Hysteroscopy | Johns Hopkins Medicine

What is a hysteroscopy?

Hysteroscopy is the exam of the inside of the cervix and uterus using a thin, lighted, flexible tube called a hysteroscope. Your healthcare provider inserts the device through the vagina.

Your provider may use hysteroscopy to:

• Take a tissue sample (biopsy)
• Remove polyps or fibroid tumors
• Prevent bleeding by destroying tissue using electric current, freezing, heat, or chemicals

Your provider may do hysteroscopy in his or her office or in an outpatient center. You may have local or no anesthesia. Procedures that are more complex may be done in the operating room under local, regional, or general anesthesia.

Why might I need a hysteroscopy?

You may need a hysteroscopy for:

• Abnormal Pap test results
• Abnormal uterine bleeding
• Bleeding after menopause
• Diagnose the cause of infertility or repeated miscarriages
• Examine and remove uterine scarring, polyps, or fibroids
• Find and remove displaced IUDs (intrauterine devices)
• Place small birth control inserts into the fallopian tubes
• Removal of a small tissue sample (biopsy)
• Removal of endometrial lining

You can’t have a hysteroscopy if you are pregnant.

Your healthcare provider may have other reasons to do a hysteroscopy.

What are the risks for a hysteroscopy?

Some possible complications of hysteroscopy may include:

• Infection
• Bleeding
• Pelvic inflammatory disease
• Tearing of the uterus (rare) or damage to the cervix
• Complications from fluid or gas used to expand the uterus

You may have slight vaginal bleeding and cramps for a day or two after the procedure.

There may be other risks based on your condition. Be sure to discuss any concerns with your healthcare provider before the procedure.

Certain things may interfere with a hysteroscopy. These include:

• Pelvic inflammatory disease
• Vaginal discharge
• Inflamed cervix
• Bloated bladder

How do I get ready for a hysteroscopy?

• Your healthcare provider will explain the procedure and you can ask questions.
• You may be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if something is not clear.
• Your provider may do a physical exam to be sure you are in good health. You may have blood tests or other diagnostic tests.
• You may be asked to fast before the procedure if you are to get local or general anesthesia. You may have local or regional anesthesia or no anesthesia. This depends on what other procedures your provider will do at the same time.
• If you are pregnant or think you could be, tell your healthcare provider.
• Tell your healthcare provider if you are sensitive to or are allergic to any medicines, iodine, latex, tape, or anesthesia.
• Tell your healthcare provider of all medicines (prescription and over-the-counter) and herbal supplements that you are taking.
• Tell your healthcare provider if you have a history of bleeding disorders or if you are taking any blood-thinning medicines (anticoagulants), aspirin, or other medicines that affect blood clotting. You may be told to stop these medicines before the procedure.
• You may get a sedative before the procedure to help you relax. If so, you will need someone to drive you home.
• You will be scheduled to have the procedure after your period and before ovulation. This lets your provider get the best view of the uterus. It also avoids harm to a new pregnancy.
• Dress in clothes that give access to the area or that are easily removed.
• Follow any other instructions your provider gives you to get ready.

What happens during a hysteroscopy?

Your provider may do a hysteroscopy an outpatient basis or during a hospital stay. Procedures may vary based on your condition and your healthcare provider’s practices.

Generally, a hysteroscopy follows this process:

1. You will remove your clothing and put on a hospital gown.
2. You will empty your bladder before the procedure.
3. An intravenous (IV) line may be put in your arm or hand.
4. You will be positioned on an operating table, lying on your back with your feet in stirrups.
5. The vaginal area will be cleaned with an antiseptic solution.
6. Your provider may dilate your cervix before inserting the hysteroscope.
7. Your provider will insert the hysteroscope into the vagina, through the cervix, and into the uterus.
8. Your provider will inject a liquid or gas through the hysteroscope to expand the uterus for a better view.
9. Your provider will examine the wall of the uterus for problems. He or she may take photographs or videos and take tissue samples (biopsies).
10. If you need a procedure, such as fibroid removal, your provider will insert tools through the hysteroscope.
11. For more complex procedures, your provider may insert another type of scope through the belly (laparoscope) to view the outside of the uterus at the same time.
12. When the procedure is done, your provider will remove the hysteroscope.

What happens after a hysteroscopy?

Your recovery will vary based on the type of anesthesia you have. If your provider used general anesthesia or a sedative, he or she will track your blood pressure, pulse, and breathing until they are stable and you are alert. When stable, you will be discharged to your home. Hysteroscopy is most often done on an outpatient basis.

Otherwise, you won’t need any special care after a hysteroscopy.

You may have cramping and vaginal bleeding for a day or two after the procedure. Report fever, severe abdominal pain, or heavy vaginal bleeding or discharge.

You may have gas in the digestive tract and pains from the gas given during the procedure. This can last for about 24 hours. You may also feel pain in your upper belly and shoulder.

Take a pain reliever for soreness as advised by your healthcare provider. Aspirin or certain other pain medicines may increase the chance of bleeding. Be sure to take only recommended medicines.

Don’t douche or have sex for 2 weeks after the procedure, or as advised by your healthcare provider.

You can go back to normal activity and diet unless your healthcare provider tells you otherwise.

Your healthcare provider may give you other instructions based on your situation.

Next steps

Before you agree to the test or the procedure make sure you know:

• The name of the test or procedure
• The reason you are having the test or procedure
• What results to expect and what they mean
• The risks and benefits of the test or procedure
• What the possible side effects or complications are
• When and where you are to have the test or procedure
• Who will do the test or procedure and what that person’s qualifications are
• What would happen if you did not have the test or procedure
• Any alternative tests or procedures to think about
• When and how will you get the results
• Who to call after the test or procedure if you have questions or problems
• How much will you have to pay for the test or procedure

Purpose, Procedure, Risks, and Recovery

If you’re having heavy menstrual periods and severe cramping, or your doctor needs to know more about your reproductive health, they may recommend you have a hysteroscopy. The procedure can give them an up-close look at your cervix and uterus and help them learn what’s causing problems.

