What is a hysteroscopy. How is a hysteroscopy performed. What conditions can be diagnosed or treated with hysteroscopy. What are the risks and benefits of hysteroscopy. How to prepare for a hysteroscopy procedure. What happens during and after a hysteroscopy. How long does recovery from a hysteroscopy take.

Understanding Hysteroscopy: A Window into Uterine Health

Hysteroscopy is a medical procedure that allows doctors to examine the inside of the uterus using a thin, telescope-like device called a hysteroscope. This minimally invasive technique provides valuable insights into uterine health and can be used for both diagnostic and therapeutic purposes.

What is a hysteroscope?

A hysteroscope is a slender instrument equipped with a light source and a camera. It transmits high-resolution images of the uterine cavity onto a screen, enabling healthcare providers to visualize and assess the uterine lining in real-time.

When is hysteroscopy recommended?

Healthcare providers may suggest a hysteroscopy for various reasons, including:

• Investigating abnormal uterine bleeding
• Diagnosing the cause of infertility or recurrent miscarriages
• Removing uterine fibroids, polyps, or adhesions
• Locating and removing displaced intrauterine devices (IUDs)
• Performing sterilization procedures
• Evaluating uterine abnormalities detected on other imaging tests

The Hysteroscopy Procedure: What to Expect

Understanding the hysteroscopy process can help alleviate anxiety and ensure proper preparation. Here’s a step-by-step breakdown of what typically occurs during a hysteroscopy:

1. Positioning: The patient lies on an examination table with their legs in supports, similar to a gynecological exam.
2. Insertion: The doctor gently inserts the hysteroscope through the vagina and cervix into the uterus.
3. Uterine distension: A fluid or gas is introduced to expand the uterine cavity, providing a clearer view.
4. Examination: The doctor examines the uterine lining, looking for any abnormalities or areas of concern.
5. Treatment: If necessary, small surgical instruments can be passed through the hysteroscope to perform procedures such as biopsy or polyp removal.
6. Completion: The hysteroscope is removed, and the procedure is concluded.

Is hysteroscopy painful?

Many women experience minimal discomfort during hysteroscopy, especially when performed without anesthesia. Some may feel mild cramping or pressure. Taking over-the-counter pain relievers before the procedure can help manage any discomfort.

Preparing for Your Hysteroscopy: Essential Steps

Proper preparation can enhance the success of your hysteroscopy and minimize potential complications. Here are some key steps to follow:

• Schedule the procedure for the week after your menstrual period, when the uterine lining is thinnest.
• Inform your doctor about any medications, supplements, or allergies you have.
• Discuss the need for fasting or any dietary restrictions prior to the procedure.
• Arrange for someone to drive you home if you’ll be receiving sedation or general anesthesia.
• Wear comfortable, loose-fitting clothing on the day of the procedure.

Are there any pre-procedure tests required?

Your healthcare provider may order certain tests before your hysteroscopy, such as:

• Blood tests to check for anemia or infection
• Pregnancy test to ensure you’re not pregnant
• Cervical cancer screening if you’re due for one
• Electrocardiogram (ECG) or other cardiac tests if you have heart-related concerns

Diagnostic vs. Operative Hysteroscopy: Understanding the Differences

Hysteroscopy procedures can be broadly categorized into two types: diagnostic and operative. Each serves a distinct purpose in women’s health care.

Diagnostic Hysteroscopy

Diagnostic hysteroscopy is primarily used to examine the uterine cavity and identify potential abnormalities. This type of procedure is typically shorter and may not require anesthesia. Common reasons for diagnostic hysteroscopy include:

• Investigating abnormal uterine bleeding or postmenopausal bleeding
• Evaluating the cause of recurrent miscarriages
• Assessing the uterine cavity in cases of infertility
• Confirming results of other diagnostic tests, such as hysterosalpingography

Operative Hysteroscopy

Operative hysteroscopy goes beyond diagnosis to provide treatment for various uterine conditions. This procedure often requires anesthesia and may take longer to perform. Some common operative hysteroscopy procedures include:

• Removing uterine fibroids or polyps
• Treating uterine adhesions (Asherman’s syndrome)
• Performing endometrial ablation to reduce heavy menstrual bleeding
• Removing displaced intrauterine devices (IUDs)
• Performing certain sterilization procedures

Potential Risks and Complications of Hysteroscopy

While hysteroscopy is generally considered a safe procedure, it’s important to be aware of potential risks and complications. These may include:

• Bleeding or spotting
• Infection
• Uterine perforation (a small hole in the uterus)
• Reactions to anesthesia or distention media
• Damage to nearby organs (rare)
• Fluid overload from absorption of distention media (uncommon)

How can risks be minimized?

To reduce the likelihood of complications, healthcare providers take several precautions:

• Careful patient selection and thorough pre-operative evaluation
• Use of sterile techniques to minimize infection risk
• Monitoring of fluid balance during the procedure
• Proper training and experience of the surgeon performing the hysteroscopy

Recovery and Aftercare Following Hysteroscopy

Most women can return to their normal activities within a day or two after a hysteroscopy. However, the recovery process may vary depending on the type of procedure performed and individual factors.

What can you expect after the procedure?

• Mild cramping or discomfort for a day or two
• Light bleeding or spotting for several days
• Shoulder pain (if gas was used to distend the uterus)
• Feeling tired or groggy if general anesthesia was used

Post-procedure care instructions

Your healthcare provider will give you specific instructions, which may include:

• Taking pain relievers as needed for cramping
• Using pads instead of tampons for any post-procedure bleeding
• Avoiding sexual intercourse for a specified period
• Refraining from douching or using vaginal medications
• Watching for signs of infection, such as fever or foul-smelling discharge

Advancements in Hysteroscopy Technology

The field of hysteroscopy continues to evolve, with new technologies enhancing the procedure’s effectiveness and patient comfort. Some recent advancements include:

Miniaturized hysteroscopes

Smaller diameter hysteroscopes allow for easier insertion and reduced discomfort, potentially eliminating the need for anesthesia in some cases.

Office hysteroscopy

Many diagnostic and minor operative procedures can now be performed in an outpatient setting, reducing costs and improving accessibility.

Improved imaging systems

High-definition cameras and advanced optics provide clearer, more detailed views of the uterine cavity, enhancing diagnostic accuracy.

Computer-assisted navigation

New software helps guide surgeons during complex procedures, improving precision and potentially reducing operative time.

Hysteroscopy vs. Other Diagnostic Tools: A Comparative Analysis

While hysteroscopy offers unique benefits, it’s essential to understand how it compares to other diagnostic tools used in gynecology. Here’s a brief comparison:

Hysteroscopy vs. Transvaginal Ultrasound

• Hysteroscopy provides direct visualization of the uterine cavity, while ultrasound offers indirect imaging.
• Ultrasound is non-invasive but may miss smaller lesions that hysteroscopy can detect.
• Hysteroscopy allows for immediate treatment of certain conditions, which ultrasound cannot do.

Hysteroscopy vs. Hysterosalpingography (HSG)

• HSG uses X-rays and contrast dye to examine the uterus and fallopian tubes, while hysteroscopy only visualizes the uterine cavity.
• Hysteroscopy provides more detailed images of the uterine lining and can detect smaller abnormalities.
• HSG is often used to assess tubal patency in infertility evaluations, which hysteroscopy cannot do.

Hysteroscopy vs. Endometrial Biopsy

• Endometrial biopsy involves taking a small sample of the uterine lining for analysis, while hysteroscopy allows for visual inspection and targeted biopsies.
• Hysteroscopy can provide more comprehensive information about the entire uterine cavity.
• Endometrial biopsy is often quicker and may be performed without visual guidance in some cases.

Each of these diagnostic tools has its place in gynecological care, and healthcare providers often use a combination of methods to ensure accurate diagnosis and appropriate treatment.

The Role of Hysteroscopy in Fertility and Reproductive Health

Hysteroscopy plays a crucial role in diagnosing and treating various conditions that can affect fertility and reproductive health. Here are some key applications:

Investigating Recurrent Miscarriages

Hysteroscopy can help identify uterine abnormalities that may contribute to recurrent pregnancy loss, such as:

• Uterine septum or other congenital malformations
• Intrauterine adhesions
• Submucosal fibroids or polyps

Assessing Infertility

For women struggling with infertility, hysteroscopy can:

• Evaluate the shape and structure of the uterine cavity
• Detect and remove potential obstacles to embryo implantation
• Complement other fertility investigations, such as hormone testing and semen analysis

Preconception Care

Hysteroscopy may be recommended as part of preconception care to:

• Identify and treat any uterine abnormalities before attempting pregnancy
• Improve the chances of successful conception and pregnancy
• Address any concerns about the uterine environment

How does hysteroscopy compare to other fertility treatments?

While hysteroscopy is not a fertility treatment itself, it can significantly enhance the success rates of other assisted reproductive technologies, such as:

• In vitro fertilization (IVF)
• Intrauterine insemination (IUI)
• Embryo transfer procedures

By ensuring an optimal uterine environment, hysteroscopy can improve the chances of successful implantation and pregnancy.

Patient Experiences and Testimonials: Real-Life Hysteroscopy Stories

Understanding the experiences of women who have undergone hysteroscopy can provide valuable insights and reassurance for those considering the procedure. Here are some anonymized patient testimonials:

Sarah’s Diagnostic Hysteroscopy Experience

“I was nervous about having a hysteroscopy, but it wasn’t nearly as bad as I imagined. The procedure was quick, and while I felt some cramping, it was manageable. The best part was getting immediate answers about my abnormal bleeding. I’m glad I didn’t put it off.”

Emily’s Operative Hysteroscopy for Fibroids

“After years of heavy periods due to fibroids, I finally had them removed via hysteroscopy. The recovery was much easier than I expected, and my periods have improved significantly. I wish I had done it sooner!”

Lisa’s Fertility Journey and Hysteroscopy

“Hysteroscopy was a game-changer in my fertility journey. It revealed a uterine septum that was likely causing my recurrent miscarriages. After having it corrected, I successfully carried my daughter to term. I’m grateful for this technology and the skilled doctors who use it.”

What can these experiences teach us?

These testimonials highlight several important points:

• Many women find the procedure less uncomfortable than anticipated
• Hysteroscopy can provide immediate answers and peace of mind
• The benefits often outweigh the temporary discomfort
• Early intervention can lead to better outcomes, especially in fertility cases

While individual experiences may vary, these stories underscore the value of hysteroscopy in women’s health care and the positive impact it can have on quality of life.

Hysteroscopy | Women’s Health Services

A hysteroscopy can be used to diagnose or treat your symptoms if you are experiencing issues or pain in your uterus.

A hysteroscope is a thin, telescope-like device that has a light. The scope is inserted through the vagina and into the uterus. The scope is able to transmit the image of the inside of the uterus onto a screen for further examination.

A hysteroscopy can also be used in situations such as, but not limited to, the following:

• Removing adhesions
• Diagnosing the cause of repeated miscarriages
• Locating an intrauterine device (IUD)
• Performing sterilization

Watch a video of Dr. Susan Hunter (retired) below performing a Hysteroscopy on a patient with a uterine polyp. 

Video Transcription:
Today, I’m showing you a video recording of a hysteroscopy that I performed on a patient with a uterine polyp. You are now seeing a view of the inside of the uterus. This is with hysteroscopy, which is a small, thin, telescope-like device that’s put up inside the uterine cavity. You are now seeing a view of the polyp that’s inside the uterus attached to the back wall of the uterus. This is a good view of the polyp right here. The polyp is going to be removed with a device called MyoSure. You can see the MyoSure is being inserted into the uterine cavity right now and I’m going to remove the polyp by using the MyoSure device. This device is a cutting blade that rotates and cuts the polyp up into pieces and sucks them up into a tube that then is saved and the tissue is sent to the pathology department to analyze the polyp. This patient had a lot of bleeding in between her periods. We had performed an ultrasound in the office which showed the polyp and then she was scheduled for this hysteroscopy procedure to remove the polyp. This view right here shows that the polyp is almost completely removed. Just a few more little fragments are being removed now. This procedure can be performed as an outpatient surgery usually under general anesthesia, and the patient can usually return to her regular activities the next day. This is a good view of the inside of the uterus now with a polyp completely removed.

