In line with its mission, the Editorial Board of MedTvoiLokony makes every effort to provide reliable medical content supported by the latest scientific knowledge. The additional flag “Checked Content” indicates that the article has been reviewed by or written directly by a physician. This two-step verification: a medical journalist and a doctor allows us to provide the highest quality content in line with current medical knowledge.

Our commitment in this area has been appreciated, among others, by by the Association of Journalists for Health, which awarded the Editorial Board of MedTvoiLokony with the honorary title of the Great Educator.

Hysteroscopy, or uterine endoscopy, is a diagnostic method (diagnostic hysteroscopy) or an endoscopic surgery (operative hysteroscopy), which is used as a non-invasive or minimally invasive method of removing hyperplastic changes from the inside of the uterus. Hysteroscopy can remove fibroids, polyps and adhesions from the uterus.

Hysteroscopy and infertility

Hysteroscopy is a method used to assess the structure of the uterine cavity, cervix and fallopian tubes, but it is also used during surgical procedures. Hysteroscopic examination It is performed for various medical indications, especially when pathological changes in the female reproductive system are suspected. The procedure is also important in the diagnostic process of female infertility.

Tests diagnosing female infertility

Couples planning to expand their families do not always achieve this goal quickly and without problems. Getting pregnant can be hampered by infertility, a condition that affects both women and men. Infertility is defined as when, despite regular intercourse without the use of contraceptives, fertilization has not taken place within one year. The reasons for this may be different, but with proper diagnosis, in many cases it is a chance to cure infertility.

Problems with infertility affect both men and women equally. For this reason, the most effective way to discover the cause of the problems is to diagnose both partners. In the case of women, the research focuses on hormones, the analysis of the anatomical structure of the reproductive system, and the detection of infectious or neoplastic diseases. Diagnosis of infertility in women includes the following tests:

  1. hysteroscopy;
  2. cytology;
  3. ovarian reserve assessment (AMH);
  4. FSH hormone (follitropins);
  5. sono HSG – ultrasound examination of ovarian patency;
  6. thyroid profile;
  7. for infectious diseases (including chlamydiosis, hepatitis B and C, syphilis, HIV or cytomegalovirus).
important

Infertility is not the same as infertility – the former is treatable, while the latter is completely unable to have children.

  1. Read also about genetic testing for infertility.

What is hysteroscopy?

Hysteroscopy involves endoscopy of the inside of the uterus with a special apparatus (endoscope). A speculum with a camera is inserted into the uterus, the image from it (enlarged) is transmitted to the monitor screen, where the doctor can trace the inside of this organ and diagnose any changes.

Diagnostic hysteroscopy allows to precisely determine the location and size of hypertrophic changes inside the uterus. If polyps, adhesions, fibroids or other intra-uterine hypertrophic changes are detected, surgical hysteroscopy is ordered,

Operative hysteroscopy is based on endoscopic removal of lesions from the uterus. Then, micro-tools are introduced into this organ through the hysteroscope, and the surgeon performs the procedure, observing the enlarged image of the uterus on the computer screen. The hysteroscope used for surgical hysteroscopy has a larger diameter than the one used for diagnostic purposes – so that it can be used to insert surgical instruments into the uterus.

Surgical hysteroscopy requires the administration of anticoagulants, anti-growth drugs and an antibiotic shield, and is performed under general anesthesia, but it is a much less invasive procedure than the traditional surgery with open abdominal integuments. The patient may leave the hospital as early as 3 hours after the operative hysteroscopy. In some cases, however, it is recommended to stay in the hospital for a day after the procedure.

  1. See also: Semen analysis in the diagnosis of male infertility

Indications for hysteroscopy

Hysteroscopy makes it possible to diagnose changes inside the uterus, and to remove these changes (in some cases) using the endoscopic method, which is minimally invasive and does not require opening the abdominal wall. Hysteroscopy is used in the following cases:

  1. for the removal of endometrial polyps,
  2. to remove submucosal fibroids,
  3. when a rupture of the uterine wall is suspected,
  4. as a method of treating too heavy menstrual bleeding or uterine bleeding – part of the endometrium is then removed,
  5. in the treatment of benign growths of the mucosa – in this case, the technique of endometrial resection is used,
  6. to remove intrauterine adhesions,
  7. for the removal of the uterine septum and other defects of this organ,
  8. in women struggling with difficulties in getting pregnant,
  9. in the case of recurrent miscarriages.

How to prepare for the hysteroscopy procedure?

Before the hysteroscopy procedure, hormonal treatment should be used for a period of 2 to 4 weeks, which will reduce the thickness of the uterine walls, and in the case of uterine fibroids – reduce their volume. Before hysteroscopy a cytology and a diagnostic test of vaginal cleanliness should also be performed to avoid intrauterine infection with pathogenic bacteria that may be present in the vagina. If the test shows the presence of such bacteria, antibacterial vaginal globules recommended by your doctor should be used for several days before the hysteroscopy procedure.

The possibility of administering anesthesia should also be verified on the basis of blood counts and the determination of glucose, sodium, potassium and kaolin-kephalin time (ATTP).

important

Diagnostic hysteroscopy can be performed on any day of the cycle, while surgical hysteroscopy is performed at the beginning of ovulation, right after menstrual bleeding has stopped. For 6 hours before the procedure, you should not eat, drink or chew gum. You are also not allowed to take any medications during this time. Two hours before the procedure, we should also refrain from urinating.

Recommendations after hysteroscopy

After hysteroscopy, it’s best to go home and rest. It is recommended to limit the activity, especially the ones that burden the body, for three days after the treatment. Avoid lifting heavy objects and take medications (e.g. antibiotics) if prescribed by your doctor. If you experience prolonged symptoms such as fever, pain or bleeding after the procedure, please consult your doctor.

Hysteroscopy – possible complications

Complications after an operative hysteroscopy they happen relatively rarely. These include intrauterine infections, bleeding when removing large hypertrophic lesions, and rupture of the uterus. In such cases, it is necessary to perform a laparoscopic operation, and even a traditional operation to open the abdominal wall.

Leave a Reply