Hysteroscopy

16-06-2021
Histeroskopija

Hysteroscopy is a procedure during which the uterine cavity is examined with an instrument called a hysteroscope. A hysteroscope is a special optical instrument that is connected to a light source (to illuminate the inside of the uterus), a camera and a monitor. Due to its small diameter, it allows us a quality view of the uterine cavity and possible changes that are in it.

In most cases, the procedure is performed under short-term intravenous general anesthesia and lasts 10-20 min.

The hysteroscope is used for:

  • Diagnosis of the condition in the uterine cavity (diagnostic hysteroscopy), and the observed changes can often be removed with a hysteroscope (operative hysteroscopy).
  •  In case of infertility (it belongs to the obligatory part of the preparatory procedure before the beginning of the process of in vitro fertilization).
  •  Bleeding
  •  Early stages of uterine mucosa cancer
  •  Fibroids entering the uterine cavity (submucosal fibroids)
  •  Polyps of the uterine mucosa
  •  Barriers (uterine septum)
  •  Intrauterine contraceptive device (IUD)
  •  Scar tissue (synechiae)

Contraindications for performing hysteroscopy:

  • The procedure is not performed if you bleed that day (because the blood can make it difficult to see the uterine cavity).
  •  Before hysteroscopy, you should be sure that you are not pregnant, which means that you will receive advice on contraception (application of measures to prevent conception) from the first day of the cycle in which the procedure is planned. If there is a suspicion that you are pregnant, it is necessary to do a pregnancy test.

 

After adequate preoperative preparation, which includes examination by an internist, anesthesiologist and laboratory analysis, the intervention is performed. During the intervention, a small amount of uterine mucosa can be taken for histopathological analysis (this is called an endometrial biopsy). If a polyp or growth is seen in the uterine cavity, these changes can be removed with special instruments.

Postoperative course:

You may have abdominal pain (similar to menstrual cramps). This is to be expected and if necessary, you will receive painkillers.

After the intervention, scanty bleeding may occur, especially if the polyp has been removed or an endometrial biopsy has been performed.

Scarce bleeding after the intervention is expected and can last for 7 to 10 days. If the bleeding is heavy (soak the pad every 1-2 hours) or if there are blood clots, contact your doctor. Increased vaginal discharge may be present for two weeks after the intervention. To reduce the risk of infection, use pads instead of tampons in the hysteroscopy cycle.

You can take a shower the same day, while the baths can be used from the next day.

If weakness or dizziness is present, we advise you to perform these activities while someone else is in the house.

Avoid sexual intercourse 5-7 days after the intervention, in order to reduce the risk of infection.

Symptoms that indicate that you should see a doctor after the intervention:

  • Vaginal discharge with an unpleasant odor
  • Prolonged heavy bleeding
  • Stronger abdominal pain
  • Elevated body temperature (over 38 degrees C).
  • Expressed feeling of weakness, fatigue

Hysteroscopy allows the uterine change to be seen and then completely removed. Similarly, if an endometrial biopsy is required, a “targeted biopsy” of the change that the doctor sees directly can be done during hysteroscopy, giving a better result.

Due to all the above, hystercopy is the method of choice (gold standard) in modern gynecology for the diagnosis and treatment of changes in the uterine cavity.

Interventions are performed by Dr. Igor Pilić.