Why Would I Need the Procedure?

During a hysteroscopy, your doctor inserts a hysteroscope — a thin tube with light on the end — into your vagina. They’ll be able to see into your cervix and inside your uterus. If they find anything abnormal, they can take a sample for later testing.

Among the most common reasons for a hysteroscopy are periods that are longer or heavier than normal, or bleeding between periods.

You might also need the procedure in these situations:

• Your Pap test results are abnormal.
• You’ve been bleeding after menopause.
• There are fibroids, polyps, or scarring on your uterus.
• You’ve had more than one miscarriage or problems getting pregnant.
• Your doctor needs a small tissue sample (biopsy) of the lining of your uterus.
• You’re having a sterilization procedure as a permanent form of birth control.
• Your IUD has come out of place.

How is It Done?

A hysteroscopy can either be in a hospital or at your doctor’s office. You can be either awake or under general anesthesia during the procedure. If you’re awake, your doctor will give you medicine to help you relax. They’ll also use medication or tools called dilators to help open your cervix.

Your doctor will likely use a tool called a speculum to keep your vagina open. If you’ve ever had a Pap smear, your doctor has probably used one during that procedure, too.

Next, they’ll gently insert the hysteroscope through the cervix into your uterus and push gas or a liquid-like saline through the hysteroscope into your uterus to expand it. This will give them a clear view of its lining and the opening of your fallopian tubes through the hysteroscope.

After the Procedure

You’ll probably be able to go home soon after. But if you received local or general anesthetic, you’ll need someone to drive you.

For a few days after the procedure, you may have some mild cramping or bleeding. You might also have gas that can last for about 24 hours. Your doctor may give you medicine to help with any pain.

You’ll have to avoid sex for at least 2 weeks after the procedure. Before you’re sent home, your doctor will tell you more about how to take care of yourself after surgery.

What Are the Risks?

Just like any medical procedure, you could have some complications from a hysteroscopy, including:

• Problems from the anesthesia
• Infection
• Tearing or damage to your cervix, though this is rare
• Problems with gas or fluid from the uterus
• Damage to nearby organs like the bladder, bowel, or ovaries
• Pelvic inflammatory disease

If you experience symptoms like a fever, severe abdominal pain, or heavy bleeding after the procedure, call your doctor immediately or go to the emergency room.

Hysteroscopy – Advanced Gynecology

Hysteroscopy is a procedure that provides a way for the physician to look inside the uterus. A hysteroscope is a thin tube with a light and camera at the end. This scope is inserted into the cervix and uterus through the vagina. A doctor will use the hysteroscope to look for anything abnormal and even take samples from the uterine wall to test for factors that will help diagnose or treat a uterine problem. Hysteroscopy is a minor, outpatient surgery which can be performed with local, regional, or general anesthesia. Sometimes no anesthesia is needed. There is little to no risk involved with this procedure for most women.

There are two kinds of hysteroscopy: diagnostic and operative. Diagnostic hysteroscopy is commonly performed on women who are experiencing heavy menstrual periods and severe cramping; or, it may be ordered if your doctor needs to know more about your reproductive health. Operative hysteroscopy can be used to correct various uterine conditions.

Who Is A Candidate for Hysteroscopy?

Common reasons for the need for a hysteroscopy are periods that are longer or heavier than usual or bleeding between periods.

You might also need the procedure in these situations:

•     Abnormal Pap test results
•     Bleeding or spotting after menopause.
•     Uterine fibroids, polyps, or uterine scarring
•     More than one miscarriage
•     Problems getting pregnant
•     Sterilization
•     If a tissue biopsy of the uterus is needed
•     To replace a dislodged IUD

Hysteroscopy Procedure Explained

A hysteroscopy is an outpatient surgery that is done under either local or general anesthesia. Most hysteroscopies also require medication used to dilate the cervix as well. During the procedure, the doctor will use a speculum inserted into the vagina to keep it open. Next, your doctor will gently insert the hysteroscope through the cervix into the uterus. Saline or gas will then be pushed through the hysteroscope into the uterus to expand the walls so that your doctor will have a clear view of the uterine lining and the opening of the fallopian tubes. If surgery or biopsies are required, small instruments are inserted into the uterus through the hysteroscope.

While a hysteroscopy is used to see the inside of the uterus and the opening of the fallopian tubes, sometimes your doctor will also want to view the outside of these organs. This is done through a procedure called laparoscopy, in which a laparoscope is used at the same time to view the outside of the uterus. In laparoscopy, a doctor will insert an endoscope (a thin tube attached with a fiber optic camera at the end) into your abdomen through a small incision made through or below the navel. Laparoscopy allows your doctor to view the outside of the uterus, ovaries and fallopian tubes.

Operative hysteroscopy is used to correct abnormalities that were detected during a diagnostic hysteroscopy. Diagnostic and operative hysteroscopies can be performed at the same time. During operative hysteroscopy, small instruments used to correct the condition are inserted through the hysteroscope. Hysteroscopy can be used to remove uterine polyps and fibroids, locate and remove bands of uterine scar tissue called adhesions, can determine whether a septum (a malformation of the uterus formed at birth) is present, and can help identify the cause of abnormal bleeding and menstrual flow.

Just like any medical procedure, some complications may arise from a hysteroscopy, including:

• Complications from the anesthesia
• Infection
• Tearing or damage to your cervix (though this is rare)
• Issues as a result of the gas or fluid used to expand the uterus
• Damage to nearby organs like the bladder, bowel, or ovaries
• Pelvic inflammatory disease

Hysteroscopy is a reasonably safe procedure and problems arise in less than one percent of cases. If you experience symptoms like a fever, severe abdominal pain, or heavy bleeding after the procedure, call your doctor immediately or go to the emergency room.