Hysteroscopy – What happens – NHS

A hysteroscopy is a simple procedure usually carried out on an outpatient or day-case basis. This means you won’t normally need to stay in hospital overnight.

Preparing for a hysteroscopy

In the days and weeks before a hysteroscopy, you may be advised to:

• have tests to check whether you can have the procedure, such as blood tests and a pregnancy test – these may be done at an appointment about a week before your hysteroscopy
• use contraception – a hysteroscopy cannot be carried out if you’re pregnant
• stop smoking – if you’re due to have a general anaesthetic and you smoke, stopping smoking in the lead-up to the procedure can help reduce your risk of complications from the anaesthetic

If you’re going to have fibroids removed, you may be given medicine to help shrink them beforehand.

Choice of anaesthetic

A hysteroscopy is not usually carried out under anaesthetic, as it’s a relatively quick procedure and does not involve making cuts (incisions) in your skin.

Taking painkillers such as ibuprofen or paracetamol about an hour beforehand can help reduce discomfort after the procedure.

Occasionally, a local anaesthetic may be used to numb your cervix (entrance to the womb) during the procedure.

Longer or more complicated procedures, such as the removal of fibroids, may be done under general anaesthetic. This means you’ll be asleep while the operation is carried out.

On the day of your hysteroscopy

If you’re having a general anaesthetic, you’ll need to avoid eating or drinking for a few hours before the procedure. Your appointment letter will mention whether this applies to you.

If you’re having no anaesthetic or just a local anaesthetic, you can eat and drink as normal.

It’s a good idea to wear loose, comfortable clothes when you arrive for your appointment, as you’ll be asked to remove any clothes from below your waist and change into a hospital gown for the procedure.

You can bring a friend or relative with you for support, although they may not be allowed in the room during your hysteroscopy.

The hysteroscopy procedure

A hysteroscopy usually takes between 5 and 30 minutes. During the procedure:

• you lie on a couch with your legs held in supports, and a sheet is used to cover your lower half
• an instrument called a speculum may be inserted into your vagina to hold it open (the same instrument used for a cervical screening test), although this is not always needed
• the vagina and cervix are cleaned with an antiseptic solution
• a hysteroscope (long, thin tube containing a light and camera) is passed into your womb – you may experience some cramping and discomfort as it passes through your cervix
• fluid is gently pumped into the womb to make it easier for your doctor to see inside
• the camera sends pictures to a monitor so your doctor or specialist nurse can spot any abnormalities

If at any point you are finding the procedure too uncomfortable, tell the doctor or nurse. They can stop at any time.

In some cases, a small sample of tissue from the womb lining may be removed for further testing. This is known as an endometrial biopsy.

If you’re having a hysteroscopy to treat a condition such as fibroids or polyps, fine surgical instruments can be passed along the hysteroscope. These are used to cut or burn away the abnormal tissue.

After a hysteroscopy

You should be able to go home soon after a hysteroscopy, although you may need to stay in hospital for a few hours if you had a general anaesthetic.

Your doctor or nurse will discuss their findings with you before you leave, although it may take a few weeks to get the results of a biopsy.

You can usually return to your normal activities later the same day or the following day if no anaesthetic or just a local anaesthetic was used. If you had a general anaesthetic, you may need to take things easy for a day or 2.

Read more about recovering from a hysteroscopy.

Page last reviewed: 05 December 2018
Next review due: 05 December 2021

Hysteroscopy – Tests & treatments

A hysteroscopy is a simple procedure usually carried out on an outpatient or day-case basis. This means you won’t normally need to stay in hospital overnight.

Preparing for a hysteroscopy

In the days and weeks before a hysteroscopy, you may be advised to:

• have tests to check whether you can have the procedure, such as blood tests and a pregnancy test  – these may be done at an appointment about a week before your hysteroscopy
• use contraception – a hysteroscopy can’t be carried out if you’re pregnant
• stop smoking – if you’re due to have a general anaesthetic and you smoke, stopping smoking in the lead up to the procedure can help reduce your risk of complications from the anaesthetic

If you’re going to have fibroids removed, you may be given medicine to help shrink them beforehand.

Choice of anaesthetic

A hysteroscopy isn’t usually carried out under anaesthetic, as it’s a relatively quick procedure and doesn’t involve making cuts (incisions) in your skin.

The procedure shouldn’t be painful, although you may experience some discomfort, similar to period pain. Taking painkillers such as ibuprofen or paracetamol about an hour beforehand can help reduce this.

Occasionally, a local anaesthetic may be used to numb your cervix (entrance to the womb) during the procedure.

Longer or more complicated procedures, such as the removal of fibroids, may be done under general anaesthetic. This means you’ll be asleep while the operation is carried out.

On the day of your hysteroscopy

If you’re having a general anaesthetic, you’ll need to avoid eating or drinking for a few hours before the procedure. Your appointment letter will mention whether this applies to you.

If you’re having no anaesthetic or just a local anaesthetic, you can eat and drink as normal.

It’s a good idea to wear loose, comfortable clothes when you arrive for your appointment, as you’ll be asked to remove any clothes from below your waist and change into a hospital gown for the procedure.

You can bring a friend or relative with you for support, although they may not be allowed in the room during your hysteroscopy.

The hysteroscopy procedure

A hysteroscopy usually takes between 5 and 30 minutes. During the procedure:

• you lie on a couch with your legs held in supports and a sheet is used to cover your lower half
• an instrument called a speculum may be inserted into your vagina to hold it open (the same instrument used for a cervical screening test), although this isn’t always needed
• the vagina and cervix are cleaned with an antiseptic solution
• a hysteroscope (long, thin tube containing a light and camera) is passed into your womb – you may experience some cramping and discomfort as it passes through your cervix
• fluid is gently pumped into the womb to make it easier for your doctor to see inside
• the camera sends pictures to a monitor, so your doctor or specialist nurse can spot any abnormalities

In some cases, a small sample of tissue from the womb lining may be removed for further testing. This is known as an endometrial biopsy.

If you’re having a hysteroscopy to treat a condition such as fibroids or polyps, fine surgical instruments can be passed along the hysteroscope. These are used to cut or burn away the abnormal tissue.

After a hysteroscopy

You should be able to go home soon after a hysteroscopy, although you may need to stay in hospital for a few hours if you had a general anaesthetic.

Your doctor or nurse will discuss their findings with you before you leave, although it may take a few weeks to get the results of a biopsy.

You can usually return to your normal activities later the same day or the following day if no anaesthetic or just a local anaesthetic was used. If you had a general anaesthetic, you may need to take things easy for a day or two.

What is a Colposcopy? | Procedure, Risks and Results

Colposcopy is a way to get a close-up look at your cervix. It’s a quick and easy way to find cell changes in your cervix that may turn into cancer.

What’s a colposcopy?

A colposcopy is a type of cervical cancer test. It lets your doctor or nurse get a close-up look at your cervix — the opening to your uterus. It’s used to find abnormal cells in your cervix.

What happens during a colposcopy and biopsy?

You’ll lie down on an exam table like you would for a pelvic exam. The doctor or nurse will put a speculum into your vagina and open it. This separates the walls of your vagina so they can get a really good look at your cervix.

They’ll wash your cervix with a vinegar-like solution. This makes it easier to see abnormal cells. Next they’ll look at your cervix through a colposcope — an instrument that looks like binoculars on a stand with a bright light. The colposcope doesn’t touch you or go inside you.

If your doctor or nurse sees something that doesn’t look normal, they’ll do a biopsy. This means they’ll take a tiny sample of tissue and send it to a lab.

There are 2 types of biopsies: One takes tissue from outside your cervix. The other takes tissue from inside the opening of your cervix. Sometimes you need more than one biopsy.

A colposcopy and biopsy only takes about 5-10 minutes.

Does a colposcopy hurt?

A colposcopy is nearly pain-free. You might feel pressure when the speculum goes in. It might also sting or burn a little when they wash your cervix with the vinegar-like solution.

If you get a biopsy, you might have some discomfort. Most people describe it feeling like a sharp pinch or a period cramp. You might have a little spotting, bleeding, or dark discharge from your vagina for a few days after a biopsy.

What should I know before my appointment?

You don’t have to do much to prepare for a colposcopy. Here are 2 things you can do to make things easier:

1. Schedule your colposcopy for when you won’t have your period or when the bleeding is light. That makes it easier to see your cervix.

2. Don’t have vaginal sex or put anything in your vagina (like fingers or sex toys) the day before your appointment.

Where can I get a colposcopy?

You can get a colposcopy at your doctor or nurse’s office, some community health clinics, or your local Planned Parenthood health center.

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Uterine Fibroids: Should I Have Surgery?

You may want to have a say in this decision, or you may simply want to follow your doctor’s recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Uterine Fibroids: Should I Have Surgery?

Get the facts

Your options

• Have surgery to take out just your fibroids or to take out your uterus.
• Don’t have surgery. You can choose another treatment, such as over-the-counter pain medicine, hormones, or fibroid embolization.

This decision aid is for women who have decided to treat their uterine fibroids. Many fibroids do not need treatment.

If you’ve decided to treat your uterine fibroids, you may also need to make a decision about embolization or a decision about GnRH-A hormone therapy.

Key points to remember

• You might want to choose surgery if fibroids are making it hard for you to get pregnant or if you have other symptoms that affect your quality of life, and other treatments have not worked for you. There are two surgical treatments for fibroids: taking fibroids out of the uterus (myomectomy) and removing the uterus (hysterectomy).
• After menopause, fibroids usually get smaller or go away. If you are close to menopause, you could take nonsteroidal anti-inflammatory drugs (NSAIDs) (such as ibuprofen or naproxen) for pain or have fibroid embolization. You also could try birth control hormones, get a certain type of IUD, or take hormone therapy (GnRH-a) for a short time if you have bad symptoms.
• If you want to have a baby, taking out just the fibroids may improve your chance of getting pregnant. But this type of surgery can lead to a problem with the placenta. It also can make a cesarean delivery more likely.
• Taking out the uterus is the only cure for uterine fibroids. But it’s not a good choice if you want to have children (or more children). You can’t get pregnant after your uterus is taken out.
• Both types of surgery have short-term risks, such as blood loss and infection. Both surgeries also can cause scar tissue, which can cause pelvic pain and infertility.

FAQs

Uterine fibroids are growths in or on the uterus. They are not cancer. Fibroids can grow on the inside of the uterus, within the muscle wall of the uterus, or on the outer surface of the uterus. They can change the shape of the uterus as they grow. This can make it hard for you to get pregnant.

Over time, the size, shape, location, and symptoms of fibroids may change.

As women get older, they are more likely to have uterine fibroids, especially from their 30s and 40s until menopause. Most have mild or no symptoms. But fibroids can cause bad pain, bleeding, and other problems.

The cause of fibroids is not known. But the hormones estrogen and progesterone can make them grow. A woman’s body makes the highest levels of these hormones during her childbearing years. After menopause, when hormone levels decrease, fibroids often shrink or disappear.

Uterine fibroids usually need treatment when they cause:

• Anemia from heavy fibroid bleeding.
• Ongoing low back pain or a feeling of pressure in the lower belly.
• Trouble getting pregnant.
• Problems during pregnancy, such as miscarriage or preterm labor.
• Problems with the urinary tract or bowels.
• Infection, if the tissue of a large fibroid dies.

Depending on the reasons you need treatment, one type of treatment may work better for you than another.

Myomectomy, which is surgery to take out just the fibroids, can decrease pain and other symptoms. It also may make it possible for you to get pregnant.

Surgery can be done:

• Through the vagina and into the uterus using a lighted scope.
• Through a large cut in the belly.
• Through several small cuts in the belly using a lighted scope. This is called a laparoscopy.

How well myomectomy works

Taking out fibroids decreases menstrual bleeding and pelvic pain from fibroids. It may improve your chances of having a baby.

Chance that fibroids can come back

Fibroids tend to grow back, unless you have your uterus taken out. New fibroids also can grow. Fibroids return in up to half of women who have surgery to take out just the fibroids. They are more likely to come back if you had many fibroids.^{footnote 1} Talk to your doctor about whether your type of fibroid is likely to grow back.

Risks of myomectomy

Cutting into the uterine wall during this surgery can cause problems in a future pregnancy. There could be a problem with the way the placenta grows, such as placenta abruptio or placenta accreta. During labor, the uterus might not work like it should. This could mean that you would need a cesarean delivery.

