Hysteroscopy uterus: what it is, how it is carried out, especially the preparation and the necessary tests

To identify the gynecological pathology and put the correct diagnosis, doctors prescribe various studies, including that there are those that are used not only to detect disease, but also to remove the pathological foci. One of them is hysteroscopy. What kind of diagnostic procedure and how it is conducted, it is necessary to know in advance, then be able to properly prepare for it.

Characteristics of hysteroscopy

Hysteroscopy endometrium - the uterine cavity is a research method by which is possible to identify various gynecological diseases. a special instrument called a "hysteroscope" is used in the course of. He is a tube equipped with a video camera. Due to this the doctor can examine the body in an enlarged view and in good light.

During the procedure, can not identify abnormal development, assess the condition of uterine tissue to detect a variety of tumors, to determine their size and place of localization. The method is more informative than ultrasound.

Hysteroscopy uterus is an invasive method, wherein the abdominal wall is not cut. Tools in the body cavity is introduced through the vagina. Thanks to this procedure ends with no injuries and fractures. Only in rare cases, the possibility of accidental damage.

One of the main advantages of the method is considered to be possible to remove abnormal areas directly in the course of the study. As a result, the recovery rate is significantly increased.

types of hysteroscopy

Depending on the purpose of the procedure it identified a number of varieties. Office (Diagnostic) hysteroscopy assigned when the need to identify various diseases. have recourse to hysteroscopy before IVFIn the course of preparation. The procedure is performed in endometriosis, polyps, fibroids, intrauterine adhesions and abnormal thickening of the mucus layer of the body.

Diagnostic (office)

The visualization of the uterine cavity for diagnosis is carried out in the following cases:

• violation of the cycle;
• detection of fibroids, endometriosis, endometritis, and other pathological processes;
• removing intrauterine systems and other foreign bodies.

The following manipulations are performed:

• minor invasive surgery: colliotomy, partitions, adhesions, removal of small volume polyps, cysts, nodules;
• biopsy sampling required for histological examination;
• visual inspection;
• study of the characteristics of the uterine mucosa.

Perform manipulation is recommended for 6-9 days after the critical days. In preparation for surgery tests appointed a woman to hysteroscopy:

• HIV, RW, general urinalysis, blood;
• definition of blood clotting and Rh factor.

In addition, you need:

• gynecological examination;
• ultrasound;
• colposcopy if indicated.

Increasingly used short-term local anesthesia. The maximum duration of the procedure - 30 minutes (office - 10-15). After performing manipulations do not require hospitalization.

surgical

A healthy uterus is important for the pregnancy and birth of a child, so still in the planning stage can be assigned to the treatment of pathologies using a hysteroscope.

For therapeutic purposes, hysteroscopy uterus is appointed to deal with such gynecological problems:

• removing remaining portions after delivery of the placenta;
• elimination of uterine perforation walls;
• removal of polyps and other malignant neoplasms such as fibroids.

Apply short anesthesia (intravenous). When performing surgical procedures resectoscope operate more frequently with a diameter of 10 mm. tools are also used:

• loop electrode - to remove polyps or fibroids;
• Special syringes - allow you to perform a biopsy of a point;
• scissors for dissection of adhesions or undercut walls in the uterus;
• exciting special tools - when removing intrauterine devices and other foreign bodies;
• electrodes - can destroy tissue polyps, septa, myomas.

Typically used rigid hysteroscope, which is inserted directly into the uterus through the vagina. Adaptive equipment is used at the wrong structure of the genitals - pronounced bend.

Also, the procedure is carried out before IVF - determine the readiness of the uterus wall for carrying a child.

control

This method is used to assess the results of surgical treatment - removal of fibroids, polyps, cancer, endometrial adhesions. Inspection of the uterine cavity with a video camera allows you to describe the state of the mucous membrane of the uterus, to reveal the adhesive process.

On hysteroscopy sent to:

• after laparoscopy;
• metroplasty;
• open myomectomy;
• Opening uterine sparing surgery;
• remote sites adenomyosis;
• when planning conception.

Examination masterbatch shell collar, pipe hysteroscope reveals the adhesive process in the early stages. In this case, a surgery to remove adhesions or introduced special absorbable gel.

Follow-up care is necessary and to evaluate the effectiveness of treatment - conservative or surgical.

When you need treatment

There are certain indications for hysteroscopy. Various studies, examination, ultrasound and analyzes do not always make it possible to identify the problems in the body. Some diseases can be asymptomatic, most diagnostic methods in this case are not informative. The safest and most reliable way to detect and treat fibroids, polyps, endometriosis and endometrial hyperplasia is considered hysteroscopic study.

No matter how great was not a list of tests that women prescribed by the physician, the most accurate information can be obtained using a hysteroscope.