How Advanced Gynecology Can Help: Is Hysteroscopy the Right Diagnostic Tool for You?

If you are suffering from uterine pain and heavy or unusual menstrual bleeding, Advanced Gynecology is here for you.

Our board-certified team of women’s health experts are ready to help you with diagnostic care and a range of treatment options.

We will counsel you about the best options for you and your health.

Correlation of laparoscopic and hysteroscopic 30° scope camera navigation skills on box trainers | Gynecological Surgery

Training programs for endoscopic skills vary throughout institutions worldwide. Furthermore, every specialty has its own training models for specific procedures. As described in the introduction, the basic skills required for different endoscopic procedures are fairly similar and endoscopy training outside the operating room could be standardized [7, 12]. This led to the idea that certain general endoscopic skills, such as 30° camera navigation, might be trained on a uniform training model. This study investigated whether a correlation exists between training of camera navigation skills with a 30° optic in hysteroscopy and laparoscopy by exploring whether 30° camera navigation training in hysteroscopy provides a certain expertise in laparoscopic camera navigation.

Firstly, the results show that regardless of training on the HYSTT or the LASTT model, 30° optic skills are easily learned when a standardized explanation and specific exercises for camera navigation are provided. Medical students were able to strongly improve their performance within five repetitions on the LASTT model, reaching a time score of 110 s. This was faster than expected by the results of Molinas et al., where novices (students and inexperienced gynecologists) needed approximately 10 repetitions to reach a procedure time of 110 s [12]. However, in both studies, certain variability between subjects is observed. In the current study, it is not investigated whether this fast performance is lasting.

Secondly, concerning a possible correlation for camera navigation, a similar performance of both groups during the LASTT post-test was found (analysis 1). This might indicate that previous hysteroscopy training does provide built up of expertise in laparoscopic camera navigation. However, after apprehending the fast learning curve in this study, a similar performance after five repetitions can be expected regardless of previous training. And even though group A (with previous HYSTT training) did perform slightly better than group B (without previous HYSTT training) during their first LASTT exercise, this finding was not significant (analysis 2). In addition, the learning curves of both groups were fairly similar when they started performing exercises on the LASTT. Therefore, according to these results, the existence of a pronounced correlation between training of 30° camera navigation skills in hysteroscopy and laparoscopy seems implausible.

A possible explanation for not finding a correlation could be that even though the principles of angled optics are easy to learn when time, attention, and exercises are provided, the abdominal and uterine cavity are too different regarding space and shape. In the uterus and in the corresponding HYSTT model, camera navigation takes place within a small and narrow cavity (a specific organ), which requires subtle movements of the scope combined with extensive angled optic use. In the abdomen and in the corresponding LASTT model, a distinctly higher degree of freedom of scope movement is observed. This is due to the wide space after CO² inflation during laparoscopy and the environment within the spacious box trainer, respectively. One has to train how to navigate and to apply the principles of angled optics in each different cavity. Camera navigation in hysteroscopy and laparoscopy should be trained separately to reach adequate levels of expertise for each procedure.

Strong points of the present study are the power analysis performed prior to the study and the randomization process, which was executed effectively. The study was nonblinded, because blinding was not possible due to the distinctly different appearances of the two box trainers. Medical students were included in this study as novices, because of their blank training background which gave all participants the same starting point.

The current study design was not established as a proficiency-based training curriculum, since the aim was to investigate a correlation between skills acquisition in two training environments and not to evaluate the efficacy of a curriculum. The number of repetitions was kept small to ensure that participants were not yet fully proficient at the HYSTT model before training at the LASTT box. We wanted to see if the change of environment would alter the ongoing learning curve in comparison to the group that continuously trained at the LASTT model. One could argue that a proficiency-based study design with a ‘retention test’ performed several weeks to months after the training might provide a better way to investigate our hypothesis, and this presents an area for future research. For clinical use, it should be emphasized that the design of an efficient training curriculum needs to be proficiency-focused to accommodate the ability and development of each individual [16].

One of the factors that might have influenced the current results is the fact that the exercises per model differ in the way they have to be executed. During the HYSTT exercise, the participants had to follow the investigator’s commands, whereas in the LASTT exercise, the visualized sign itself included the next command. Furthermore, time to correctly perform the exercise is the only outcome parameter recorded, and it is recorded by a person. One can imagine that a computerized system as in a virtual reality simulator can offer a more objective scoring and that other factors might affect performance; after all, a faster performance does not automatically mean a better performance. Outcome parameters as the number of errors, path length, camera stability, and number of collisions were not recorded, which is inherent to the design of box trainers. In addition, box trainers in general often lack a realistic display of human anatomy. Even though, box trainers have proven to be simple and relatively cheap models that can effectively train specific psychomotor skills needed for endoscopy [4, 12, 17]. On the other hand, the possibly influencing factors of a box trainer might be overcome by using virtual reality simulators, which objectively record various parameters. The software could provide similar commands for both exercises and record parameters that could display the varying nuances in camera navigation that one has to train when performing both hysteroscopy and laparoscopy. This might provide an area for future research. In addition, it could be an interesting idea for future research to include a test on visuospatial abilities for all participants, in order to retrieve extra information on the training capacity for endoscopic skills.

Hysteroscopy | Patient

Hysteroscopy lets your doctor look inside your womb (uterus). This is done using an instrument called a hysteroscope. The hysteroscope is very slim (about 3 to 5 millimetres in diameter). It’s carefully passed through the vagina and neck of the womb (cervix) and into your uterus. The hysteroscope has a video camera inside which sends pictures to a computer screen. This allows your doctor to check for any abnormalities inside your womb. The hysteroscope also has special channels which allow the doctor to pass various instruments into the uterus. This means that as well as being able to look inside the uterus, the doctor can perform certain procedures, like taking a biopsy or removing a polyp.