Hysterectomy, which is surgery to take out the uterus, cures fibroids. But it’s usually the last choice for treatment, because it’s major surgery and it makes you unable to get pregnant. Having this surgery means that you will no longer have menstrual periods. The ovaries and fallopian tubes also may be taken out at the same time.

This surgery gives most women relief from their symptoms.

Talk to your doctor if you are not close to menopause (about age 50) and you’re thinking about having your uterus and ovaries taken out. Experts say that women live longer when they keep their ovaries until at least age 65. This may be because women who have their ovaries have fewer hip fractures and are less likely to get heart disease. ^{footnote 2}

How well hysterectomy works

This surgery:

• Relieves pain from fibroids.
• Stops anemia from heavy and irregular vaginal bleeding.
• May fix leakage of urine if it was caused by fibroids.

Chance that fibroids can come back

Fibroids do not grow back after your uterus is taken out.

Risks of hysterectomy

Most women don’t have problems from this surgery. But possible long-term problems include:

• Scar tissue that can cause pelvic pain.
• Early menopause caused by a slow, early decline of the ovaries.
• Weakness of the pelvic muscles and ligaments that support the vagina, bladder, and rectum. This can cause bladder or bowel problems.
• Trouble urinating.
• Pelvic pain. If you had pain before surgery, taking out your uterus may not relieve your pain.

Most women do not have problems after either surgery to treat fibroids. But problems can include:

• A fever. A slight fever is common after any surgery.
• Rare problems, such as:
  • Infection.
  • Blood clots in the legs or lungs.
  • Scar tissue (also called adhesions).
  • Injury to other organs, such as the bladder or bowel.
  • A collection of blood at the surgical site.
  • Continued heavy bleeding. Some vaginal bleeding within 4 to 6 weeks after you have the uterus removed is normal.
  • Problems from the medicine used to make you sleep during surgery.
  • Severe blood loss that causes you to need more blood (transfusion).

Your doctor might suggest that you have surgery to take out just your fibroids if:

• You want to treat your fibroids in a way that may make it possible for you to get pregnant later.

Your doctor might suggest that you have surgery to remove your uterus if:

• You have bad symptoms and:
  • Other treatments have not helped.
  • You’re not near menopause.
  • You don’t plan to have children (or more children).
  • There is a risk of cancer.

Compare your options

Compare Option 1Have surgery to take out fibroids or your uterusDon’t have either surgery

Compare Option 2Have surgery to take out fibroids or your uterusDon’t have either surgery

What is usually involved?
What are the benefits?
What are the risks and side effects?

Have surgery to take out fibroids or your uterus Have surgery to take out fibroids or your uterus

• You may take the hormone GnRH-a before surgery to shrink your fibroids.
• You may have outpatient surgery, which means you would go home the same day. Or you may spend 1 to 4 days in the hospital after surgery.
• Recovery can take from a few days to 6 weeks, depending on the type of surgery you have.
• If you have your uterus taken out, you won’t be able to get pregnant.

• Either surgery can ease your pain and other symptoms.
• Surgery to take out just your fibroids (myomectomy) may make it possible for you to get pregnant.
• Surgery to take out your uterus (hysterectomy) will cure your fibroids.

• Both surgeries have risks, some of which are rare. Risks include bleeding, infection, and scar tissue.
• Cutting into the uterus to take out just the fibroids could cause a problem with how the uterus works in a future pregnancy.
• Pelvic pain that you had before either surgery may not get better.
• If you have just the fibroids taken out but not the uterus, the fibroids can grow back.

Don’t have either surgery Don’t have either surgery

• You may take hormones (GnRH-a) to shrink the fibroids.
• You can take nonsteroidal anti-inflammatory drugs (NSAIDs), take birth control hormones, or get a certain type of IUD to reduce pain and bleeding.
• You may have other procedures such as fibroid embolization, endometrial ablation or magnetic resonance guided ultrasound.
• You may choose to have surgery later if you change your mind.

• You may be able to control your symptoms without surgery.
• If you have bad symptoms and are close to menopause, you may be able to control your symptoms long enough to go through menopause.
• You won’t have the risks of surgery.

• Your pain or other symptoms could get worse.
• If fibroids are making it hard for you to get pregnant, NSAIDs and hormones won’t help you get pregnant.
• NSAIDs can cause bleeding and other problems in some people. Talk to your doctor before taking them.
• Hormones can have serious side effects, such as menopause symptoms and bone-thinning.
• Fibroid embolization can have side effects such as infection and pain.

Uterine fibroids made me miserable for a week to 10 days every month. Since my husband and I did not want any more children, I decided it was time to take action. Not only was the pain getting to me, but I was losing enough blood that I had anemia I couldn’t beat. I was tired all the time! I knew a hysterectomy was the only sure cure for the pain caused by uterine fibroids. My doctor talked with me about the discomfort and risks of a hysterectomy. She also said she might have to remove my ovaries. I had a hysterectomy, and my ovaries were removed. The first 2 weeks after the surgery were pretty rough, but my family and I managed. I now take estrogen every day. It’s been a year since my surgery, and I feel great.

My periods were really painful about 5 years ago. I went to my doctor, and he asked a lot of questions about my periods and did an exam and some tests. When all the tests came back normal, he said uterine fibroids might be the cause of my pain. He said the only sure treatment for uterine fibroids was a hysterectomy. I didn’t want to have surgery, so I asked if waiting a few months would be dangerous. He said waiting would be fine, and maybe I should try birth control pills and taking ibuprofen during my periods. After a few months, the pain eased up. I am glad I decided to wait and see if my pain decreased before having surgery.

I have large uterine fibroids and have had them since I was in my early 30s. They didn’t cause any problems until I got pregnant with my first child. I went into labor about a month early, and my daughter had to spend several days in the intensive care unit. My husband and I would like to have one more child, but I want to avoid another preterm labor if I can. My doctor has told me about a procedure called a myomectomy. It doesn’t guarantee that I won’t deliver early, but it may help. He will be able to remove the uterine fibroids from my uterus without taking my uterus out. I won’t have to have a large incision in my abdomen either. I am looking forward to having this done. We will wait several months and then try to have another child. Even if I need to deliver by cesarean after a myomectomy, I’m happy to have the chance of a full-term pregnancy!

I was surprised when my doctor told me that uterine fibroids could be the cause of the pain I was having with my periods. I had never heard of uterine fibroids before. He told me all about uterine fibroids and the treatments I could try. When he said using ibuprofen for a few days right before my period starts and then for several days during my period might stop the pain, I thought I might as well try it. It took a couple of months of using this system, but now I hardly have any pain. I am glad that I did not have surgery.

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have surgery for fibroids

Reasons not to have surgery for fibroids

I’m having trouble getting pregnant because of fibroids, so I want to have them taken out.

Fibroids aren’t keeping me from getting pregnant.

More important

Equally important

More important

I have so much bleeding and pain that I’m miserable part of every month.

I can control my symptoms with medicine.

More important

Equally important

More important

I want to do everything I can to treat my fibroids.

I don’t want to have any surgery.

More important

Equally important

More important

I’m not close to menopause, and I can’t stand my symptoms, so I want surgery.

I’m close to menopause, so I’d rather try hormones and pain medicine until menopause.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

Where are you leaning now?

Now that you’ve thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having surgery

NOT having surgery

Leaning toward

Undecided

Leaning toward

What else do you need to make your decision?

1.1, Surgery to take out just my fibroids will cure my problem. 2.2, Surgery to take out just my fibroids is the best choice if fibroids are keeping me from getting pregnant. 3.3, If I’m close to menopause, taking nonsteroidal anti-inflammatory drugs (NSAIDs) and maybe hormones may be all that I need to help my symptoms. 1.1,Do you understand the options available to you?2.2,Are you clear about which benefits and side effects matter most to you?3.3,Do you have enough support and advice from others to make a choice?

1.
How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2.2, Check what you need to do before you make this decision.

Use the following space to list questions, concerns, and next steps.

Your Summary

Here’s a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Next steps

Which way you’re leaning

How sure you are

Your comments

Key concepts that you understood

Key concepts that may need review

Credits

Author	Healthwise Staff
Primary Medical Reviewer	Sarah Marshall MD – Family Medicine
Primary Medical Reviewer	Kathleen Romito MD – Family Medicine
Primary Medical Reviewer	Martin J. Gabica MD – Family Medicine
Primary Medical Reviewer	Elizabeth T. Russo MD – Internal Medicine
Primary Medical Reviewer	Divya Gupta MD – Obstetrics and Gynecology, Gynecologic Oncology

---

References

Citations

1. Parker WH (2012). Uterine fibroids. In JS Berek, ed., Berek and Novak’s Gynecology, 15th ed., pp. 438–469. Philadelphia: Lippincott Williams and Wilkins.
2. Parker WH, et al. (2009). Ovarian conservation at the time of hysterectomy and long-term health outcomes in the Nurses’ Health Study. Obstetrics and Gynecology, 113(5): 1027–1037.

You may want to have a say in this decision, or you may simply want to follow your doctor’s recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Uterine Fibroids: Should I Have Surgery?

Here’s a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

1. Get the facts
2. Compare your options
3. What matters most to you?
4. Where are you leaning now?
5. What else do you need to make your decision?

1. Get the Facts

Your options

• Have surgery to take out just your fibroids or to take out your uterus.
• Don’t have surgery. You can choose another treatment, such as over-the-counter pain medicine, hormones, or fibroid embolization.

This decision aid is for women who have decided to treat their uterine fibroids. Many fibroids do not need treatment.

If you’ve decided to treat your uterine fibroids, you may also need to make a decision about embolization or a decision about GnRH-A hormone therapy.

Key points to remember

• You might want to choose surgery if fibroids are making it hard for you to get pregnant or if you have other symptoms that affect your quality of life, and other treatments have not worked for you. There are two surgical treatments for fibroids: taking fibroids out of the uterus (myomectomy) and removing the uterus (hysterectomy).
• After menopause, fibroids usually get smaller or go away. If you are close to menopause, you could take nonsteroidal anti-inflammatory drugs (NSAIDs) (such as ibuprofen or naproxen) for pain or have fibroid embolization. You also could try birth control hormones, get a certain type of IUD, or take hormone therapy (GnRH-a) for a short time if you have bad symptoms.
• If you want to have a baby, taking out just the fibroids may improve your chance of getting pregnant. But this type of surgery can lead to a problem with the placenta. It also can make a cesarean delivery more likely.
• Taking out the uterus is the only cure for uterine fibroids. But it’s not a good choice if you want to have children (or more children). You can’t get pregnant after your uterus is taken out.
• Both types of surgery have short-term risks, such as blood loss and infection. Both surgeries also can cause scar tissue, which can cause pelvic pain and infertility.

FAQs

What are uterine fibroids?

Uterine fibroids are growths in or on the uterus. They are not cancer. Fibroids can grow on the inside of the uterus , within the muscle wall of the uterus , or on the outer surface of the uterus . They can change the shape of the uterus as they grow. This can make it hard for you to get pregnant.

Over time, the size, shape, location, and symptoms of fibroids may change.

As women get older, they are more likely to have uterine fibroids, especially from their 30s and 40s until menopause. Most have mild or no symptoms. But fibroids can cause bad pain, bleeding, and other problems.

The cause of fibroids is not known. But the hormones estrogen and progesterone can make them grow. A woman’s body makes the highest levels of these hormones during her childbearing years. After menopause, when hormone levels decrease, fibroids often shrink or disappear.

When do fibroids need to be treated?

Uterine fibroids usually need treatment when they cause:

• Anemia from heavy fibroid bleeding.
• Ongoing low back pain or a feeling of pressure in the lower belly.
• Trouble getting pregnant.
• Problems during pregnancy, such as miscarriage or preterm labor.
• Problems with the urinary tract or bowels.
• Infection, if the tissue of a large fibroid dies.

Depending on the reasons you need treatment, one type of treatment may work better for you than another.

What should you know about surgery to take out just the fibroids?

Myomectomy, which is surgery to take out just the fibroids, can decrease pain and other symptoms. It also may make it possible for you to get pregnant.

Surgery can be done:

• Through the vagina and into the uterus using a lighted scope.
• Through a large cut in the belly.
• Through several small cuts in the belly using a lighted scope. This is called a laparoscopy.

