunas, and having sex. It is necessary to carry out regular hygiene procedures.

You can get pregnant no earlier than after 3-5 months. This time period is purely individual and is adjusted by the doctor.

Possible consequences and complications

Complications after hysteroscopy of the uterus can be of a different nature. If the procedure was carried out correctly with preliminary preparation, then Negative consequences are reduced to a minimum. There is only discomfort and minor symptoms mentioned above. But, alas, there are exceptions.

Anesthetic complications

Complications of this nature are associated with an incorrect assessment of the anesthetic risk, impaired anesthesia technique, and an allergic reaction to the drug used.

If anesthesia is not suitable for the patient, it may begin:

tachycardia:
dyspnea;
cyanosis;
pulmonary edema;
vasospasm;
hives;
loss of consciousness.

With improper removal from general anesthesia, there is:

chills;
shiver;
development of thrombophlebitis;
apnea;
muscle weakness;
paralysis;
increased heartbeat;
cyanosis;
breathing difficulties.

Sometimes, with the introduction of small doses, anesthesia does not give the desired result, after which the woman feels everything that happens.

Surgical complication

If tissues were touched during the procedure, then the following may occur:

Bleeding that does not decrease, but increases.
The occurrence of endometritis (due to tissue infection). Characterized elevated temperature, pulling pain in the lower abdomen, the presence of purulent bloody discharge.
Perforation of the uterine wall. At the same time, the woman feels sharp pain in the lower abdomen, she feels sick, dizzy, blood pressure drops due to severe blood loss.

In any case, you should immediately consult a doctor.

Other kinds of complications

Also, a woman can observe discharge from the genital tract, which smells unpleasant and contains pus. This also indicates the presence of a pathology that cannot be delayed. A timely appeal to a gynecologist will prevent further negative consequences.

How much does the operation cost?

How much does hysteroscopy of the uterus cost in Moscow? It all depends on the distance from the center, the qualifications and experience of specialists, the popularity of honey. center. Consider three clinics.

Conclusion

How hysteroscopy of the uterus is done and what it is is no longer a secret. The procedure does not take much time, when using anesthesia it does not cause pain. There is nothing wrong with her if you find good clinic and an experienced qualified doctor. You must first undergo an examination that will make it clear if there are any contraindications to hysteroscopy. If there are any changes in the discharge for the worse in the postoperative period or if there are sharp increasing pains in the lower abdomen, you should immediately contact a gynecologist.

Hysteroscopy of the uterus new method condition surveys reproductive system women using a special sensor. Timely determination of the reasons due to which conception cannot take place, and proper treatment are the key to successful pregnancy and childbirth. What is hysteroscopy, when is it necessary to undergo this procedure and what may be the consequences - the answers to these questions can be found below in the article.

What is this procedure and its types

Hysteroscopy of the uterus is a method of examining the internal cavity of the uterus using a special device.

A hysteroscope is an illuminated instrument that is inserted into the internal genital organs. He perceives the image inside the uterus and transmits it to the screen, where it is analyzed by doctors.

diagnostic:
operational;
control.

Diagnostic hysteroscopy is performed at the stage of diagnosis. The reproductive system of a woman is examined for the presence of pathologies, infectious and inflammatory processes or tumors.

Operative is carried out at the stage of treatment of diseases. As a rule, it is used during surgical operations on the uterus.

In parallel with the visual examination, surgical instruments are inserted into the uterine cavity and treatment is carried out.

Control hysteroscopy is performed during the rehabilitation of a woman after surgery or treatment.

The technique of carrying out does not differ from diagnostic, but at this stage there is no diagnosis. The doctor checks the effectiveness of the treatment prescribed by him.

Indications

It is prescribed for suspected of the following pathologies:

inflammation of the endometrium in the uterine cavity;
various types of adhesions and adhesions in the uterine cavity and fallopian tubes;
remnants of the fetal egg or membranes after termination of pregnancy;
oncological neoplasms;
violation of the integrity of the walls of the uterus after cleaning or abortion;
intrauterine pathology of fetal development;
pathology of the menstrual cycle;
abnormal development of the uterus;
the occurrence of vaginal bleeding after menopause;
infertility;
monitoring the state of the uterine cavity after termination of pregnancy or hormone therapy.

indications during surgical intervention:

benign tumors in the uterus;
adhesions and synechia in the uterus;
polyps:
excessive growth of the endometrium;
removal of the intrauterine device.

It is carried out exclusively according to the testimony of a doctor after a comprehensive examination of the genital organs and testing.

Contraindications

Contraindicated in some cases:

inflammatory processes of the genital organs in a woman. It is also not recommended to carry out hysteroscopy after the treatment of inflammation, little time has passed;
active pregnancy. In this case, hysteroscopy can be performed only in case of a threat of death;
severe internal bleeding in the uterus;
pathological narrowing of the lumen of the cervix in a woman;
oncological neoplasm in the cervix;
acute period infectious diseases(any viral infections);
insufficiency of the cardiovascular system;
pathology of the development and functioning of the kidneys;
hepatic pathologies.