A hysteroscopy can either be done under general or with local anaesthetic. If you have a local anaesthetic you will be awake. If you have a general anaesthetic you will be asleep. Some women will not have either a general or a local anaesthetic. Occasionally, a sedative may be used, which won’t put you to sleep but may help you feel more relaxed. You may be advised to take a non-steroidal anti-inflammatory painkiller (for example, ibuprofen) around one hour before your appointment, to help reduce pain immediately after the procedure. If you do not have a general anaesthetic (ie you are awake) you may be asked if you wish to see the pictures coming from the hysteroscope. Some people do not wish to do this but others find it helpful.

Your doctor may use a speculum (the same instrument used in a cervical screening test) so that they can see the neck of your womb. They pass the hysteroscope through your cervix into the uterus. Sometimes the hysteroscope will be passed into your vagina, without having to use a speculum.

Hysteroscopy

By BruceBlaus (Own work) via Wikimedia Commons

The hysteroscope is connected to a camera and a TV monitor, which show the inside of your uterus. Some gas or fluid may be pumped into your uterus to make it swell a little. This makes it easier to see the lining of your uterus. After this, the doctor may take a tiny piece of tissue (biopsy) from your uterus. This will be sent to the laboratory for examination under the microscope. Sometimes small lumps (polyps) are found. It may be possible to remove these during the test. After the procedure is completed the hysteroscope is gently removed.

A hysteroscopy takes between 5-30 minutes.

In some hospitals you may have an ultrasound scan before you have the hysteroscopy. See the separate leaflet called Ultrasound Scan for more details.

Uses

A hysteroscopy may be used to find the cause of various problems such as:

As well as being used to investigate the cause of various problems, it can also be used to:

Before you have the procedure your doctor will talk to you about the test. Your doctor may discuss a number of different treatment options with you. This is because it may be possible to treat the cause of your symptoms immediately, using the hysteroscope. In order to do this you must agree (consent) to the treatment. It is up to you to decide which treatment option is best for you.

Is it painful?

If you are awake you may feel something like period cramps at some stages. A lot of women feel no discomfort, or only minimal discomfort. For other women it is very painful and the procedure has to be stopped. In this case you can come back on a different day and have a general anaesthetic.  Many different things may influence how painful it is. This includes:

• Whether an anaesthetic is used.
• Whether local or general anaesthetic is used and if local, which type of local anaesthetic. (There are a number of options.)
• Whether pain relief is used.
• The size of hysteroscope used (the thinner ones tend to be less painful).
• The type of hysteroscope used (flexible or rigid).
• Whether a speculum is used.
• The reason you are having the test done.
• Whether you have had babies born through your vagina (vaginal delivery) in the past.
• Whether you are past your menopause or not.

When you are asked to give your consent to the procedure, these sorts of issues should be discussed. Ask your doctor or nurse about the options if you are worried about the possibility of pain. It is not possible to safely have a hysteroscopy whilst you are pregnant.

What can I expect after a hysteroscopy?

If you have general anaesthetic, you will need to rest until the effects of the anaesthetic have passed. You will need to arrange for someone to drive you home. You should try to have a friend or relative stay with you for the first 24 hours.

If you have a local anaesthetic, you will usually be able to go home after a short rest. You should feel well enough to walk, travel by bus or train – or to drive home, providing you haven’t been given a sedative.

You may experience some period-like cramps and mild bleeding. The bleeding is usually mild and should settle within seven days. To reduce the risk of infection whilst you are bleeding you should:

• Use sanitary towels rather than tampons.
• Not have vaginal sex for one week after and until you stop bleeding.
• Take it easy for the first one or two days and take painkillers as needed.

Side-effects

The most common side-effects are bleeding and pain. Very rarely it is possible that a small hole may be made in the womb (uterus) by the hysteroscope. If this happens you would need to stay in hospital overnight. It is also possible, although not common, to develop an infection of the uterus as a result of hysteroscopy.

You should contact your doctor if you develop any problems such as:

• A temperature.
• Increased unexplained pain not relieved with painkillers.
• Increased discharge, which is smelly and unpleasant.
• Heavy bleeding.

What should I do to prepare for a hysteroscopy?

Your local hospital should give you guidance on what to do before a hysteroscopy. If you are having a hysteroscopy with local anaesthetic, you will not usually need any special preparation.

If you are having a general anaesthetic you will be asked not to eat or drink for a number of hours before the procedure. Your hospital should give you detailed information on this.

Hysteroscopy – Raleigh-OBGYN

Hysteroscopy is used to diagnose or treat problems in the uterus. This procedure is performed by a doctor with an instrument called a hysteroscope, which is a thin lighted tube that acts as a sort of telescope. It is inserted through the vagina into the uterus. The scope transmits images from inside the body to a screen. Depending on why the procedure is being performed, other instruments may be used along with the hysteroscope. 

Why Hysteroscopy is Done

According to the American College of Obstetricians and Gynecologists (ACOG), the most common reason for a hysteroscopy to be done is to diagnose the cause of abnormal uterine bleeding. Abnormal uterine bleeding includes unusually heavy or long menstrual periods or bleeding between menstrual periods.  

Other reasons a hysteroscopy may be performed:

• Removing non-cancerous fibroids or polyps
• Diagnosing the cause of repeated miscarriage
• Removing adhesions that are the result of an infection or previous surgery
• Finding the location of an intrauterine device (IUD)

What to Expect

At Raleigh OB/GYN Centre, hysteroscopies are performed in-office (change this if needed) by our physicians. The procedure is scheduled for a day that you are not having your menstrual period. 