How well myomectomy works

Taking out fibroids decreases menstrual bleeding and pelvic pain from fibroids. It may improve your chances of having a baby.

Chance that fibroids can come back

Fibroids tend to grow back, unless you have your uterus taken out. New fibroids also can grow. Fibroids return in up to half of women who have surgery to take out just the fibroids. They are more likely to come back if you had many fibroids.¹ Talk to your doctor about whether your type of fibroid is likely to grow back.

Risks of myomectomy

Cutting into the uterine wall during this surgery can cause problems in a future pregnancy. There could be a problem with the way the placenta grows, such as placenta abruptio or placenta accreta. During labor, the uterus might not work like it should. This could mean that you would need a cesarean delivery.

What should you know about surgery to take out the uterus?

Hysterectomy, which is surgery to take out the uterus, cures fibroids. But it’s usually the last choice for treatment, because it’s major surgery and it makes you unable to get pregnant. Having this surgery means that you will no longer have menstrual periods. The ovaries and fallopian tubes also may be taken out at the same time.

This surgery gives most women relief from their symptoms.

Talk to your doctor if you are not close to menopause (about age 50) and you’re thinking about having your uterus and ovaries taken out. Experts say that women live longer when they keep their ovaries until at least age 65. This may be because women who have their ovaries have fewer hip fractures and are less likely to get heart disease.²

How well hysterectomy works

This surgery:

• Relieves pain from fibroids.
• Stops anemia from heavy and irregular vaginal bleeding.
• May fix leakage of urine if it was caused by fibroids.

Chance that fibroids can come back

Fibroids do not grow back after your uterus is taken out.

Risks of hysterectomy

Most women don’t have problems from this surgery. But possible long-term problems include:

• Scar tissue that can cause pelvic pain.
• Early menopause caused by a slow, early decline of the ovaries.
• Weakness of the pelvic muscles and ligaments that support the vagina, bladder, and rectum. This can cause bladder or bowel problems.
• Trouble urinating.
• Pelvic pain. If you had pain before surgery, taking out your uterus may not relieve your pain.

What are the risks of having either surgery?

Most women do not have problems after either surgery to treat fibroids. But problems can include:

• A fever. A slight fever is common after any surgery.
• Rare problems, such as:
  • Infection.
  • Blood clots in the legs or lungs.
  • Scar tissue (also called adhesions).
  • Injury to other organs, such as the bladder or bowel.
  • A collection of blood at the surgical site.
  • Continued heavy bleeding. Some vaginal bleeding within 4 to 6 weeks after you have the uterus removed is normal.
  • Problems from the medicine used to make you sleep during surgery.
  • Severe blood loss that causes you to need more blood (transfusion).

Why might your doctor recommend surgery to treat fibroids?

Your doctor might suggest that you have surgery to take out just your fibroids if:

• You want to treat your fibroids in a way that may make it possible for you to get pregnant later.

Your doctor might suggest that you have surgery to remove your uterus if:

• You have bad symptoms and:
  • Other treatments have not helped.
  • You’re not near menopause.
  • You don’t plan to have children (or more children).
  • There is a risk of cancer.

2. Compare your options

	Have surgery to take out fibroids or your uterus	Don’t have either surgery
What is usually involved?	You may take the hormone GnRH-a before surgery to shrink your fibroids. You may have outpatient surgery, which means you would go home the same day. Or you may spend 1 to 4 days in the hospital after surgery. Recovery can take from a few days to 6 weeks, depending on the type of surgery you have. If you have your uterus taken out, you won’t be able to get pregnant.	You may take hormones (GnRH-a) to shrink the fibroids. You can take nonsteroidal anti-inflammatory drugs (NSAIDs), take birth control hormones, or get a certain type of IUD to reduce pain and bleeding. You may have other procedures such as fibroid embolization, endometrial ablation or magnetic resonance guided ultrasound. You may choose to have surgery later if you change your mind.
What are the benefits?	Either surgery can ease your pain and other symptoms. Surgery to take out just your fibroids (myomectomy) may make it possible for you to get pregnant. Surgery to take out your uterus (hysterectomy) will cure your fibroids.	You may be able to control your symptoms without surgery. If you have bad symptoms and are close to menopause, you may be able to control your symptoms long enough to go through menopause. You won’t have the risks of surgery.
What are the risks and side effects?	Both surgeries have risks, some of which are rare. Risks include bleeding, infection, and scar tissue. Cutting into the uterus to take out just the fibroids could cause a problem with how the uterus works in a future pregnancy. Pelvic pain that you had before either surgery may not get better. If you have just the fibroids taken out but not the uterus, the fibroids can grow back.	Your pain or other symptoms could get worse. If fibroids are making it hard for you to get pregnant, NSAIDs and hormones won’t help you get pregnant. NSAIDs can cause bleeding and other problems in some people. Talk to your doctor before taking them. Hormones can have serious side effects, such as menopause symptoms and bone-thinning. Fibroid embolization can have side effects such as infection and pain.

Personal stories

Personal stories about surgery to treat uterine fibroids

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

“Uterine fibroids made me miserable for a week to 10 days every month. Since my husband and I did not want any more children, I decided it was time to take action. Not only was the pain getting to me, but I was losing enough blood that I had anemia I couldn’t beat. I was tired all the time! I knew a hysterectomy was the only sure cure for the pain caused by uterine fibroids. My doctor talked with me about the discomfort and risks of a hysterectomy. She also said she might have to remove my ovaries. I had a hysterectomy, and my ovaries were removed. The first 2 weeks after the surgery were pretty rough, but my family and I managed. I now take estrogen every day. It’s been a year since my surgery, and I feel great.”

“My periods were really painful about 5 years ago. I went to my doctor, and he asked a lot of questions about my periods and did an exam and some tests. When all the tests came back normal, he said uterine fibroids might be the cause of my pain. He said the only sure treatment for uterine fibroids was a hysterectomy. I didn’t want to have surgery, so I asked if waiting a few months would be dangerous. He said waiting would be fine, and maybe I should try birth control pills and taking ibuprofen during my periods. After a few months, the pain eased up. I am glad I decided to wait and see if my pain decreased before having surgery.”

“I have large uterine fibroids and have had them since I was in my early 30s. They didn’t cause any problems until I got pregnant with my first child. I went into labor about a month early, and my daughter had to spend several days in the intensive care unit. My husband and I would like to have one more child, but I want to avoid another preterm labor if I can. My doctor has told me about a procedure called a myomectomy. It doesn’t guarantee that I won’t deliver early, but it may help. He will be able to remove the uterine fibroids from my uterus without taking my uterus out. I won’t have to have a large incision in my abdomen either. I am looking forward to having this done. We will wait several months and then try to have another child. Even if I need to deliver by cesarean after a myomectomy, I’m happy to have the chance of a full-term pregnancy!”

“I was surprised when my doctor told me that uterine fibroids could be the cause of the pain I was having with my periods. I had never heard of uterine fibroids before. He told me all about uterine fibroids and the treatments I could try. When he said using ibuprofen for a few days right before my period starts and then for several days during my period might stop the pain, I thought I might as well try it. It took a couple of months of using this system, but now I hardly have any pain. I am glad that I did not have surgery.”

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have surgery for fibroids

Reasons not to have surgery for fibroids

I’m having trouble getting pregnant because of fibroids, so I want to have them taken out.

Fibroids aren’t keeping me from getting pregnant.

More important

Equally important

More important

I have so much bleeding and pain that I’m miserable part of every month.

I can control my symptoms with medicine.

More important

Equally important

More important

I want to do everything I can to treat my fibroids.

I don’t want to have any surgery.

More important

Equally important

More important

I’m not close to menopause, and I can’t stand my symptoms, so I want surgery.

I’m close to menopause, so I’d rather try hormones and pain medicine until menopause.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you’ve thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having surgery

NOT having surgery

Leaning toward

Undecided

Leaning toward

5. What else do you need to make your decision?

Check the facts

1.
Surgery to take out just my fibroids will cure my problem.

You’re right. Fibroids can grow back after surgery to take them out. The only cure for fibroids is surgery to take out your uterus (hysterectomy).

2.
Surgery to take out just my fibroids is the best choice if fibroids are keeping me from getting pregnant.

That’s right. Surgery to take out fibroids is the best choice if you want to get pregnant. Surgery to take out your uterus would mean that you can’t get pregnant.

3.
If I’m close to menopause, taking nonsteroidal anti-inflammatory drugs (NSAIDs) and maybe hormones may be all that I need to help my symptoms.

You’re right. Fibroids usually get smaller or go away after menopause. Taking nonsteroidal anti-inflammatory drugs (NSAIDs) and maybe hormones may help your symptoms until you go through menopause.

Decide what’s next

1.
Do you understand the options available to you?

2.
Are you clear about which benefits and side effects matter most to you?

3.
Do you have enough support and advice from others to make a choice?

Certainty

1.
How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2.
Check what you need to do before you make this decision.

Use the following space to list questions, concerns, and next steps.

Credits

By	Healthwise Staff
Primary Medical Reviewer	Sarah Marshall MD – Family Medicine
Primary Medical Reviewer	Kathleen Romito MD – Family Medicine
Primary Medical Reviewer	Martin J. Gabica MD – Family Medicine
Primary Medical Reviewer	Elizabeth T. Russo MD – Internal Medicine
Primary Medical Reviewer	Divya Gupta MD – Obstetrics and Gynecology, Gynecologic Oncology

---

References

Citations

1. Parker WH (2012). Uterine fibroids. In JS Berek, ed., Berek and Novak’s Gynecology, 15th ed., pp. 438–469. Philadelphia: Lippincott Williams and Wilkins.
2. Parker WH, et al. (2009). Ovarian conservation at the time of hysterectomy and long-term health outcomes in the Nurses’ Health Study. Obstetrics and Gynecology, 113(5): 1027–1037.

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Note: The “printer friendly” document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.

Current as of: July 17, 2020

Author:
Healthwise Staff

Medical Review:Sarah Marshall MD – Family Medicine & Kathleen Romito MD – Family Medicine & Martin J. Gabica MD – Family Medicine & Elizabeth T. Russo MD – Internal Medicine & Divya Gupta MD – Obstetrics and Gynecology, Gynecologic Oncology

Parker WH (2012). Uterine fibroids. In JS Berek, ed., Berek and Novak’s Gynecology, 15th ed., pp. 438-469. Philadelphia: Lippincott Williams and Wilkins.

Parker WH, et al. (2009). Ovarian conservation at the time of hysterectomy and long-term health outcomes in the Nurses’ Health Study. Obstetrics and Gynecology, 113(5): 1027-1037.

Uterine fibroids | Office on Women’s Health

How are fibroids treated?

Most women with fibroids do not have any symptoms. For women who do have symptoms, there are treatments that can help. Talk with your doctor about the best way to treat your fibroids. She or he will consider many things before helping you choose a treatment. Some of these things include:

• Whether or not you are having symptoms from the fibroids
• If you might want to become pregnant in the future
• The size of the fibroids
• The location of the fibroids
• Your age and how close to menopause you might be

If you have fibroids but do not have any symptoms, you may not need treatment. Your doctor will check during your regular exams to see if they have grown.

Medications

If you have fibroids and have mild symptoms, your doctor may suggest taking medication. Over-the-counter drugs such as ibuprofen or acetaminophen can be used for mild pain. If you have heavy bleeding during your period, taking an iron supplement can keep you from getting anemia or correct it if you already are anemic.

Several drugs commonly used for birth control can be prescribed to help control symptoms of fibroids. Low-dose birth control pills do not make fibroids grow and can help control heavy bleeding. The same is true of progesterone-like injections (e.g., Depo-Provera®). An IUD (intrauterine device) called Mirena® contains a small amount of progesterone-like medication, which can be used to control heavy bleeding as well as for birth control.

Other drugs used to treat fibroids are “gonadotropin releasing hormone agonists” (GnRHa). The one most commonly used is Lupron®. These drugs, given by injection, nasal spray, or implanted, can shrink your fibroids. Sometimes they are used before surgery to make fibroids easier to remove. Side effects of GnRHas can include hot flashes, depression, not being able to sleep, decreased sex drive, and joint pain. Most women tolerate GnRHas quite well. Most women do not get a period when taking GnRHas. This can be a big relief to women who have heavy bleeding. It also allows women with anemia to recover to a normal blood count. GnRHas can cause bone thinning, so their use is generally limited to six months or less. These drugs also are very expensive, and some insurance companies will cover only some or none of the cost. GnRHas offer temporary relief from the symptoms of fibroids; once you stop taking the drugs, the fibroids often grow back quickly.