How is the study going

How is hysteroscopy done? A question that confronts every woman who has received a referral for this type of examination or treatment.

Depending on the type, this procedure can be performed with or without anesthetics.

If prescribed for the purpose of diagnosing a disease, anesthesia is not used. During the surgical type The procedure uses general anesthesia for the woman.

Stages of implementation:

expansion of the lumen of the cervical canal;
insertion into the cervix of the hysteroscope;
the introduction of saline into the uterine cavity to expand it. Instead of saline, carbon dioxide can be used.

The next stages of the procedure depend on the purpose of its implementation.

Diagnostic hysteroscopy lasts no more than 10 minutes.

With the help of a special caper on a gyroscope, the doctor examines the organ from the inside and makes a medical conclusion.

Operative hysteroscopy is longer and its duration depends on the complexity of the operation.

Complications

After hysteroscopy of the uterus, negative consequences and complications may occur. Most often appear:

trauma to the cervical canal;
trauma to the uterus;
infection of the genital organs of a woman;
internal bleeding;
individual allergic reactions to the components of the anesthetic.

The incidence of complications after hysteroscopy is very low. It does not exceed 1% of cases.

If a woman has noticed alarming symptoms, it is necessary to seek medical help as soon as possible.

Symptoms to watch out for:

pulling pain in the lower abdomen;
bleeding from the vagina;
vaginal discharge has a sharp unpleasant odor;
Wrong selection color - yellow or green;
general malaise;
nausea or vomiting;
dizziness and visual disturbances;
increase in body temperature;
weakness and loss of consciousness.

Complications can arise from improper preparation for the procedure and individual features woman's body.

Features of the postoperative period

Recovery after hysteroscopy is quite fast.

As a rule, within 2-3 days after the procedure, a woman may experience discomfort in the abdomen and minor discomfort.

This is considered normal and should not cause concern.

What is prescribed after

Women who have undergone a diagnostic hysteroscopy may be prescribed an anesthetic to relieve unpleasant symptoms.

After the surgical procedure, patients are prescribed antibiotics and anti-inflammatory drugs. medicines. In some cases, the doctor may recommend hormonal therapy.

Recovery after surgery lasts about 14 days, in the presence of complications it can reach 1 month.

For successful rehabilitation, it is important to follow all the prescribed recommendations of the doctor.

Hysteroscopy is a technique for diagnosing and treating many pathologies of the female reproductive system.

It is successfully used in the treatment of infertility, inflammation and tumor processes in the uterine cavity.

It has a number of contraindications, therefore, before passing it, it is necessary to undergo an examination and consult a doctor.

Interesting video: what is hysteroscopy

The sooner the disease is detected and the sooner treatment is started, the higher the probability of obtaining good results and complete elimination of the disease. Women's diseases also require primary diagnosis and a carefully designed treatment plan.

In gynecology, there are several methods of examination of women in order to identify various diseases or pathologies. The most effective of them is considered such a technique as hysteroscopy of the uterus. There are many materials and special literature about how hysteroscopy is done. The essence of the procedure is to conduct a study of the patient with the help of a special medical device - a hysteroscope. This device allows you to "see" the uterine cavity from the inside, identify existing deviations from the norm, for an accurate diagnosis.

Let's try to find out how hysteroscopy of the uterus is performed, how long it will take and how to prepare for the procedure.

Varieties of hysteroscopy of the uterus

Hysteroscopy is performed by experienced gynecologists, however, depending on the condition of the patient and the primary diagnosis. There are two types of hysteroscopy:

diagnostic (office);
medical.

Doctors consider this type of study the most informative and effective. It is with the help of this technique that specialists can identify almost any violation in the development of the uterus. Another advantage of such a study is that with the help of a hysteroscope, you can not only make an accurate diagnosis, but also perform a small surgical intervention within the uterus.

Hysteroscopy office or diagnostic is performed on an outpatient basis. The main purpose of this method is to identify or confirm an already diagnosed disease. The study lasts 5-25 minutes and for its implementation the woman needs to go to the hospital. During the study, a video is being recorded so that in the future the doctor has the opportunity to review the received material again. It should be noted that during office diagnostics, the integrity of the tissues of the uterine cavity is not violated. Diagnosis can be made without the use of anesthesia, most often with local anesthesia.

Hysteroscopy of the surgical type involves surgical intrauterine intervention, when the integrity of the tissues is compromised. During the study, the uterine cavity is stretched to carefully examine its walls. In turn, surgical hysteroscopy is divided into gas and liquid. This classification is based on the method of stretching the organ. As for the time that the diagnosis takes, and the period in which it is carried out, here the procedure can be classified into:

postoperative;
intraoperative;
preoperative;
urgent;
emergency;
planned.