Hysteroscopic surgery is necessary in the event that there is an abnormal proliferation of the endometrium, the formation of fibroids, polypous growths. Eliminate endometriosis in other ways is very problematic.

As a rule, carried out hysteroscopy with biopsy. Excised tissue after the operation is sent to histological laboratory. Due to this it is possible to identify the cells that degenerate into malignant, and then accurately determine the tactics of further treatment.

testimony

Carrying hysteroscopic uterine cavity study shows the presence of such problems:

• endometrial hyperplasia;
• endometriosis and adenomyosis;
• abnormal development of the uterus and fallopian tubes;
• uterine fibroids;
• intrauterine adhesions;
• infertility;
• failure menstrual cycle;
• determination of the place of localization of the spiral;
• several unsuccessful IVF attempts;
• suspicion of cancer;
• inspected the field of hormone replacement therapy and surgery.

Contraindications

The method has a number of advantages, but there are many contraindications to its use. The procedure is not performed if a woman has been progressing pregnancy. This is due to the fact that any intervention in the area of ​​the neck and genitals able to lead to spontaneous miscarriage. There is also a risk of damage to the fetus.

Hysteroscopy in nulliparous women is contraindicated if there is a history of inflammatory or infectious diseases of the genitourinary system. In the case of such manipulations are at high risk of infectious complications.

It is not carried out the procedure at a cervical stenosis. It considered an absolute contraindication oncology. If cancer is detected the operation do not.

Also, to perform research not resort in severe renal disease, cardiac and pulmonary failure, problems with blood clotting and after myocardial.

The method is not applicable in case of intolerance of drugs used for anesthesia.

patient preparation

Before performing hysteroscopy woman goes through special training. It should be ready for operations, both physically and psychologically. Due to the fact that anesthesia is used during hysteroscopy, there are a number of special requirements. The doctor must be sure before anesthesia, anesthetics that do not cause complications.

In addition, prior to the procedure, there are certain limitations that the gynecologist informs in advance. Duration of the operation does not exceed an hour. As a rule, a woman is sent home on the day of its carrying out.

mental attitude

It is imperative that the patient was psychologically prepared for surgery. Fear of pain, the thought that the uterus hysteroscopy is performed without anesthesia - all this can become a serious problem.

The physician should explain that this is a painless procedure in which anesthesia is used. No discomfort during its conduct does not appear.

In addition, the hysteroscopy operation is considered one of the safest research. The risk of complications after the event is minimized. This woman needs to tell in advance.

basic research

Preparation for hysteroscopy involves carrying out the following studies:

• general blood analysis;
• bacterial inoculation;
• determining clotting rate (coagulation);
• Analysis of urine;
• blood chemistry;
• determining the level of sugar in the blood;
• chest X-ray;
• Pelvic ultrasound and the peritoneum;
• cardiogram;
• smears fence;
• bimanual study.

The purpose of this research is to identify the conditions under which use a hysteroscope is contraindicated. If they are found, initially conducted a course of treatment aimed at removing existing pathologies. A woman is considered to be ready for the procedure, when the test results indicate the absence of disease, preventing its implementation.

drug preparation

In preparation for the operation requires certain preparations. Antibiotics need to reduce the risk of infectious processes after the study. In addition, seven days prior to the procedure are also prescribed antifungal agents, irrigation with use of such drugs or as a Octenisept Miramistin.

If the problem is hormonal nature, prior to hysteroscopic study medication prepared by the endometrium. For this purpose, appointed by the hormonal treatments.

Hygienic measures

Before the uterus hysteroscopy is performed, during which will be able to examine the state of the mucous membrane, and to purge, gynecologist appoints certain sanitary measures. They suggest a thorough reorganization of the genital tract. For this purpose, use candles, which have antifungal, antiprotozoal and synergistic.

Immediately before the procedure the woman should be carefully washed away and shave intimate zone.

procedures equipment

The procedure is performed on a normal gynecological chair. Initially anesthesiologist system establishes induction of anesthesia, a gynecologist processes the cervix, vagina and external genitalia special antiseptic. Only after this neck channel gradually expanded by expanders manufactured from metal, characterized in diameter.

This stage is considered the most painful and can cause a reflex reaction. For this reason, it is done only after induction of anesthesia and loss of sensitivity.

Type of anesthesia chosen anesthesiologist. The decision depends on factors such as:

• duration of the procedure and the scope of work;
• condition of the woman;
• a history related pathologies;
• the risk of an allergic reaction;
• whether to perform surgery. Hysteroresectoscopy - a more serious procedure, which uses longer hysteroscope and hysteroresectoscopy (exact electrosurgical instrument);
• Possible complications during surgery, including bleeding, fluid imbalance, electrolyte disorders.