Surgery

If you have fibroids with moderate or severe symptoms, surgery may be the best way to treat them. Here are the options:

• Myomectomy (meye-oh-MEK-tuh-mee) – Surgery to remove fibroids without taking out the healthy tissue of the uterus. It is best for women who wish to have children after treatment for their fibroids or who wish to keep their uterus for other reasons. You can become pregnant after myomectomy. But if your fibroids were imbedded deeply in the uterus, you might need a cesarean section to deliver. Myomectomy can be performed in many ways. It can be major surgery (involving cutting into the abdomen) or performed with laparoscopy or hysteroscopy. The type of surgery that can be done depends on the type, size, and location of the fibroids. After myomectomy new fibroids can grow and cause trouble later. All of the possible risks of surgery are true for myomectomy. The risks depend on how extensive the surgery is.
• Hysterectomy (hiss-tur-EK-tuh-mee) – Surgery to remove the uterus. This surgery is the only sure way to cure uterine fibroids. Fibroids are the most common reason that hysterectomy is performed. This surgery is used when a woman’s fibroids are large, if she has heavy bleeding, is either near or past menopause, or does not want children. If the fibroids are large, a woman may need a hysterectomy that involves cutting into the abdomen to remove the uterus. If the fibroids are smaller, the doctor may be able to reach the uterus through the vagina, instead of making a cut in the abdomen. In some cases hysterectomy can be performed through the laparoscope. Removal of the ovaries and the cervix at the time of hysterectomy is usually optional. Women whose ovaries are not removed do not go into menopause at the time of hysterectomy. Hysterectomy is a major surgery. Although hysterectomy is usually quite safe, it does carry a significant risk of complications. Recovery from hysterectomy usually takes several weeks.
• Endometrial ablation (en-doh-MEE-tree-uhl uh-BLAY-shuhn) – The lining of the uterus is removed or destroyed to control very heavy bleeding. This can be done with laser, wire loops, boiling water, electric current, microwaves, freezing, and other methods. This procedure usually is considered minor surgery. It can be done on an outpatient basis or even in a doctor’s office. Complications can occur, but are uncommon with most of the methods. Most people recover quickly. About half of women who have this procedure have no more menstrual bleeding. About three in 10 women have much lighter bleeding. But, a woman cannot have children after this surgery.
• Myolysis (meye-OL-uh-siss) – A needle is inserted into the fibroids, usually guided by laparoscopy, and electric current or freezing is used to destroy the fibroids.
• Uterine Fibroid Embolization (UFE), or Uterine Artery Embolization (UAE) – A thin tube is thread into the blood vessels that supply blood to the fibroid. Then, tiny plastic or gel particles are injected into the blood vessels. This blocks the blood supply to the fibroid, causing it to shrink. UFE can be an outpatient or inpatient procedure. Complications, including early menopause, are uncommon but can occur. Studies suggest fibroids are not likely to grow back after UFE, but more long-term research is needed. Not all fibroids can be treated with UFE. The best candidates for UFE are women who:
  • Have fibroids that are causing heavy bleeding
  • Have fibroids that are causing pain or pressing on the bladder or rectum
  • Don’t want to have a hysterectomy
  • Don’t want to have children in the future

Diagnosing cancer of the uterus

 

Your doctor will usually start with a physical examination and ultrasound of the pelvic area, but a diagnosis of uterine cancer can only be made by removing a tissue sample for checking (biopsy). Cervical screening tests and Pap tests are not used to diagnose uterine cancer.

Pelvic examination

The doctor will feel your abdomen (belly) to check for swelling and any masses. To check your uterus, they will place two fingers inside your vagina while pressing on your abdomen with their other hand. You may also have a vaginal or cervical examination using a speculum, an instrument that separates the walls of the vagina.

Pelvic ultrasound

A pelvic ultrasound uses soundwaves to create a picture of the uterus and ovaries. The soundwaves echo when they meet something dense, like an organ or tumour, then a computer creates a picture from these echoes. It can be done in two ways, and often you have both types at the same appointment:

• Abdominal ultrasound – You will lie on an examination table while the sonographer moves a small handheld device called a transducer over your abdomen.
• Transvaginal ultrasound – The sonographer inserts a transducer wand into your vagina. It will be covered with a disposable plastic sheath and gel to make it easier to insert. You may find a transvaginal ultrasound uncomfortable, but it should not be painful. 

If you have had an abdominal ultrasound, you will usually also need a transvaginal ultrasound as it provides a clearer picture of the uterus. A pelvic ultrasound appointment usually takes 15–30 minutes. The pictures can show if any masses (tumours) are present in the uterus. If anything appears unusual, your doctor will suggest you have a biopsy.

Endometrial biopsy

This type of biopsy can be done in the specialist’s office and takes just a few minutes. A long, thin plastic tube called a pipelle is inserted into your vagina and through the cervix to gently suck cells from the lining of the uterus. This may cause some discomfort similar to period cramps.

The sample of cells will be sent to a specialist doctor called a pathologist for examination under a microscope. If the results of an endometrial biopsy are unclear, you may need another type of biopsy taken during a hysteroscopy.

Hysteroscopy and biopsy

This type of biopsy is taken during a hysteroscopy, which allows the specialist to see inside your uterus and examine the lining for abnormalities. It will usually be done under a general anaesthetic as day surgery in hospital. The doctor inserts a thin tube with a tiny light and camera (known as a hysteroscope) through your vagina into the uterus.

To take the biopsy, the doctor uses surgical instruments to gently widen (dilate) the cervix and then remove some tissue from the uterine lining. You will stay in hospital for a few hours and are likely to have period-like cramps and light bleeding for a few days afterwards. From the tissue sample, the pathologist will be able to confirm whether or not the cells are cancerous, and which type of uterine cancer it is.

Further tests

After uterine cancer is diagnosed, you may have blood tests to check your general health. Your doctor may also arrange one or more of the imaging tests below to see if the cancer has spread outside the uterus:

• X-rays – You may have a chest x-ray to check your lungs and heart.
• CT scan – You will usually have a CT (computerised tomography) scan of your chest, abdomen and pelvis.
• MRI scan – This scan uses a powerful magnet and radio waves to create detailed cross-sectional pictures of the inside of your body.
• PET scan – You will be injected with a small amount of a glucose (sugar) solution, to allow cancer cells to show up brighter on the scan. PET scans are not routine tests for endometrial cancers, but may be recommended in particular cases.

Genetic tests after surgery

Cancer of the uterus is usually removed surgically and the removed tissue is sent to a laboratory for further testing. For endometrial cancer, some of these tests will check whether the cancer cells have features that indicate a genetic cause for the cancer. Knowing whether the tumour has one of these features may help your treatment team decide on suitable treatment options.

For example, a small number of endometrial cancers are caused by Lynch syndrome. This syndrome is characterised by a fault in the genes that helps the cell’s DNA repair itself (called mismatch repair or MMR genes). If you have Lynch syndrome, you are at increased risk of developing other cancers and it is important for you, your family and your doctors to know about this. 

Staging and grading

Knowing the stage and grade of the cancer helps your doctors recommend the best treatment for your situation. Uterine sarcomas are staged differently, so discuss this with your specialist.

Staging is a way to describe the size of the cancer and whether it has spread to other parts of the body.

• Stage 1 (early or localised) – The cancer is found only in the uterus.
• Stage 2 (regionalised) – The cancer has spread from the uterus to the cervix. 
• Stage 3 (regionalised) – The cancer has spread beyond the uterus/cervix to the ovaries, fallopian tubes, vagina, or lymph nodes in the pelvis or abdomen.
• Stage 4 (metastatic or advanced) – The cancer has spread further, to the bladder, bowel or rectum, throughout the abdomen, to other parts of the body such as the bones or lung, or to lymph nodes in the groin. 

Grading describes how the cancer cells look under a microscope compared to normal cells and estimates how fast the cancer is likely to grow.

• Grade 1 (low grade) – The cancer cells look slightly abnormal.
• Grade 2 (moderate grade) – The cancer cells look moderately abnormal.
• Grade 3 (high grade) – The cancer cells look more abnormal. These cancers tend to be more aggressive than lower-grade cancers.

Prognosis

Prognosis means the expected outcome of a disease. While it is not possible to predict the exact course of the disease, your doctor can give you an idea about the general outlook for people with the same type and stage of uterine cancer.

To work out your prognosis, your doctor will consider test results, the type of uterine cancer, the rate and depth of tumour growth, the likelihood of response to treatment, and factors such as your age, level of fitness and medical history.

In general, the earlier cancer of the uterus is diagnosed, the better the outcome. Most early-stage endometrial cancers have a good prognosis with high survival rates. If cancer is found after it has spread to other parts of the body (advanced cancer), the prognosis is not as good and there is a higher chance of the cancer coming back after treatment.

Understanding Cancer of the Uterus

Download our Understanding Cancer of the Uterus booklet to learn more.

Download now

 

 

Expert content reviewers:

 A/Prof Jim Nicklin, Director, Gynaecological Oncology, Royal Brisbane and Women’s Hospital, and Associate Professor Gynaecologic Oncology, The University of Queensland, QLD; Dr Robyn Cheuk, Senior Radiation Oncologist, Royal Brisbane and Women’s Hospital, QLD; Prof Michael Friedlander, Medical Oncologist, The Prince of Wales Hospital and Conjoint Professor of Medicine, The University of NSW, NSW; Kim Hobbs, Clinical Specialist Social Worker, Gynaecological Cancer, Westmead Hospital, NSW; Adele Hudson, Statewide Clinical Nurse Consultant, Gynaecological Oncology Service, Royal Hobart Hospital, TAS; Dr Anthony Richards, Gynaecological Oncologist, The Royal Women’s Hospital and Joan Kirner Women’s and Children’s Hospital, VIC; Georgina Richter, Gynaecological Oncology Clinical Nurse Consultant, Royal Adelaide Hospital, SA; Deb Roffe, 13 11 20 Consultant, Cancer Council SA.

Page last updated:

The information on this webpage was adapted from Understanding Cancer of the Uterus – A guide for people with cancer, their families and friends (2021 edition). This webpage was last updated in June 2021. 

90,000 ultrasound of the uterus and appendages price in Moscow

Ultrasound of the small pelvis in women is a diagnostic study of the uterus and appendages using ultrasound. The procedure is completely painless and safe for a woman’s body, while being very informative. With the help of ultrasound, it is possible to quickly diagnose a large number of gynecological pathologies.

Where to do ultrasound of the uterus and appendages

You can undergo an ultrasound examination of the uterus and appendages in the MedCenterService network of clinics.The medical center has many advantages:

• Accurate examination result. The clinic is equipped in accordance with modern standards, and ultrasound is performed using the latest generation equipment.
• Individual approach. The doctor is attentive to the patient’s problem, which helps to make the diagnosis more effective.
• Convenient location of clinics and appointments by appointment. There are no queues, each patient arrives at the appointed time.
• High diagnostic speed.The result of the study of the structures of the small pelvis will be given immediately.

At will, the patient can immediately contact the gynecologist to decipher the result and prescribe treatment.

What does ultrasound of the uterus and appendages show?

• Inflammatory processes in the uterus, ovaries and fallopian tubes;
• tumors of a malignant and benign nature;
• fluid accumulation, cysts;
• endometriosis, endometrial hyperplasia;
• ectopic pregnancy;
• infertility;
• prolapse of the pelvic organs;
• polycystic ovary syndrome, etc.

Ultrasound of the uterus and appendages is prescribed not only in the presence of diseases, but also during pregnancy. You can see the ovum already at the 4th week of gestation, and further research is carried out in order to make sure that the baby is developing correctly and nothing threatens his life and health.

