Hysteroscopy

What is a hysteroscopy?

This is a diagnostic procedure that allows the doctor to examine the uterine cavity, the cervical canal (canalis cervicis uteri) and the ostium of fallopian tubes. It is performed with a narrow telescope with a light at the end which is called a hysteroscope.

What happens during a hysteroscopy

A hysteroscope is inserted into the uterine cavity through the vaginal opening and cervical canal, the uterine cavity is filled with a sterile saline for optimal expansion and then examined. The image is displayed on the screen.

Indications for a hysteroscopy

The purposes can be both diagnostic and therapeutic:

• Infertility of unknown origin;
• Unsuccessful IVF;
• Endometrial hyperplastic process detected during the pelvic ultrasound (endometrium more than 15 mm in women of reproductive age, more than 4 mm in postmenopausal age);
• Endometrial polyps detected during the pelvic ultrasound;
• Menstrual disorders (heavy menstruation, intermenstrual blood-tinged discharge);
• Preparation for surgery (removal of the uterus);
• Placental polyps after childbirth, abortion;
• Ultrasound data on the presence of organic changes of the endometrium after separate diagnostic curettage or endometrial papel biopsy;
• Presence of an intrauterine device (spiral) without wires in the absence of inflammation signs;
• Polyps of the cervical canal (cervicoscopy);
• Ingrown intrauterine device.

Most of the above-mentioned indications prevent the normal conception, transfer and implantation of embryos obtained during IVF.

The examination is prescribed by the attending doctor. It is scheduled according to appropriate days of the menstrual cycle and performed by a gynecologist-surgeon under general anaesthesia.

After examination, the doctor performs endometrial biopsy or curettage (removal of tissue with a curette) as the circumstances require.

The curette has a loop-like cutting edge that allows the doctor to remove pathological formations and obtain material for histology.

After curettage the endometrium grows again and the usual menstruation begins. After it a pregnancy may occur, or an embryo obtained during IVF may be implanted.

Preparation for the procedure

It is important to have an obligatory medical examination before such a treatment. It will allow the doctor to learn about your general state of health and to identify possible diseases and infections. This will reduce the risk of complications before, during and after the procedure.

The examination includes:

• Blood and urine tests
• Electrocardiography (ECG)
• Chest X-ray
• Gonorrhea swab
• GP’s consultation.

The laboratory of our clinic works 24 hours a day. You can have tests at any time, as well as be examined by our skilled medical specialists.

Preparation for the procedure
On the day of a hysteroscopy one should neither drink, nor eat until it’s performed. Also it is recommended to empty the intestines. The whole procedure takes about 15-25 minutes.
How to book an appointment?
1. Online appointment is the fastest and most convenient way. It is available 24 hours a day, 7 days a week. It takes less than 5 minutes to schedule!
2. You can also call us at +7 812 327 03 01 (24/7), and the call-centre specialists will schedule an appointment whenever convenient to you.

Hysteroresectoscopy
A hysteroresectoscopy (a surgical hysteroscopy) is a minimally invasive and sparing method of diagnostics and treatment of uterine diseases.
A special tool (a hysteroresectoscope) is introduced into the uterine cavity. This tool is equipped with a camera for examining the condition of the organ and an electric loop for microsurgery.

A hysteroresectoscopy is performed on the 5-7th day of the cycle. It is the time when the endometrium thickness is minimal, which allows to detect the pathology more accurately.

What happens during a hysteroresectoscopy
A gynecologist and an anesthesiologist interview the patient. The gynecologist examines the patient and determines the scope of intervention. The anesthesiologist prepares the patient for general anesthesia. When anesthesia has been applied, a hysteroscope is inserted into the uterine cavity.
The doctor performs surgical treatment (for example, excision of polyp or myoma). The tissues get removed from the uterine cavity and sent for histology.
The procedure may take 15-40 minutes depending on its complexity. Small blood-tinged discharge may occur after it (about 50 ml).
After a hysteroresectoscopy
The entire visit to the clinic (including the procedure) takes no more than 3 – 3.5 hours. After a hysteroresectoscopy the patient stays in the ward under the supervision of a nurse and a doctor for two hours.
Why Euromed?
At city hospitals a hysteroresectoscopy requires admission for 3-5 days. At our clinic this procedure takes one day or even a couple of hours. The high qualifications of our doctors and nurses provide for absolute safety of the procedure and comfortable stay in our clinic.
It is clear that a hysteroresectoscopy is more effective and less traumatizing than a traditional surgery.
Indications for a hysteroresectoscopy
· Endometrial and cervical polyps
· Fibroids with submucous location of the myomatous node with a diameter of less than 3 cm (it is possible to operate on nodes 3-5 cm in size, but the surgery will be performed in two stages)
· Necessity to remove the remains of the ovum and placenta after childbirth or abortion
· Diagnostics of recurrent miscarriage causes
· Endometrial hyperplasia according to a pelvic ultrasound
· Diagnosing the causes of abnormal uterine bleeding
· Diagnosing of indirect signs of internal endometriosis (adenomyosis)
· Diagnosing of synechiae
· Suspected endometrial cancer.
Contraindications
· Inflammatory diseases of the genital organs
· General diseases (acute diseases or acute stages of chronic diseases)
· Diseases of liver, kidney, lungs, heart (severe condition)
· Desired uterine pregnancy
· Ectopic pregnancy
· Submucous uterine myoma of more than 5 cm in size
· Advanced cervical cancer
· Blood clotting disorders.
Preparation for a hysteroresectoscopy
· It is necessary to have laboratory tests prescribed by the attending doctor and/or instrumental examinations (ultrasound, colposcopy) within 7-10 days prior to the procedure.
· The hormonal preparation is performed according to prescriptions of the doctor.
· If an inflammation occurs in the vaginal opening a week before the procedure, vaginal suppositories may be prescribed for the sanitation of the genital tract.
· We recommend you to bring compression stockings of the 1st compression class to prevent thrombosis and thromboembolism.
Recommendations after the procedure
· Application of a cold compress to abdomen on the first day
· Personal hygiene (shower)
· One should avoid bathing, sauna, sex, supercooling, swimming in open water and physical activities.
How to book an appointment?
1. Online appointment is the fastest and most convenient way. It is available 24 hours a day, 7 days a week. It takes less than 5 minutes to schedule!
2. You can also call us at +7 812 327 03 01 (24/7), and the call-centre specialists will schedule an appointment whenever convenient to you.