In most cases, the study is carried out under general anesthesia, which is administered intravenously. Selection of anesthetic is carried out individually. Sometimes resort to Endotracheal, spinal or epidural anesthesia. Regardless of the option selected, the physician continuously monitors heart activity and breathing and thus how well the blood is saturated with oxygen.

After the bodies treated with a disinfectant solution, expand the uterine cavity with a liquid or gas is introduced into it hysteroscope. Further examination is carried uterine tissues evaluated relief walls, their shape, determine the amount of body and its contents. Also draws attention to the thickness and the color tone of the mucosa. Thus learn about the presence of inflammation, lesions and growths sprouting.

If, once they are removed in the cavity foreign bodies have been detected, then using the clamp which is introduced through the instrument channel. Lots causing suspicion, subjected to biopsy. Subsequently excised tissue is sent to histological laboratory.

At the end of the procedure make separate body Clean and remove all tools. For a woman to watch in the future as long as the effect of anesthesia is complete. After that, as a rule, it can leave the hospital.

possible risks

If research was conducted qualitatively, the woman obey all the rules of preparation for it, the complications in most cases is not observed. Nevertheless, certain risks still exist in the postoperative period. Among the main gynecological disorders are the following:

• organ damage tools;
• bleeding caused by disturbance of large vessels mucosal integrity;
• penetration of infection in the genital organ and the beginning of the inflammatory process.

Indicate the development of complications can be severe pain in the lower abdomen, hyperthermia, increased discharge volume, the acquisition of odor, pus impurity in the blood that comes out of sex ways.

If during the pathologies of uterine perforation occurred therapy body, the pain in the abdominal area becomes too pronounced. Thus begins internal bleeding and appear unpleasant symptoms such as nausea, vomiting, dizziness and low blood pressure.

It is also possible development hematometra (pathological condition wherein blood accumulates in the body and breaks its outflow). Consequently, the marked occurrence of pronounced pain. In order to remove clots and prevent the initiation of an inflammatory process operate scraping.

If there are unpleasant symptoms in the postoperative period, you need to immediately contact the medical facility. It is extremely important to promptly deal with the complications and take all necessary measures.

recovery

The recovery period after hysteroscopic study in women for several hours noted the appearance of discomfort in the abdomen. To stop pain help painkillers or No-spa.

Within ten days after this procedure also spotting gradually decreasing in volume. During the recovery period often resort to the use of antibiotic agents.

The arrival of menstruation to occur after 30-40 days after the operation. In some cases, there is their delay. Regula become leaner or intense. In many respects it depends on what kind of manipulation made.

In order to avoid deterioration in the postoperative period, a woman needs to adhere to certain rules. It is extremely important to avoid thermal procedures, taking hot baths, applying a heating pad to the abdomen hot, overheating in the sun. Such actions can lead to increased bleeding intensity.

Not recommended at this time tampons, douching perform, use vaginal suppositories and ointments. Hygiene procedures should be done with utmost care.

Routine gynecological examination need take place in a timely manner, regardless of whether the operation was carried out in menopause or reproductive age. Even a slight discomfort in the abdominal area is the reason for the visit to the gynecologist.

Sex life for a month should be excluded. Pregnancy after hysteroscopy It is made possible in a couple of weeks, but doctors strongly advised to plan conception for at least three months.

medical therapies

Tactics of treatment after hysteroscopic study largely depends on the purpose of the meeting and identified pathologies.

If the diagnostic hysteroscopy uterus was carried out, the main goal of treatment is to stop the bleeding and prevent infection in the reproductive organ penetration. When you remove the polyp also resort to the use of hemostatic and antibiotic agents.

In identifying endometriosis and uterine curettage further woman appointed hormones. They need to drink at least three months. After that the scheduled examination and if appropriate treatment strategy is adjusted.

If, after the removal of polyps of the cervical canal, a simple cleaning or study developed complications, in some cases resorted to re-execute hysteroscopy.

prevention

Regardless of when the operation is carried out - in postmenopausal women or of childbearing age, it is extremely important after the comply with preventive measures by which the recovery period will end and no complications arise.

Having sex for the first two weeks it is strongly recommended. Restrictions sex life help prevent uterine bleeding and penetration of infection in the body. On the conceiving thus it is possible to reflect only after full recovery cycle (after 3 months).

To preserve the health of the sexual sphere, it is essential to observe all the rules of personal hygiene, wash twice a day, and hygiene items to change at intervals during the critical days, no more than four hours. Preference in this case is to give napkins rather than tampons.

Hysteroscopy - a minimally invasive method for studying the reproductive organ, which allows during the procedure to excise the pathological sites. Increasingly, doctors have resorted to this method of diagnosis because of its safety and ability to produce a visual inspection during the operation. Women only need to perform all the doctor's recommendations in preparation for the procedure and after the conference.