Indications for ultrasound of the uterus and appendages

For the prevention of ultrasound of the uterus and appendages, it is recommended to undergo an annual examination of all women and girls over 16 years of age.An examination is urgently prescribed if the following symptoms are disturbing:

• Irregular menstruation, delayed menstruation for more than 5 days.
• Changes in the nature of menstruation. Your periods may become too heavy or too scarce, which is not typical for a particular woman.
• Severe pain in the lower abdomen during menstruation.
• Pain in the lower abdomen, not associated with menstruation, as well as pain during intercourse.
• Bleeding for an unknown reason.
• Purulent vaginal discharge with an unpleasant odor.

The gynecologist directs for ultrasound diagnostics of the pelvic organs, if there is a suspicion of an inflammatory process, tumor neoplasms or other pathologies.

It is recommended to undergo the study regularly for women at risk:

• After 45 years, especially nulliparous, as the risk of cancer increases.
• Women who have taken oral contraceptives and smoked for a long time.
• If there is a history of breast pathology, the condition of the pelvic organs should also be regularly monitored.
• Pregnant women in each trimester.

Ultrasound is a safe and informative type of diagnosis, therefore it is prescribed for patients of all ages. You can be examined as often as necessary, which is an undoubted plus, since it becomes possible to control the effectiveness of treatment without negatively affecting the body and without radiation.

Preparation for examination

Gynecological ultrasound examination requires preparation, which will depend on the method chosen. Before transabdominal ultrasound (through the anterior abdominal wall), it is recommended to fill the bladder, for this you need to drink a liter of water without gas in 30 minutes. A full bladder will press on the uterus and appendages, straightening them out, making the organs easier to see.

If the doctor has prescribed a transvaginal ultrasound, then there is no need to drink water.In this case, the sensor is inserted into the vagina, which allows a good view of all structures.

Before examining the pelvic organs, it is recommended to empty the intestines and follow a diet, excluding gas-forming products, such as:

• raw vegetables and fruits;
• cakes, pastries and other sweets;
• yeast baked goods;
• legumes, peas, corn;
• carbonated drinks and alcohol.

Excess air in the intestines interferes and complicates the examination process for the doctor.

How do ultrasound of the uterus and appendages

For a transabdominal examination, a woman exposes her lower abdomen and lies down on a couch. The doctor applies a hydrogel to the skin and applies an ultrasound probe. The device emits high-frequency ultrasonic waves that pass through and are repelled by tissues, returning at different frequencies. The received data is transferred to a computer and transformed into a visual image.

During the procedure, the doctor examines the resulting picture, takes measurements and enters all the data into the study protocol. After the end of the procedure, the woman wipes off the remnants of the hydrogel from the skin, dresses and receives the result on her hands.

The second diagnostic option is transvaginal, using a vaginal sensor. For the procedure, the woman undresses from the waist down, takes off her underwear and lies down on the couch. The doctor takes a vaginal probe, puts a disposable condom on it, lubricates it with a hydrogel and inserts it into the vagina.

Transvaginal ultrasound examination is considered more preferable, since with this access it is possible to identify pathologies in the early stages. Transabdominal ultrasound is performed for virgins, women at 2-3 gestational age, with large uterine myoma and other pathologies that are well visualized.

Standards and interpretation of results

During the diagnostic examination, the doctor assesses the contours of the organs, the homogeneity of the tissue, takes measurements to find out the length, width and weight of the organ.The doctor compares the obtained figures with the average values, which are taken as the norm.

The rates depend on many factors, in particular, on the age of the patient and on whether she gave birth and how long ago. In addition, the results of ultrasound diagnostics alone are not enough to make a diagnosis and prescribe treatment. Additionally, the gynecologist conducts a survey and collection of anamnesis, bimanual examination, and, if necessary, prescribes additional diagnostic measures.Therefore, it is better to entrust the decoding to a gynecologist and not self-medicate.

Normal indicators of ultrasound of the uterus and appendages:

• Uterine location without abnormalities or anteflexia. If the study protocol says retroflection or lateroflexia, this indicates organ displacement.
• The size of the uterus of a nulliparous woman is 4-7 cm in length, 4.5-6 cm in width, the antero-posterior size is 3-4 cm. The weight of the organ is 50 g. A week after giving birth, the organ weighs 500 grams, and after 2 months it returns to normal size and weighs within 80 grams.
• The thickness of the endometrium varies with the day of the menstrual cycle. From 1 to 7 days – 1-4 mm, from 7 to 20 days – 4-8 mm, from 20 to 30 days – 8-16 mm. The structure of the mucosa is normally homogeneous.
• The walls of the uterus are homogeneous, there are no neoplasms, the contours are even.
• The size of the uterine cervix is ​​3.5-4.5 cm, the size of the pharynx is up to 5 mm. The patency of the cervical canal is normal, the mucous membrane is homogeneous.
• Ovaries on ultrasound look like lumpy formations, homogeneous interspersed, the dominant follicle is visualized.
• Size 2-3 cm, volume 8 cm³.
• The fallopian tubes are not normally visualized.

If the genital organ is too small, and does not correspond to the patient’s age, pathology, for example, infantilism or hypoplasia, can be suspected. Too large size indicates an inflammatory process, the presence of a neoplasm, hyperplasia or endometriosis.

If the uterus is too large after childbirth and does not shrink, the doctor will suspect subinvolution of the organ.This is a pathology in which the contraction process is disrupted, which may be associated with weak muscle activity, the presence of inflammation in the cavity of the genital organ and other abnormalities.

Insufficient thickness of the endometrium is a sign of hypoplasia. With such a violation, the endometrium grows poorly, which leads to the development of infertility, since a sufficient thickness of the mucous membrane is necessary to secure the embryo. If the endometrium is too thick, endometriosis or mucosal hyperplasia may be suspected.Often, the violation is accompanied by the formation of polyps and cysts, the mucous membrane becomes heterogeneous.

An increase in the size of the ovaries is a sign of the development of adnexitis, that is, inflammation. If the doctor sees a large mass, a cyst (with fluid inside), a benign or malignant tumor, can be suspected. A large number of cysts is a sign of polycystic ovary syndrome.

If the uterine tubes are visible on an ultrasound, this is a sign of their pathology. Normally, the fallopian tubes are small and cannot be seen behind the genital organ.If they become inflamed, they increase in size and render. To check the patency of the fallopian tubes, ultrasound is performed with contrast, for this, a warm solution is injected through the uterine neck, which enters the tubes and tints them, allowing the doctor to identify a violation of patency.

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Bulletin of Vitebsk State Medical University.- 2013. – T. 12, No. 1

Library of UO “VSMU”

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Ultrasound of the uterus and appendages in Novosibirsk

Specialists in the field of gynecology note that women’s diseases are getting younger every year.And if earlier many problems associated with women’s health arose in women over 45, today doctors from an early age diagnose diseases such as fibroids, dysplasia, inflammation, polycystic ovary disease, erosion, etc.

In order to diagnose the disease in a timely manner and prescribe an effective course of treatment, it is necessary to undergo an ultrasound of the uterus and ovaries.

A few years ago, such a progressive procedure was available only to a few and abroad.Today in the DLC “Info Medica” you have the opportunity to perform ultrasound of the uterus in Novosibirsk and get an accurate opinion from qualified specialists.

When does a specialist prescribe an ultrasound of the ovaries of the uterus?

1. Infertility.
2. Erosion of the cervix.
3. Cycle failure (irregular cycle or delay).
4. Inflammation of the appendages.
5. Pathology of development of the uterus and ovaries.
6. Painful sensations.
7. Ectopic pregnancy.

Ultrasound of the appendages and uterus is one of the most effective and accurate methods for diagnosing women’s health, allowing you to study and diagnose the slightest changes in the condition and deviations.

For women whose period of menstruation exceeds 7 days and is accompanied by pain, ultrasound examination of the state of the uterus and ovaries allows us to examine the structure of organs and determine the slightest deviations from the norm.

How does an ultrasound of the cervix take place?

If a specialist for diagnosis has prescribed an ultrasound of the uterus for you, then ask in advance how the procedure will take place.

If the doctor needs to perform a transabdominal ultrasound scan through the abdomen, then before taking it, you must drink at least 1 liter of water to fill the bladder. Only in this case the picture will be clear, and the specialist will be able to make an accurate diagnosis. In this procedure, a special gel is applied to the patient’s abdomen, which improves the contact of the sensor.

If the ultrasound doctor needs to perform a transvaginal ultrasound of the cervix to study your health status, then the procedure will go through the vagina.In this case, a full bladder is not needed, and basic sanitary and hygienic standards of care must be followed before the procedure. An ultrasound of the cervix can cause some discomfort, since a special probe is inserted deep into the vagina, but this is a completely safe procedure. To exclude the possibility of infection, a condom is put on the transducer before insertion.

Considering that certain physiological processes take place in the body during menstruation, ultrasound of the appendages should be carried out 6-7 days from the beginning of the cycle, therefore, when making an appointment with a doctor, try to take these factors into account.

Ultrasound of the uterus is one of the necessary procedures in diagnosing a woman’s health status. In order to determine deviations from the norm, the ultrasound doctor needs to measure the uterus, the size of which depends not only on the woman’s age, but also on the day of the cycle, the number of deliveries, pregnancies, etc.

The best specialists in Novosibirsk

In DLC “Info Medica” the best specialists of Novosibirsk work, who on modern and high-precision equipment will diagnose the state of women’s health, perform ultrasound of the appendages and uterus and give the most correct conclusion.

This is one of the most popular procedures, since it is the ultrasound of the uterus that makes it possible to establish a reliable diagnosis. With the help of ultrasound radiation, the ultrasound doctor determines not only the size of the uterus, but its structure, location, presence of neoplasms, etc. This is a mandatory procedure for all women who care about their health and should be performed once a year for prevention.

We care about your health and guarantee a careful and attentive attitude.

Reception lead:

Prices for ultrasound of the uterus and appendages

of the neck

of the neck

uterine diseases

1000

) ( echocardiography

)

two limbs)

902 902 902 limbs (two)

902 17

349	Vascular ultrasound, Doppler ultrasound
350	Neck vascular ultrasound ( Triplex scanning extracranial arterial regions 9000
351	Ultrasound of the head vessels ( Triplex scanning of the intracranial section of the brachiocephalic arteries)	1500
352
352
352	2800
353	Ultrasound of the kidneys and renal arteries	1000
	354 17		354 17
355	Ultrasound of the liver vessels	1000
356	arteries and abdominal aorta and its visceral branches and deep abdominal veins of the caval system)	1000
357	Ultrasound of the heart and great vessels ( echocardiography ( echocardiography
358	Ultrasound of the heart and great vessels of the fetus (after the 20th week of pregnancy)	2150
359	9 limbs)	1950
360	Ultrasound of the venous vessels of the arms (one limb)	1000
361 )	2200
362	Ultrasound of the venous vessels of the lower extremities (one)	1100 9000 906
1950
364	Ultrasound of the arterial vessels of the arms (one limb)	1000
2200
366	Ultrasound of arterial vessels of the lower extremities (one)	1100
367

***

• This information is not a public offer.Prices, names and range of services are subject to change. You can get information up-to-date at the time of applying for a medical service by phone.
• Pensioners and disabled people are provided with benefits in the amount of 10% of the price according to the list price, with the exception of laboratory diagnostics, bioresonance therapy, and the cost of consumables.