Before the Procedure

Before the procedure, you may be given medication to help you relax. In some cases, general or local anesthetic may be used to block any potential pain or discomfort. The physician may also use medication to dilate the cervix to help with the procedure.

The Procedure

First, a speculum is inserted into the vagina. If you’ve had Pap tests in the past, then you’ll be familiar with the insertion of a speculum. The hysteroscope is inserted through the speculum and is gently moved through the cervix and into the uterus. A fluid such as saline will be put through the hysteroscope. Sometimes carbon dioxide gas is used instead of fluid. (can edit based on what your office uses) The purpose of the fluid or gas is to expand the uterus so the doctor can see the uterine lining more clearly.

Your physician will examine the uterus with the images provided by the scope. If a biopsy or removal is required, small instruments will be passed through the hysteroscope to complete the procedure. 

Recovery

You will be able to go home the same day as you have the procedure. Usually, you can go home pretty quickly after the hysteroscopy. However, if you had general anesthesia, you’ll need to wait a little longer until it has worn off.

You may experience mild cramping or blood discharge in the days following the procedure. Your provider may prescribe medication to help with discomfort.  If you have heavy bleeding, fever, or chills after a hysteroscopy, call your provider immediately.

Contact Raleigh OB/GYN Centre

The physicians, nurses, and medical staff at Raleigh OB/GYN offer a comprehensive list of gynecological and obstetric services to the women of the Raleigh, NC area. If you have questions or concerns about a health issue that can be diagnosed or treated with a hysteroscopy, call our office at (919) 876-8225 to make an appointment.

Definition of Hysteroscope by Merriam-Webster

hys·​ter·​o·​scope

| \ ˈhi-stə-rō-ˌskōp

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Definition of

hysteroscope

Diagnostic hysteroscopy | Operating room No. 1

Diagnostic hysteroscopy in Operating room No. 1, Aleksandrov

Diagnostic hysteroscopy is a method of examining the uterine cavity and examining the cervical canal using an endoscopic device – a hysteroscope. In Operating Room 1, very thin hysteroscopes up to 5 mm in diameter are used, which makes it possible to diagnose the uterine cavity without dilating the cervical canal and traumatizing the woman.

The range of diagnoses that can be made based on the results of diagnostic hysteroscopy is quite wide.Diagnostic hysteroscopy allows the obstetrician-gynecologist to examine in detail the uterine cavity, assess the condition of the orifices of the fallopian tubes, help establish the presence of pathological formations and visually examine them. Also, the procedure makes it possible to take a tissue sample for examination (biopsy) without trauma. If necessary, the doctor can also take a scraping of the upper layer of the endometrium and the mucous membrane of the cervical canal, this allows you to establish an accurate diagnosis. Diagnostic hysteroscopy for diagnosis is more preferable than separate diagnostic curettage.

The diagnostic hysteroscopy method is also recommended for young nulliparous women who are planning their pregnancy, including when planning IVF. This method is preferable in that the cervix does not expand by a violent method, the doctor passes the cervical canal with a hysteroscope and enters the uterine cavity, respectively, the woman who will carry the child in the future is not threatened with isthmic-cervical insufficiency (premature opening of the cervix).

Indications for diagnostic hysteroscopy

Indications for the need for diagnostic hysteroscopy are:

• identification of the source of bleeding;
• determination of the causes of infertility;
• determination of the reasons for miscarriage of a child;
• determination of the causes of menstrual irregularities;
• assessment of the position of the intrauterine contraceptive;
• as control measures to assess the performed operations on the uterus;
• the need to analyze the effectiveness of hormone therapy.

Diagnostic hysteroscopy allows the doctor to make the following diagnoses:

• Infertility, miscarriage.
• Adhesions in the uterus.
• Synechia.
• Polyps.
• Myomas.
• Adenomyosis.
• Abnormal development of the uterus.
• Endometrial cancer.
• Chronic endometritis
• Structural changes in tissue after injury or intervention.
• Remains of the ovum as a result of medical, surgical termination of pregnancy.
• Remains of placental tissue after delivery.
• Required to study a foreign body.
• Endometrial hyperplasia.

Contraindications to diagnostic hysteroscopy

Contraindications to diagnostic hysteroscopy can be:

• acute inflammatory processes of the small pelvis;
• general malaise of a woman;
• vulvovaginitis;
• systemic cardiovascular diseases;
• endocrine and autoimmune diseases in the stage of decompensation;
• blood clotting disorder;
• taking anticoagulant drugs;
• the presence of genital infections.

Preparation for diagnostic hysteroscopy

To carry out the diagnostic hysteroscopy procedure, you will need to go through a number of preparatory measures that avoid complications, and also increase the information content of the examination.

Preparations for diagnostic hysteroscopy include:

Consultation of an obstetrician-gynecologist

Laboratory diagnostics:

• Clinical blood test
• Blood test for biochemistry
• Blood test for infectious diseases (HIV, syphilis, hepatitis C, B)
• Gynecological smear on flora from the vagina, cervix.
• Cytological examination of scrapings from the cervix and cervical canal.

Ultrasound diagnostics:

Important! Diagnostic hysteroscopy is performed taking into account the patient’s menstrual cycle. It is recommended to carry out the study before the 12th day of the menstrual cycle. After completing the study, you need to take care of the possibility of rest and minimal physical activity.

Stages of diagnostic hysteroscopy

• Anesthesia under the supervision of an anesthesiologist.
• Treatment of genitals with special antiseptic agents.
• The gynecologist fixes the cervix with special forceps, which in turn allows the uterus to remain in a static position throughout the procedure.
• Through the cervical canal, the doctor introduces a hysteroscope and proceeds to diagnose the inner surface of the uterus, a thorough analysis of the tissues, their structure and shape is carried out. In this case, an image from the hysteroscope is displayed on the monitor, which the doctor sees.
• If necessary, the doctor can carry out medical or minimally invasive surgical procedures.