As a rule, the operation is performed under short-term, general anesthesia.

In what cases is hysteroscopy prescribed, and in which not?

Before being diagnosed, the woman visits the attending gynecologist. Only a specialist can prescribe this study and only if there are certain indications:

when it is impossible to bear a fetus and when it is not possible to determine the cause in another way;
if there is an abnormal development of the uterus;
as a control measure after childbirth, extracting the remains of the amniotic egg;
when endometriosis is suspected;
if a woman of childbearing age has a menstrual cycle;
in case of suspicion of fibroids;
with pathology of the endometrium;
when cancer is suspected;
before IVF;
to study the patency of the fallopian tubes;
if there is bleeding during menopause;
when it is necessary to remove intrauterine devices of contraception.

In addition to cases where this type of diagnosis is mandatory, there are factors in the presence of which the procedure cannot be prescribed. In particular, the following can be noted:

the presence of infection and infectious processes in the body;
pregnancy;
cervical stenosis;
if there is uterine bleeding.

How to prepare for the procedure?

The attending physician will tell you in detail about how the hysteroscopy procedure is performed and answer all the questions of interest to the patient. In addition, the specialist is obliged to explain to the woman how to prepare for the procedure, how long it will take, and what tests will need to be passed before going for diagnostics. So, the results of the following analyzes will be required:

general blood and urine tests;
testing for HIV infection;
Wasserman reaction;
bacterioscopic examination of vaginal discharge.

In addition, it will be necessary to provide ultrasound images, fluorography, ECG, and also undergo a general examination by a general practitioner before going for diagnostics. The results of all these analyzes are needed in order to determine the tactics of the examination, as well as to choose the drug for anesthesia that will be required during the operation.

Immediately before the operation, the patient should be given a cleansing enema, and before the procedure, the woman needs to urinate. You can not drink on the day of the examination, it is also forbidden to eat. This is necessary to control the effects of anesthetic drugs.

Features of the hysteroscopy procedure

In many gynecological departments, it is possible to conduct a diagnostic study and surgical intervention using hysteroscopy. In other words, in order to pass the study, it is enough to find a suitable medical Center or a clinic providing similar services. The AltraVita clinic in Moscow provides such services at a high qualification level. After the medical institution is chosen, you will need to wait for the period of menstruation and between the 7th and 10th days of the menstrual cycle, undergo an examination using the hysteroscopy method.

The undoubted advantage of the technique is that the doctor does not perform surgical intervention in the patient's body, but inserts a special instrument through the vagina. Before inserting the device, you will need to treat the external genitalia and the inner thighs with an alcohol solution.

Next, a probe is inserted that measures the length of the uterine cavity and helps to insert the Heger dilators. This allows you to gradually open the church canal for the free outflow of secretions, at the moment when the uterus begins to secrete bloody fluid. A hysteroscope is inserted through the church canal, which, on the other hand, is connected to a light source, a video camera and a special fluid supply system.

As a result, a multiply enlarged image of the uterine cavity appears on a special monitor, which makes it possible to identify pathologies and other disorders. In the future, the result will become the basis for the final diagnosis and surgical treatment. Upon completion of the procedure, the device is removed from the cavity, and the closure of the cervix passes spontaneously.

Recovery measures after diagnosis

The more complex the surgical intervention in the patient's body, the longer her stay in the hospital will be. The doctor may prescribe from two hours to four days of recovery in stationary conditions. At the same time, a woman needs a sparing regimen, in which sex life, as well as significant physical exercise. You can not take a bath until the next menstruation ends.

It should be noted that within a few days after the examination, the patient may experience small bleeding.

Possible complications

If the doctor can immediately tell the patient about how hysteroscopy goes and explain how to prepare for the procedure, then possible consequences and complications will depend on the individual state of the woman's body.

It is possible to distinguish such disturbances in the work of the body as increased flatulence in the stomach and intestines, which is provoked by the ingress of gas into the internal organs, as well as the secretion of ichor, together with spasmolytic pains. However, it should be noted that complications do not occur for more than five days.

It is important for every woman to know that if bloody-purulent discharge appears after hysteroscopy of the uterus and this lasts for a long time, it means that the body has begun inflammatory process and action should be taken. An alarming symptom is an increase in body temperature.

Rehabilitation after the intervention takes about ten days, during which the woman experiences aching, pulling pains in the abdomen. If they do not go away after ten days, then this is also a sign of an inflammatory process.

Conclusion

Hysteroscopy is a special and very common examination of the uterine cavity, which is carried out as prescribed by a doctor and using a special device. To pass the study as efficiently as possible, you should contact a trusted, reliable clinic. The AltraVita clinic is a medical center that employs only highly qualified specialists. Call us and we will provide you with the necessary services at an affordable cost.