To receive benefits, you must present a certificate (pension / disability)

, bladder )

9000 550

0 transabdominal

902 900

9 0216 331

301	ULTRASONIC RESEARCH
302	Thyroid ultrasound	9000 tissues, l / nodes and the great vessels passing in this area	3000
304	Ultrasound of mammary glands	1100 1100	1100 902 Ultrasound of the abdominal organs (liver, gallbladder, pancreas, spleen)	1300
306	Complex ultrasound of the abdominal and retroperitoneal organs.	2100
307	Ultrasound of the gallbladder with determination of function	1100
1000
309	Kidney ultrasound	800
311	Ultrasound of the bladder	800
312				Ultrasound of urinary bladder 902
313	TRUS ( transrectal ultrasound of the prostate gland)	1100
314	TRUS of the urinary gland 1400
315	TRUS ( transrectal ultrasound of the prostate) + urinary bladder with determination of residual urine	1600		1000
317	Ultrasound of the prostate and bladder (transabdominal)	1400 902 0215	318	Ultrasound of the male complex (TRUS of the prostate gland, seminal vesicles, bladder, epididymis, testicles)	2500
319	319
320	Ultrasound of soft tissues, l / nodes	900
321				Ultrasound 902 902
322	Ultrasound of the pelvic organs gynecological (transabdominal)	1100
323	and tranabdominally) 90 217	1300
324	Gynecological ultrasound of the pelvic organs repeatedly within 1 month. (transvaginal, using a vaginal probe and tranabdominal)	1100
325	Gynecological pelvic ultrasound repeatedly within 3 months. (transvaginal, with vaginal probe and tranabdominal)	1200
326	Early pregnancy ultrasound (up to 12 weeks)		17 327	Folliculogenesis – 1 th times from 5 to 8 days of m / cycle	800
328	– 960 times – 960 times day m / cycle	600
329	Folliculogenesis – 3 th times from 17 to 21 days m / cycle		902 6002 330	Ultrasound of the paranasal sinuses	800
Ultrasound of the eyeballs	1000

Ultrasound during pregnancy

However, there are other reasons that simply oblige both doctors and patients to undergo ultrasounds with delayed menstruation and the first signs of early pregnancy (BRS).The main ones are:

• it is necessary to exclude an ectopic pregnancy and make sure that it is uterine;
• it is necessary to exclude cystic drift, which is similar to pregnancy in all clinical and laboratory signs, but is a dangerous disease;
• in the presence of a uterine pregnancy, it is necessary to determine the quality of the gestational process, in case of a pregnancy pathology, it is necessary to find out the causes of the pathology in a timely manner and start treatment in a timely manner;
• Ultrasound with certainty determines the duration of pregnancy: this information also determines the date of delivery;
• in the event that a delay in menstruation occurs, but pregnancy is not detected, an ultrasound scan will help determine the gynecological disease that caused the delay in menstruation.

Thus, ultrasound during early pregnancy is absolutely necessary , however, there are still ideas about the dangers of ultrasound. Nevertheless, the safety of medical ultrasound has been proven and reflected in international documents. Recommendations for shortening the duration of each LRS study are ethical in nature, taking into account the concerns of expectant mothers regarding ultrasound.
So what are the possibilities of ultrasound? With a delay of only 3-5 days, an ultrasound scanner with a transvaginal sensor can register a uterine pregnancy for a period of 2.5-3 weeks from the moment of conception.Ultrasound during early pregnancy allows you to determine the embryological period of pregnancy, i.e. the period calculated from the moment of fusion of the germ cells.

The obstetric counting from the first day of the last menstrual period may be inaccurate, and it is difficult to determine the expected time of delivery from it. To translate the embryological period of pregnancy into obstetric, it is necessary to add 2-2.5 weeks to the embryological period. In the period of 2.5-3 weeks, the process of implantation of the blastocyst into the uterine mucosa is completed.

From that moment on, it is called the fertilized egg and becomes available for research. At this time, the blastocyst or embryonic chamber looks like a dark, round or drop-shaped formation, 4-5 mm in diameter. The embryonic chamber is surrounded by a membrane and does not reflect ultrasonic waves, i.e. it is echo negative. The embryo and extraembryonic organs have a microscopic structure and parietal localization, therefore they are not yet visible with ultrasound: at this time, the ovum looks like a homogeneous liquid.The place of implantation of the ovum is most often located in the area of ​​one of the tubal corners, but sometimes the localization of the ovum is located low, closer to the isthmus. Such proximal localization occurs when the blastocyst moves into the uterine cavity for several days after leaving the fallopian tube and only then is implanted into the uterine wall.

If, with a delay in menstruation, an ultrasound does not detect a fertilized egg in the uterus, it is necessary to undergo an examination after one to two weeks so that the fertilized egg increases in size.The absence of the ovum during a second examination should alert the doctor: in this case, an ectopic pregnancy is possible. However, the diagnosis of an ectopic pregnancy cannot be established only with the help of ultrasound; a more thorough examination is necessary.

In some cases, when a round fluid formation is found in the uterine cavity, but laboratory and clinical data do not confirm the presence of pregnancy, a repeated examination will help diagnose the presence of a glandular polyp, cyst or myomatous nodule protruding into the uterine cavity.The rounded fluid formation may be small. Such problems need to be solved only in a specialized institution licensed to work with pregnant women. It is also necessary to undergo an ultrasound scan of the BRS (and any other period of pregnancy).

In the antenatal clinic, maternity hospital, perinatal center, only a professional – an echoscopist – is competent in the field of physiology and pathology of the female genital area, obstetrics and applied embryology. Currently, centers providing services on the principle of “ultrasound of everything in the world” are very widespread – these centers do not provide a professional examination at the proper level and make a large number of mistakes when making a diagnosis.

So, pregnancy was detected, the ovum was implanted into the wall of the uterus and very quickly increases in size. 17-20 mm – this is the diameter of the ovum at four weeks of pregnancy. The fertilized egg becomes oval, the size of the uterus increases slightly, and asymmetry of its walls appears – one wall becomes thicker than the other. The embryo will become visible only at 5 weeks of pregnancy, but for now, the yolk sac, which stores the supply of nutrients for the developing embryo, is well distinguished.An oblong 5-week-old embryo is several mm long, an amniotic leg stretches from the embryo to the inner surface of the ovum – the future umbilical cord. From this moment, the embryo can freely move in the fluid of the embryonic chamber – it leaves its parietal position.

With a 5-week pregnancy, it is already possible to determine whether one embryo or two have settled in the embryonic chamber. The number and structure of the amniotic membranes and chorion – the future placenta – determine the type of future twins.If the embryonic material in the blastocyst is doubled, monozygotic (monochorionic) twins with a completely identical set of chromosomes develop. Children from such twins are always same-sex and are absolutely similar to each other.

But if, before conception, two follicles ovulate in different ovaries, then two pairs of germ cells merge and two blastocysts are formed, which are implanted and two fetal eggs with two embryos are formed. In this case, fraternal twins are formed – bichorial or dichorial.Such children are not twins in the strict sense of the word, because they have different sets of chromosomes, they can be of different sex and are not at all similar to each other. 70% of born twins are fraternal. But, in addition to twins, there are also triplets, and in general multiple pregnancies. There are various options for combinations of amniotic membranes and chorions: for example, triplets can consist of two twins and one child with them. Ultrasound of the BRS easily identifies the type of twins or triplets, but in the later stages it is more difficult to do this, becausebecause the embryonic chambers will fill the entire uterine cavity. But apart from twins and triplets of this type (each embryo is in a separate embryonic chamber), there is a pathological variant of multiple pregnancy (monamniotic monochorionic pregnancy), when the embryos are not separated by an inter-amniotic septum. In this case, the possibility of the appearance of conjoined (Siamese) twins and the development of a genetically defective fetus is possible. Such a pregnancy must be terminated at the earliest possible date and the development of such a catastrophe must be prevented.It is the ultrasound of the BRS that allows you to predict and prevent the tragic development of pregnancy.
Since the development of bi-twins occurs due to the ovulation of two follicles, there are two corpus luteum (VT) in the ovaries.

What is the corpus luteum?

VT occurs in the ovary at the site of the ovulating follicle: VT is a temporary hormonal organ. VT is responsible for the production of progesterone, the main hormone of pregnancy; with ultrasound, VT looks like a rounded formation of heterogeneous soft tissues.It is impossible to determine progesterone deficiency from an ultrasound image, but clinical and laboratory studies make it possible to diagnose this deficiency.

With the development of pregnancy, cysts can sometimes form in the VT. The reason for the formation of cysts is that the corpus luteum produces small amounts of fluid. Some of this fluid is resorbed by the blood vessels of the ovary, and some remains inside the ovary, forming bubbles, which form cysts (from the Greek root “cyst” – “bubble”).By 10-15 weeks of gestation, the VT cyst completely resolves, since the VT itself decreases. VT cysts do not pose a threat to pregnancy, but sometimes a woman may feel pain in the lower abdomen, mistaking them for a symptom of threatening miscarriage.

Can an ultrasound scan identify signs of a threatening miscarriage?

With miscarriage, the ovum detaches from the inner wall of the uterus and, as a result of contraction of the myometrium, it is expelled from the uterine cavity. This process is divided into phases: a threatening miscarriage that has begun, “in progress” and has occurred.Excessive tension (hypertonicity) of the muscles of the uterus is determined by ultrasound.

What are the ultrasound signs of an incipient miscarriage?

• An ultrasound sign showing a thickening of one of the walls of the uterus can be deceiving, since there is a physiological asymmetry of the walls of the uterus, which is detected even during ultrasound of the BRS. Short-term contraction of the uterus can occur due to the pressure of the vaginal probe on the isthmus of the uterus. Such a short-term reduction can be mistaken for a sign of threatening miscarriage.Long-term hypertonicity is distinguished from short-term hypertonia using a transabdominal transducer with an empty bladder. Congestive hypertonicity, indicating the threat of miscarriage, exists for a long time, and the short-term one soon disappears.
• Changes in the configuration of the ovum, the transformation of its shape into a scaphoid or drop-shaped, a change in the outer contour of the uterus (the tubercle is raised over the flat contour of the uterus over the contracted area of ​​the myometrium).
• The most formidable sign of a threatening and incipient miscarriage is bloody discharge, resulting from the fact that a certain amount of blood is poured into the uterine cavity next to the ovum – a subchorial hematoma (gravid hematometer).When the ovum invades the wall of the uterus, it destroys small vessels, while the increasing hematoma puts pressure on the ovum, as a result of which the connection between it and the uterine wall is lost. Ultrasound determines the volume and localization of the gravidar hematometer, the time of its formation and the tendency to progression. Thus, the cause of pain and bloody discharge during threatened miscarriage can be determined by ultrasound, which will help plan a treatment strategy (with uterine hypertonicity with and without hematoma, it will be different and even mutually exclusive).But in the absence of pain in the lower abdomen, bloody discharge and other signs of a threatening miscarriage, ultrasound data indicating a threat must be interpreted as a purely hardware phenomenon. An analogue of the expression “threat by ultrasound” can be the expression “headache by urine analysis”.

However, spontaneous miscarriage occurs without pain and hypertension. This case is called a failed miscarriage (“anembryonia”, “undeveloped” or “frozen pregnancy”).With a frozen pregnancy, the vital activity of the embryo stops, and the contractile activity of the uterus, aimed at expelling the non-viable ovum from its cavity, is absent.

The embryo and all elements of the embryonic complex are not visualized by ultrasound at the 5th week of pregnancy in case of anembryonia. This indicates that the development of the embryo stopped before the embryo reached a size of 1–2 mm. Re-examination at weekly intervals if anembryonic disease is suspected will clarify the diagnosis.When the embryo is clearly visible (for example, with a short amniotic leg and a parietal location of the embryo), it becomes possible to exclude aneibryony, in which the ovum grows due to the accumulated fluid in it, but the image of the embryo is still not possible.

In the case of anembryony of one of the fetal eggs with twins, the so-called biamniotic mono-embryonic pregnancy, one of the embryos does not develop (failed twins). Next to the normal one, an “empty” amniotic cavity is found, then, as the ovum grows, it crescently bends around the image of the normal amniotic cavity and then merges with it completely.The ultrasound phenomenon, described as a “double contour of the ovum” or “amniotic filament in the uterine cavity,” is a sign of failed twins. This symptom does not interfere with the course of a singleton pregnancy.

A missed miscarriage in a period of 5 weeks or more is called a frozen pregnancy. With a frozen pregnancy, the embryonic complex is visible (in contrast to anembryony). However, the embryonic complex consists of poorly differentiated linear objects, in which there are no signs of vital activity – heartbeat and physical activity, characteristic of a normal embryo in a progressive pregnancy.

Normally, with a 5-week pregnancy, the embryo reaches 7-8 mm, with a 6-week pregnancy – 12-13 mm and 18-19 mm – with a 7-week pregnancy. The “growth” of an embryo is called the parietal-coccygeal size (CTE). The “waist circumference” of the embryo also increases – from 2-3 mm to 6-8 in two weeks. “Pulsation of the embryo” – heartbeats are detected starting from 5 weeks, but the heart on the screen is still impossible to distinguish. At 5-6 weeks of pregnancy, the frequency of contractions is 120-130 beats / min, by 7-8 weeks it reaches up to 200 beats / min.In this period, with ultrasound, the extensor movements of the embryo are already visible.