Benefits of Diagnostic Hysteroscopy

Diagnostic hysteroscopy:

• has a high information content;
• has low invasiveness;
• the procedure has a short rehabilitation period;
• does not require a long stay in a day hospital.
• allows biopsy and curettage.
• allows you to simultaneously remove a foreign body, polyp, fibroids in one procedure.

Results of diagnostic hysteroscopy

The results of the obstetrician-gynecologist draw conclusions about the functional state, the presence or absence of pathology.

At the end of the study, the obstetrician-gynecologist issues a detailed and informative conclusion on the diagnosis, which allows you to draw up a detailed scheme for further treatment.

Advantages of Diagnostic Hysteroscopy in Operating Room No. 1

You can make a diagnostic hysteroscopy in the Operating Room No. 1.Alexandrov under the supervision of experienced obstetricians and gynecologists.

We are distinguished by:

• High qualifications and experience of obstetricians and gynecologists.
• High-precision research equipment.
• Individual approach – based on the results of diagnostics, our specialists develop treatment tactics and a rehabilitation program for each patient.

Diagnostic hysteroscopy in Operating room No. 1 price.

Taking care of you and your health, medical center “Paracelsus”.

Hysteroscopy

Hysteroscopy is the only method that allows you to visually examine the uterine cavity, which makes it possible to immediately establish the nature of intrauterine pathology and allows you to immediately proceed to intrauterine surgical interventions.

A new direction in gynecology is outpatient or so-called office hysteroscopy, which is the “gold” standard for the examination and treatment of women with intrauterine pathology at the outpatient stage.

Office hysteroscopy is considered a low-traumatic medical intervention, is easily tolerated by patients, reducing the patient’s stay in a medical facility and reducing the cost of treatment.

This method serves both for the diagnosis and for the treatment of various gynecological diseases.

Only visual control makes it possible to remove from the uterus the entire pathologically altered mucous membrane, which is extremely important, since the remaining tissue can subsequently provoke a relapse of the disease.

Office hysteroscopy is of great help in diagnosing submucous nodes, intrauterine synechiae, endometrial polyps, malformations of the uterus and foreign bodies in its cavity, infertility and miscarriage.

The office (or outpatient) hysteroscope, which is available at the MedSef clinic, consists of a modern optical system with a very thin outer diameter, which allows you to perform this procedure in a comfortable environment for patients, without the use of intravenous anesthesia.It is also equipped with a working channel through which an experienced gynecologist can remove small polyps, destroy fine synechiae or take an endometrial biopsy to diagnose chronic endometritis in infertility.

Using the special DILAPAN sticks, the hysteroscopy procedure can be performed without anesthetic aid, vaginal speculum or bullet forceps. This hygroscopic dilator gradually increases in volume while absorbing fluid, gradually expanding the cervix, which makes it possible to conduct hysteroscopy in a comfortable environment for patients, without traumatizing the cervix with mechanical dilators, which is important for nulliparous women.

Indications for hysteroscopy:

1. Menstrual irregularities

2. Postmenopausal bleeding

3. Suspected endometrial pathology (polyps, endometrial hyperplasia, endometrial cancer)

4. Suspicion of adenomyosis, submucous myomatous node, synechiae in the uterine cavity

5. Suspicion of malformations of the uterus

6.Removal of a foreign body (intrauterine device, remnants of the ovum)

7. Infertility

8. Miscarriage

9. Preparation for IVF

10. Control study after surgery on the uterus

11. Sterilization ESSURE

Before hysteroscopy, the patient should be excluded from STIs, various severe somatic diseases.Blood should be donated for Syphilis, HIV, hepatitis B, hepatitis C and syphilis, a general blood and urine test, a general smear and a smear for chlamydia. The required day of the cycle for the study is determined by the attending physician, depending on the goals set.

The article was prepared by a gynecologist-endocrinologist, an ultrasound doctor at the MedSef clinic Dibirova Khadizhat Magomedovna

Diagnostic hysteroscopy of the uterus: procedure, preparation, how it goes

Hysteroscopy of the uterus at the Genom-Don clinic is a method of visual examination of the inner uterine surface using a special optical system.In this case, an enlarged image of the investigated areas is displayed on the screen for detailed examination. Hysteroscopy is included in the complex of examinations before IVF.

The hysteroscope is a slim instrument equipped with an optical system. The part of the device, which is inserted into the uterus, has a flexible structure that is able to “adjust” to the physiological shape of the uterus. In some cases, the use of a rigid hysteroscope is justified. Hysteroscopy is a minimally invasive (minimally invasive) procedure.

Diagnostic examination of the uterine cavity using a hysteroscope allows you to determine the general condition of the organ and mucous membrane. In this case, the following are assessed: the relief of the mucous membrane of the uterine cavity, the shape and size of the uterus, the vascular pattern of the endometrium, its color and thickness, the presence of neoplasms. In the process of diagnostic hysteroscopy, it is possible to conduct an endometrial biopsy – taking a biopsy for histological examination.

Diagnostic hysteroscopy is also called office.As a rule, the study is carried out in the first half of the menstrual cycle. The procedure takes 5 to 20 minutes. If removal of neoplasms (endometrial polyps, submucous myomatous nodes), dissection of intrauterine synechiae or other manipulations is indicated, then the procedure will be called “hysteroresectoscopy”.

Hysteroscopy is prescribed by a gynecologist for infertility, as well as if there are suspicions of the following pathologies:
– tumor process in the uterus;
– uterine fibroids;
– endometrial polyps;
– malformations of the uterus;

– chronic endometritis;

– the presence of an adhesive process in the uterus.

Also diagnostic hysteroscopy is indicated:
– if necessary, remove the intrauterine contraceptive;
– if there are remnants of the ovum or placental tissue in the uterine cavity;
– before the IVF procedure.

