Hysteroscopy - a survey of the uterine cavity using a special endoscope device (hysteroscope). The term comes from the words hysteroscopy Hystero (womb) and Skopje (watch inspection). Danae manipulation is often used in an outpatient gynecology, and can be both diagnostic and therapeutic (operational) character. After hysteroscopy patient may be allowed to go home at once, and if the study was diagnostic in nature, then the next day she can go to work.
In gynecological practice, there are many different ways to diagnose (pelvic ultrasound, diagnostic curettage, hysterosalpingography), but only the uterus hysteroscopy allows accurate diagnosis, take a biopsy material (tissue site endometrium) and, if necessary, carry out remedial measures. Diagnostic hysteroscopy is performed to confirm the diagnosis, therapeutic hysteroscopy - a minimally invasive gynecological procedure which may treat various pathology of the uterus (eg, removal of a polyp).
Currently, you can make a hysteroscopy in a hospital and in the antenatal clinic (or private centers). To carry out this manipulation must be a specialist with the appropriate certificate. When diagnostic hysteroscopy visually inspected the condition of the cervical canal (cervix), uterine cavity and the mouth of the fallopian tubes. In identifying possible endometrial pathology biopsy or perform curettage (scraping of the uterus) to send the resulting material tissue for histological examination. Discharge after hysteroscopy are short and do not require special treatment.
Indications for hysteroscopy
Diagnostic hysteroscopy is performed in the following cases:
- Abnormal uterine bleeding;
- Suspected endometriosis, uterine fibroids submucosal tumor of the body of the uterus;
- Menstrual disorders, abnormal development of the uterus;
- Foreign bodies of the uterus (eg, IUD, the remains of the ovum after abortion);
- Control examination of the uterine cavity after surgery, curettage, for miscarriage, and after treatment with hormonal therapy.
Indications for therapeutic hysteroscopy uterus
- Endometrial polyps;
- Endometrial hyperplasia;
- Intrauterine adhesions (adhesions) or intrauterine septum;
- Submucosal fibroids;
- Narrowing the mouth of the fallopian tubes;
- To perform sterilization;
- To remove the IUD (spiral).
- Intrauterine pregnancy (progressive). Patients of childbearing age before performing this procedure must be ruled out the possibility of pregnancy (a pregnancy test or determination of hCG in urine or blood);
- Acute inflammation of the pelvic organs. Performing hysteroscopy in acute inflammation can lead to the spread of infection, chronic pain in the pelvic area, infertility;
- Excessive uterine bleeding;
- Fixed a common cancer of the uterus or cervix. Make hysteroscopy in cancer during pelvic technically possible, but this may lead to the spread of cancer cells into the peritoneal cavity;
- Heavy state of the patient as a result of cardiovascular disease, respiratory and nervous systems, with severe diseases of the liver and kidneys.
When you can do hysteroscopy
The diagnostic hysteroscopy performed 12 days of the menstrual cycle (typically 7-10 days), in the so-called proliferative phase (when the endometrium thickens under the influence of hormones). In the secretory phase (second half of the menstrual cycle), the survey is not conducted, as in this period, the endometrium can be assessed properly.
In urgent cases, and in patients receiving hormonal contraceptives do hysteroscopy is possible at any day of the cycle.
Most patients experience pain during hysteroscopy, which may prevent full inspection of the uterine cavity. Recently preference hysteroscopy uterus under local anesthesia, but may perform manipulation and under general anesthesia (intravenous).
Technique of hysteroscopy
When performing hysteroscopy cervical dilatation is not required, as the hysteroscope is thin enough to pass into the uterus. During the procedure, a sterile fluid is introduced, in order to make them available for inspection all the walls of the uterus. The physician can visually inspect the uterus, a procedure to record the video. If any piece is taken tkanina pathology biopsy, or carry out other manipulations. Typically hysteroscopic procedure lasts 10-30 minutes.
Complications of hysteroscopy are rare (less than 1%). Nevertheless, the procedure is invasive and may negative consequences in the form of perforation of the uterine wall, cervical tears, bleeding, acute exacerbation of chronic inflammation.
Discharge after hysteroscopy
After hysteroscopy may experience bleeding from the genital tract. Scarce bleeding after hysteroscopy there is almost always within a few days (usually 2-3). Also possible moderate pain in the lower abdomen as spasms (usually within 1-2 days).
When isolated after hysteroscopy not use tampons to prevent the inflammatory process. Also, the doctor will recommend to abstain from sexual intercourse for a few days (after diagnostic hysteroscopy) or 2-3 weeks (after healing).