The head end from the pelvic end can be distinguished as early as 5 weeks from conception, and by 6 weeks tubercles appear in the place of future limbs. After 8 weeks of gestation, the internal organs of the fetus are visible, the spine and bones of the skull are visible by the end of 7 weeks. A living, healthy and mobile embryo will meet with the expectant mother and the doctor in the ultrasound diagnostics room in the period of 10-14 obstetric weeks (that is, 8-12 weeks from conception). The story of this meeting is yet to come.During pregnancy, the embryo will face many events and dangers, which it will successfully avoid with the help of a mother, a doctor and, of course, medical ultrasound. Soon it will become not an embryo, but a fetus, and a little later – and a newborn!

Our equipment

In our work, we use the latest achievements of world practice. Our doctors conduct ultrasound examinations using expert-level devices such as GE LOGIQ E9, GE VIVID 9, GE VOLUSON E8, GE VOLUSON E10.

The VOLUSON E10 ultrasound machine is equipped with a special electronic sensor that allows doctors to diagnose fetal malformations with maximum accuracy, assess the risk of hereditary pathology, pregnancy complications.
Already from the earliest time, using the unique Radience Flow modes, it is possible to assess with maximum accuracy the structures of the fetal heart, to exclude malformations, and the widest range of 3D and 4D capabilities, including HD life imaging, makes it possible not only to assess in detail the anatomy of internal organs of the fetus, but also with the maximum realism to see your baby from the very beginning of pregnancy.

Pregnancy management

When the long-awaited pregnancy comes, you really need to find your doctor. This should be a person who can be trusted, with whom it will be easy to find mutual understanding, who respects privacy and confidentiality. It is these obstetricians-gynecologists who work in “Scandinavia” so that pregnancy is as easy as possible, and the birth of a baby remains a joyful memory.

You can view our pregnancy management programs here.

Department of pregnancy pathology

Despite the naturalness of the process, not every pregnancy goes smoothly, and you need to be prepared for this. Therefore, in “Scandinavia” the department of pregnancy pathology works around the clock: here you can contact with the symptoms or complications that have arisen and count on timely and high-quality assistance.

Our doctors

Service prices:

Service available

+7 (812) 600-77-77

St. Petersburg, 197372, st.Ilyushin, 4, building 1

Komendantsky prospect

+7 (812) 600-78-25 (adult department) +7 (812) 600-78-52 (children department)

St. Petersburg, 194354, Uchebny per., 2

+7 (812) 600-77-77

St. Petersburg, 1

, Liteiny pr., 55A

Gostiny Dvor

Mayakovskaya

+7 (812) 600-77-77

St. Petersburg, 196066, Moskovsky pr., 193/2

Plastic of the body of the uterus

The uterus is an unpaired, hollow, smooth muscle organ located in the pelvic cavity, at the same distance from the pubic symphysis and the sacrum, at such a height that its uppermost part, the bottom, does not protrude beyond the upper edge of the pubic bone.The uterus is pear-shaped, flattened in the anteroposterior direction. Its wide part is facing up and forward (this is the most frequent position, but options are possible), narrow – down and forward. The shape and size of the uterus changes significantly at different periods of life and mainly in connection with pregnancy. The length of the uterus in a nulliparous woman is 7 – 8 cm, in a woman who has given birth – 8 – 9.5 cm, width at the level of the bottom is 4 – 5.5 cm; weight ranges from 30 to 100 g.
In the uterus, a distinction is made between the cervix, body and fundus.
The cervix sometimes gradually passes into the body of the uterus, sometimes sharply delimited from it; its length reaches 3 cm; it is divided into two parts: supravaginal and vaginal.The upper two-thirds of the cervix is ​​located above the vagina and constitutes its supravaginal portion. The lower third of the neck is, as it were, pressed into the vagina and makes up the vaginal part. At its lower end there is a rounded or oval opening of the uterus, the edges of which form the front lip and the back lip. In women who have given birth, the opening of the uterus has the form of a transverse slit, in those who have not given birth, it is rounded. The hind lip is somewhat longer and less thick. The opening of the uterus is directed towards the back wall of the vagina.
The body of the uterus has a triangular shape with a truncated lower angle extending into the cervix.The body is separated from the neck by a narrowed part – an isthmus, which corresponds to the position of the internal os (opening) of the cervix. The upper part of the uterus, which rises in the form of a vault over the openings of the fallopian tubes, is called the fundus. It presents a bulge and forms corners with the lateral edges of the uterus into which the fallopian tubes enter. The part of the body of the uterus, corresponding to the place of confluence of the tubes, is called the horns of the uterus. It is possible to detect pathology with the help of a comprehensive study. During hysteroscopy or hysterosalpingography, a special substance is injected into the uterine cavity, the presence of which makes it possible to make contrasting X-rays.If on them in the area of ​​the bottom of the uterus it is possible to identify a small depression, then this indicates the presence of a defect. In addition, magnetic resonance imaging (MRI) is used, which allows you to fix the structure of the pelvic organs at different levels. This technique has a fairly high accuracy, especially for the identification of septa.

A16.20.034	Plastic surgery of the body of the uterus with developmental anomalies	25 380,00
B01.003.004.010	using endotracheal anesthesia	37880.00
	using inhaled endotracheal anesthesia with sevoflurane	37 380,00

The full price list can be found at the reception or https://new.perinatal-center.pro/platnye-uslugi

We accept bank cards VISA, MASTERCARD, MAESTRO

GKB №31 – What is the basis of the therapeutic effect of UAE

The therapeutic effect of uterine artery embolization in patients with uterine myoma is due to the cessation of arterial blood flow in the vessels of the peripheral plexus at the time of emboli injection and, as a consequence, to the occurrence of aseptic necrosis of myoma nodes.

Small arteries that form the periphyroid plexus and feed the myoma have a terminal branching type. When emboli enter them with the blood flow, their accumulation occurs, which ultimately causes a stop of blood flow and a malnutrition of the myoma. As the branches supplying the myomatous node become clogged, and the corresponding increase in vascular resistance in them, it is possible for a small amount of embolizing particles to enter the vasculature of the myometrium. However, given the large number of internal anastomoses of the “wonderful” network of the uterus, complete cessation of blood circulation in the myometrium does not occur.

Stopping blood flow in the myomatous nodes and a sharp decrease in the volumetric blood flow in the uterine artery basin leads to a number of anatomical changes. The volume of the uterus and myomatous nodes by the year of observation is reduced by 2.8 and 3 times, respectively. The effectiveness of UAE for uterine fibroids of various localization and for submucous fibroids in particular is expressed primarily in the normalization of menstrual function. Uterine bleeding stops from the moment of UAE, the volume of blood loss during menstruation decreases 3-4 times, which leads to a rapid recovery of red blood counts.

The restoration of the contractility of the myometrium due to a decrease in the size of myomatous nodes, as well as the restoration of the anatomical parameters of the uterine cavity after the release of submucous nodes from it, certainly contributes to a decrease in blood loss. Clinical manifestations due to the large volume of the uterus and myomatous interstitial-subserous nodes (dysuric manifestations, pain, discomfort during sexual activity, etc.) are stopped in most in the period from 3 to 6 months.

In patients with large fibroids corresponding to 24-32 weeks of gestation, UAE can be used as a preoperative preparation before myomectomy (removal of myomatous nodes).

The terms for performing myomectomy by laparotomy access after UAE are different. It is possible to perform myomectomy immediately after UAE – this tactic allows to reduce the level of intraoperative blood loss, myomatous nodes due to contraction of the uterus become more accessible for isolation from the muscle bed. Performing the second stage in a delayed period (after 6-9 months) has its advantages: myomatous nodes decrease in size by almost 2 times, the mass of a healthy myometrium increases – this allows to reduce surgical trauma and cicatricial transformation.

Removal of myomatous nodes by laparoscopic approach after UAE is possible when there is a formed leg of the node. Two-stage treatment with UAE and laparoscopic myomectomy for subserous nodes on the pedicle is advisable only for multiple uterine myoma. Single subserous nodes on the pedicle are an indication for laparoscopic myomectomy and do not require preliminary preparation (UAE, vascular ligation, use of hormonal therapy).

UAE is very effective in the treatment of submucosal nodes.Several outcomes are possible: spontaneous expulsion of myomatous nodes, isolation of nodes in the form of fragments of necrotic tissue or necrotic detritus.

Expulsion of submucous myoma after UAE

In some patients, myomatous nodes released into the uterine cavity become available for transcervical myomectomy under the control of hysteroscopy or ultrasound. The maximum size of a submucous node can reach 14 cm in diameter, the minimum is 3 cm in diameter.Nodes 0 and 1 types can be removed mechanically (by unscrewing or chipping).

Myomectomy of nodes with a pronounced muscle bed can be performed using bipolar resection. The initial dimensions of the nodes are up to 10-12 cm in diameter. Within 6 – 12 months from the moment of UAE, optimal conditions are achieved for performing hysteroresection: the volume of the nodes decreases by 50-65%, the muscle bed is accordingly reduced, and intraoperative blood loss is significantly reduced.

It should be considered important that in patients with uterine fibroids with other factors of infertility, after effective UAE, it is possible to preserve reproductive function.

Hysterectomy (removal of the uterus) by vaginal access

Hysterectomy (removal of the uterus) by vaginal access

At Our MC Paracelsus, gynecological surgeons have the skills to perform any type of hysterectomy. At the preoperative appointment, the Gynecologist will select the most appropriate method of performing the operation, taking into account all the factors individually for each patient.

Vaginal hysterectomy.

Vaginal access is an operation in which all manipulations are carried out through incisions in the woman’s vagina.

T otal hysterectomy – is an operation that removes the entire uterus, both the body and the cervix. This volume of surgical intervention has to be resorted to in case of prolapse of internal genital organs, as well as a combination of pathology of the body and cervix, for example, with multiple cysts and precancerous changes in the cervix.In some cases, together with the body of the uterus, the surgeon removes the fallopian tubes and ovaries.

The decision on the amount of surgery is made by the gynecologist at the preoperative consultation.

Indications: The main indication for total hysterectomy by vaginal access is prolapse of the uterus in combination with pathology of the body and cervix.

1. Complete and incomplete prolapse of the uterus and vaginal walls. 2. Fibroids (leiomyoma, fibroids) Fibroids are small in size.

Rapid progressive growth of uterine fibroids.

Multiple myomatous nodes.

Myoma, accompanied by profuse uterine bleeding, leading to anemia. Fibroids with questionable biopsy results (suspected malignancy).

3. Endometriosis of the uterus (adenomyosis) 3-4 degrees, not amenable to conservative treatment.
4. Recurrent endometrial hyperplasia, atypical hyperplasia.
5. Precancerous diseases of the cervix.

Examination for surgical intervention and the validity of the examination results: You can undergo the entire volume of the preoperative examination in Our MC Paracel in one day!

colposcopy-12 months

Ultrasound of the pelvic organs

Ultrasound of the kidneys, bladder, retroperitoneal space.

Ultrasound of the veins of the lower extremities – 3 months

Swab for flora, bacteriological culture from the cervical canal -10 days

Oncocytology from the cervix – 6 months

General analysis of urine-10 days, General analysis of blood and reticulocytes -10 days,

Electrocardiogram with decoding -14days,

Blood for HIV, Hepatitis B, Hepatitis C, Syphilis 3 months.

Biochemical blood test: general, direct, indirect Bilir., Total protein, albumin,

urea, glucose, creatinine, uric acid, AST, ALT, alkaline phosphatase, blood sodium and potassium, cholesterol, blood pH -10 days

Coagulogram – 10 days

Blood group and Rh factor

Fluorography – 6 months.

Mammography -24 months (after 36 years), 12 months (after 50 years)

Consultation of the therapist, anesthesiologist and other specialists according to indications. According to indications, other examinations can be added. Anesthesia: These operations are performed under spinal anesthesia or under endotracheal anesthesia. The method of anesthesia is chosen jointly by the anesthesiologist and the surgeon, of course, taking into account the wishes of the patient. The selection of the type of pain relief is carried out strictly individually in each case. Contraindications:

Planned intervention is not performed for clinically significant blood clotting disorders, acute infections, decompensated somatic diseases (hypertension, unstable angina pectoris, severe diabetes mellitus, severe anemia).