Hysteroscopy in the Moscow Region – registration in diagnostic centers on Meds.ru

The multidisciplinary clinic of the MedCenterService network in Lyubertsy provides patients with a huge selection of diagnostic, therapeutic and preventive measures in the field of gynecology, neurology, cardiology, otolaryngology, therapy, ophthalmology, surgery and other specialties.The clinic employs highly qualified doctors, experienced specialists with many years of experience.

Make an appointment

To make an appointment at the clinic, call: +7 (499) 685-18-13

Polyclinic.ru in Zelenograd belongs to the network of clinics of the same name and specializes in providing medical care in the field of traumatology, gynecology, pediatrics, urology, surgery. The center employs doctors with the highest category, who have experience in foreign practices. In their work, specialists use advanced technologies and high-quality materials. The offices are equipped with modern equipment. There is a round-the-clock emergency room. It is possible to call a doctor at home.

Make an appointment

To make an appointment at the clinic, call: +7 (499) 685-18-13

Network of clinics ABC-Medicine

The ABC-Medicine Clinic in Krasnogorsk accepts patients with diseases in the field of allergology, dermatology, gynecology, urology, psychotherapy, surgery, oncology, ophthalmology, gastroenterology, neurology, dentistry, etc.For convenience and economy, it is possible to purchase treatment programs.

Make an appointment

To enroll in any branch of the clinic, call: +7 (499) 685-18-13

YOURMED network of clinics, a network of medical centers

Make an appointment

To enroll in any branch of the clinic, call: +7 (499) 685-18-13

It is possible to receive a wide range of medical services at affordable prices in the multidisciplinary clinic “City Medical Center” inMytischi. The main area of ​​work is the treatment of a wide range of diseases of various origins and profiles.

Make an appointment

To make an appointment at the clinic, call: +7 (499) 685-18-13

Clinic network Med-Garant

Medical Center MedGarant in the city of Balashikha provides a wide range of medical services in various areas.The main advantage of the MedGarant clinic is the use of modern methods and technologies, an experienced team, comfortable conditions for patients’ stay and affordable prices.

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To enroll in any branch of the clinic, call: +7 (499) 685-18-13

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PharmMed multidisciplinary medical center offers patients a full range of services for diagnosis, therapeutic treatment and prevention of various diseases.

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To make an appointment at the clinic, call: +7 (499) 685-18-13

Hysteroscopy – latest reviews

My sister had an intrauterine device for 5 years.In graying month there was a temperature, pain in the lower abdomen. I went to a gynecologist, did a hysteroscopy, it turned out to be inflammation, possibly associated with the penetration of an infection. The doctor suggested removing the coil and treating it. Everyone did just that, their health improved significantly.

–

Valya

,
August 27, 2016

After the abortion, I had a fever, constant aching pains in the lower abdomen, and discharge from the genital tract appeared.I took folk remedies, but there was no effect. I had to go to the hospital, the gynecologist prescribed a hysteroscopy. After the examination, the doctor said that the abortion was of poor quality, therefore, inflammation developed. Now I am being treated, the pain has become less, and there is no more discharge.

–

Natalia

,
June 2, 2016

Hysteroscopy of the uterus in the AMC clinic – Barnaul

eleven.11.2013

Hysteroscopy is a gynecological examination that allows you to examine the condition of the inner surface of the walls of the uterus. To carry out the diagnostic procedure, a hysteroscope is used – an optical system, the design of which consists of a small-diameter direct-flow tube and a high-power telescope, due to which it is possible to obtain excellent image quality.

This procedure is highly trusted by doctors, because it makes it possible to obtain accurate results and determine the correct diagnosis based on them, which is the key to successful treatment.Hysteroscopy allows you to detect intrauterine adhesions and septa, polyps, uterine fibroids, which can be impossible to detect during a gynecological examination or ultrasound.

In addition, the procedure allows you to immediately take a sample of the detected neoplasm for histological examination in order to shorten the time of diagnosis as much as possible and begin treatment without delay.

Hysteroscopy is performed on specific days of the menstrual cycle:

• For general diagnostics, the study is prescribed on the 6-10th day of the menstrual cycle.
• To determine the causes of infertility, the study is carried out in the middle of the second phase of the menstrual cycle – 20-24 days.
• In case of suspicion of endometrial hyperplasia, against the background of hormonal contraception, as well as in emergency cases (with acyclic bleeding, suspected malignant neoplasms of the cervical canal and uterine cavity) and the procedure is performed regardless of the day of the cycle.

In addition to intrauterine examinations, some surgical interventions are performed using a hysteroscope:

• removal of polyps and fibroids,
• dissection of intrauterine septa and adhesions,
• removal of a layer of overgrown endometrium (with endometrial hyperplasia).

At the same time, an important advantage of the method is the quick recovery period of the patient. The hospital stay depends on the volume of the intervention and does not exceed 2 days.

Key benefits of hysteroscopy

The use of an optical probe provides the following advantages:

• Thorough assessment of tissue condition and detection of neoplasms;
• Operational removal of a tissue particle for histological examination;
• the possibility of targeted removal of polyps and nodes, as well as curettage of the uterine cavity and cervical canal;
• high level of safety – the risk of injury to the cervical canal or uterus tends to zero;
• The procedure can be performed under local or general anesthesia.

Scope and contraindications

Today, more than a dozen diseases are known for which hysteroscopy is recommended for both diagnostic and therapeutic purposes. Among them:

• suspected endometriosis;
• uterine fibroids;
• malformations and malformations of the uterus;

90,019 menstrual irregularities;

• infertility;
• pathological changes detected by ultrasound and requiring clarification;
• difficulties encountered in removing the intrauterine device;
• control of the effectiveness of gynecological treatment;
• the need to identify and remove adhesions in the uterine cavity.

