Hysteroscopy

Hysteroscopy is a survey of a cavity of the uterus by means of the special endoscopic device (hysteroscope). The term hysteroscopy comes from words гистеро (uterus) and a skopiya (to look, survey). Dany manipulation is often used in out-patient gynecology, and can carry both diagnostic, and medical (operational) character. After hysteroscopy the patient can be allowed to go home at once and if the research had diagnostic character, then next day she can come to work.

In gynecologic practice there is a set of various ways of diagnosis (ultrasonography of a small pelvis, a diagnostic scraping, a gisterosalpingografiya), but only hysteroscopy of a uterus allows to establish precisely the diagnosis, to take a material biopsy (the site of tissue of mucous uterus) and in case of need to execute medical actions. Diagnostic hysteroscopy is carried out for the purpose of specification of the diagnosis, medical hysteroscopy is a low-invasive gynecologic intervention at which treatment of various pathology from a cavity of the uterus is possible (for example, removal of a polyp).

Now it is possible to make hysteroscopy in the conditions of a hospital and in clinic for women (or the private center). The specialist having the corresponding certificate has to carry out this manipulation. At diagnostic hysteroscopy the condition of the cervical channel (neck of uterus), a cavity of the uterus and the mouth of fallopian pipes visually looks round. At detection of pathology of an endometria capture of a biopsy or performance of a curettage (a scraping of a cavity of the uterus) is possible that to send the received material of fabric to a histologic research. Allocations after hysteroscopy have short character and do not demand special treatment.

Indications to hysteroscopy

Diagnostic hysteroscopy is carried out in the following cases:

• Abnormal uterine bleedings;
• Suspicion of uterus endometriosis, submucosal myoma, tumor of a body of the womb;
• Disturbances of a menstrual cycle, anomaly of development of a uterus;
• Infertility;
• Foreign bodys of a cavity of the uterus (for example, an intrauterine spiral, the remains of fetal egg after abortion);
• Control survey of a cavity of the uterus after operative measures, a scraping, at pregnancy not incubation, and also after treatment by hormonal drugs.

Indications to medical hysteroscopy of a uterus

• Endometria polyps;
• Endometria hyperplasia;
• Intrauterine synechias (commissures) or intrauterine partition;
• Submucosal myoma;
• Narrowing of the mouth of fallopian pipes;
• For sterilization performance;
• For the purpose of removal of an intrauterine contraceptive (spiral).

Contraindications

• The intrauterine pregnancy (progressing). At patients of childbearing age before implementation of this procedure the possibility of pregnancy has to be excluded (the test for pregnancy or definition of HGCh in urine or blood);
• Acute inflammatory processes of bodies of a small pelvis. Performance of hysteroscopy at an acute inflammation can lead to spread of an infection, chronic pains in a small pelvis, to infertility;
• Plentiful uterine bleeding;
• The established widespread cancer of a uterus or neck of uterus. To make hysteroscopy at oncological process of a small pelvis perhaps technically, but it can lead to distribution of cancer cells to an abdominal cavity;
• Serious condition of the patient as a result of pathology of cardiovascular, respiratory, nervous systems, at a serious illness of a liver, kidneys.

When it is possible to make hysteroscopy

Diagnostic hysteroscopy is carried out till 12 in the afternoon a menstrual cycle (usually for 7-10 day), to a so-called proliferative phase (when the endometria under the influence of hormones is thickened). In a secretory phase (the second half of a menstrual cycle) this examination is not conducted as the condition of an endometria can be estimated at this period incorrectly.

In case of emergency and against the background of reception of hormonal contraceptives it is possible to make hysteroscopy in any day of a cycle.

Anesthesia

Most of patients feel pain when carrying out hysteroscopy that can interfere with full survey of a cavity of the uterus. Recently preference of hysteroscopy of a uterus under a local anesthesia is given, but performance of manipulation and in the conditions of the general anesthesia is possible (intravenous).

Technology of carrying out hysteroscopy

When performing hysteroscopy expansion of the cervical channel is not required as the hysteroscope rather thin for passing to a cavity of the uterus. During the procedure sterile liquid is entered to make available to survey all walls of a uterus. The doctor can visually examine a cavity of the uterus, write down the procedure on video. At detection of pathology the piece of a tkanin a biopsy undertakes, or other manipulations are carried out. Usually the procedure of hysteroscopy lasts 10-30 minutes.

Complications

Complications after hysteroscopy are rather rare (less than 1%). Nevertheless, the procedure invasive therefore negative effects in a look are possible: perforation of a wall of a uterus, rupture of a neck of uterus, bleeding, aggravation of chronic inflammatory process.

Allocations after hysteroscopy

After hysteroscopy bloody allocations from a genital tract can be noted. Scanty bloody allocations after hysteroscopy are present practically always within several days (usually 2-3). Moderate pain in lower parts of a stomach in the form of spasms is also possible (usually within 1-2 days).

At allocations after hysteroscopy it is not necessary to use tampons for the purpose of prevention of inflammatory process. Also the doctor will recommend to refrain from sexual intercourses within several days (after diagnostic hysteroscopy) or 2-3 weeks (after medical).