Contraindications for hysteroscopy:

• advanced cervical cancer;
• inflammation of the genital organs;
• pregnancy;
• severe uterine bleeding;
• acute infectious diseases;
• blood clotting disorder;
• serious conditions – heart or pulmonary failure, impaired consciousness.

Direct proof

According to statistics, a diagnosis made by a doctor, but not yet verified by hysteroscopy, is not confirmed in almost a third of patients! While the diagnosis made by this modern examination method is confirmed by other methods.In addition, almost half of the examined patients also have new problems, which makes it possible to start treatment of diseases at the earliest stages.

Hysteroscopy

Hysteroscopy is a minimally invasive procedure that involves examining the uterine cavity using an ultra-thin probe – a hysteroscope. This is the most informative instrumental method for diagnosing the state of the endometrium and the uterine cavity.

The method significantly expands the possibilities of diagnosing intrauterine pathology, helps to choose a treatment method, makes it possible to monitor the effectiveness of treatment and perform surgical manipulations.

The procedure allows you to perform targeted biopsy of the endometrium, thereby avoiding curettage of the cavity, which is a traumatic procedure. Under the control of a hysteroscope, it is possible to separate the intrauterine adhesions that interfere with the onset of pregnancy, and even remove the uterine myoma, which grows into the cavity.

In LDK “Medgard” two types of hysteroscopy are used: diagnostic, which helps to make a diagnosis, and surgical, that is, therapeutic.

The procedure is performed under short-term intravenous anesthesia. At the beginning of the procedure, anesthesia is carried out in the cervical region to facilitate its opening and for the purpose of postoperative pain relief. Then a small amount of sterile glucose solution is fed through the cervical canal, after which a hysteroscope is inserted into the uterine cavity in the same way, which transmits the image to the monitor screen.

After examining the uterine cavity and accurately determining the location of the pathology, a manipulator is inserted through a special channel of the hysteroscope and the pathological focus is removed.At the same time, coagulation is performed – stopping bleeding from damaged vessels using a laser.

Hysteroscopy is an organ-preserving procedure, which is very important for patients of childbearing age. Doctors of LDK “Medgard” carry out hysteroscopy professionally and as carefully as possible.

Preparation for hysteroscopy is the same as before diagnostic curettage of the uterine cavity: clinical blood and urine tests, bacterioscopy of a vaginal smear are performed, Wasserman’s reaction, blood group and Rh affiliation are determined.

Hysteroscopy | ldc-semia

Diagnostic video hysteroscopy using equipment Karl Storz.

An advanced development for the outpatient diagnosis of intrauterine pathologies is the Bettochi hysteroscope from Karl Storz. It allows for hysteroscopy in a polyclinic setting and for minimally invasive surgical interventions thanks to the 5 Fr.

The use of endoscopic equipment in gynecology and other branches of medicine has increased the efficiency of treatment and the quality of diagnostic studies.Hysteroscopy is a medical and diagnostic procedure designed to visually examine the uterine cavity using a special optical instrument called a hysteroscope.

What is this procedure and what is it like

Translated from Latin, the word “hystero” means the uterus, and “scopy” means to examine, look. Therefore, literally translated, this is an examination of the uterus. Hysteroscopy is a method of visual examination of the uterine cavity using special optical equipment.

What is hisstroscopy:

1. Diagnostic. A woman is simply examined by the uterine cavity to confirm or exclude the alleged diagnosis (with fibroids, etc.).

2. Surgical. During this procedure, a specialist performs a number of surgical interventions, for example, cauterizing a bleeding vessel or removing a polyp.

3. Control. It is carried out after surgical or conservative treatment to monitor its effectiveness and the absence of relapses.

Due to the fact that the possibilities of medicine are constantly growing and new types of devices appear, several more types of hysteroscopy are distinguished. So, with panoramic hysteroscopy, you can examine the entire uterine cavity under a small magnification. And microhysteroscopy makes it possible to study the structure of the uterine mucosa at the cell level and give an opinion on the presence of cellular pathology right during the procedure.

Hysteroscopy can be planned or performed as an emergency.It is prescribed as an independent study or in combination with laparoscopy. It is done before, after, or during surgery.

The main condition for hysteroscopy is the stretching of the uterine cavity with gas or liquid in order to examine in detail all the walls of the uterus, therefore it is also subdivided into gas and liquid.

Indications for appointment

In what cases experts recommend this procedure:

1. With uterine fibroids.

2. Disorders of the menstrual rhythm.

3. Uterine bleeding.

4. Endometrial hyperplasia and polyps.

5. Monitoring hormonal or surgical treatment of this area.

6. Infertility.

7. If a foreign body, neoplasm, adhesion or malformations of the uterus are suspected, etc.

Preparation for examination

• OGK fluorography or X-ray;

• conclusion of the therapist and ECG;

• analysis for HIV, syphilis and hepatitis;

• vaginal swab;

• analysis of blood, urine and blood clotting indices.

Preparation for hysteroscopy may differ in a specific medical institution, as well as depending on the intended diagnosis and the volume of surgery.

How do uterine hysteroscopy and when

The time to complete the procedure depends on the indications and the proposed diagnosis. It is urgently carried out at any time and on any day of the cycle. With fibroids and suspected endometriosis, the study is recommended to be performed in the first phase of the menstrual cycle.And in case of infertility or structural disorders of the endometrium (polyps, hyperplasia), on the contrary, it is carried out in the second phase of the cycle.

Technique of the procedure

The woman is in the gynecological chair in the usual position. The anesthesiologist introduces the patient into anesthesia, and the surgeon treats the external genitals and vagina with antiseptic solutions.

After they begin to expand the cervical canal with the help of special dilators, in order to introduce the device into the uterine cavity.

Important! If anesthesia is contraindicated for the patient for some reason, then the procedure is also performed under local anesthesia.