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Uterine Hysteroscopy - Polyp Removal

With hyperplasia, the area of ​​the uterine lining expands and a polyp can form. Initially, it is benign and does not bother a woman for a long time, but sometimes it is reborn into a cancerous tumor.

The modern method of removing a polyp is hysteroscopy of the uterus, the procedure is therapeutic and diagnostic, and allows you to see the state of the body from the inside, to remove pathological formations, and to examine the cells of polypous tissue for oncology.

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Hysteroscopy - what is it?

Uterine Hysteroscopy - Polyp Removal

From the Greek language "hysteroscopy" is translated as "inspect, examine the uterus." This minimally invasive procedure is of two types:

  • diagnostic or ambulatory;
  • operative or therapeutic diagnostic (hysteroresectoscopy).

In the first case, the doctor examines the walls and cervix, the mouth of the fallopian tubes with a small optical device - a hysteroscope. It takes from 5 to 20 minutes, anesthesia does not apply or may be local. As a result, the cause of infertility or miscarriage, bleeding is detected, the diagnosis is diagnosed if endometriosis and other uterine pathologies are suspected.

Surgical hysteroscopy requires general anesthesia, during which not only the examination takes place, but also surgical treatment, for example, removal of a uterine polyp or cervical canal, adhesions, fibroids, cysts. She is appointed if the pathology is already defined or there is a reasonable suspicion of her.

What is hysteroscopy of the uterus polyp and endometrium?

What is hysteroscopy uterus polyp

photo scheme of hysteroscopy

At first, a uterine polyp does not pose an immediate danger to life and health. The situation changes when it grows in size - this causes infertility or tumor development.

Also appear intermenstrual bleeding, discomfort and pain in the lower abdomen, especially during intimacy. Therefore, timely removal of endometrial polyps is necessary, and hysteroscopy is the best method for this.

During hysteroscopy, a tube with a video camera is inserted into the uterine cavity, which displays an image of its walls on the screen, and the detected polyp is removed using endoscopic instruments.

Indications for hysteroscopy

Diagnostic hysteroscopy is indicated in cases of suspected submucosal myoma, endometriosis, developmental anomalies of the cervical canal and uterus, miscarriage and the inability to become pregnant.

It is carried out for examination after enhanced hormonal therapy, in the case of heavy menstruation , intermenstrual bleeding and post-menopausal bleeding. This method also allows you to see the remains of fetal membranes.

Surgical hysteroscopy is used for the surgical treatment of the following pathologies:

  • endometrial polyps - multiple or single;
  • submucous or submucous myoma;
  • uterine bleeding of unknown origin (metrorrhagia);
  • endometrial thickening of the uterus ( endometrial hyperplasia );
  • synechiae (adhesions, or fusion of the walls of the organ).

Also, the method is used to extract the intrauterine device.

Rules for preparing for hysteroscopy of the uterus

The operation is carried out a few days after the end of the month. The doctor first examines the patient using gynecological mirrors, performs a bimanual examination. A woman takes a vaginal smear test to detect infectious pathologies - they act as a contraindication for hysteroscopy.

With the help of ultrasound, pregnancy is excluded and the number and location of the polyps are predetermined.

Other studies before hysteroscopy:

  • general blood and urine analysis;
  • smear on cytology from the cervix;
  • the study of blood clotting;
  • blood test for HIV, syphilis, hepatitis;
  • samples for bilirubin, glucose, hepatic transaminases;
  • examination by an anesthesiologist;
  • chest x-ray, electrocardiography.

Rules for preparing for hysteroscopy of the uterus:

  1. During the week prior to the operation, do not use douching, vaginal suppositories and tablets;
  2. For 4-5 days to refuse sexual intercourse;
  3. Overnight not to have dinner, but you can drink clean water or tea, and lunch should be light and not contain products that cause gas formation;
  4. At bedtime, put a cleansing enema;
  5. The morning of the procedure can not be eaten.

Method of conducting hysteroscopy

hysteroscope photo

hysteroscope photo

Diagnostic hysteroscopy is performed on an outpatient basis while receiving a gynecologist. It does not require preparation, but does not allow the use of therapeutic methods.

Methodology of operative hysteroscopy:

  • a sedative is administered intramuscularly for 1-2 hours;
  • the patient is placed in a gynecological chair;
  • intravenously injected solution for anesthesia and after its operation begins the operation;
  • the cervical canal expands, a small amount of gas or fluid enters through it so that the organ cavity opens and the walls spread out;
  • a hysteroresectoscope is placed in it - it is a thin flexible tube with a video camera, a backlight at the end and a channel for inserting surgical instruments - the doctor sees the cervical canal, the walls of the uterus, the mouth of the tube;
  • if there are no polyps, adhesions or myomas, then the surgeon immediately performs an RDV - separate diagnostic curettage - takes the part of the mucous membrane with the curette;
  • remove uterine polyp during hysteroscopy with a clamp or surgical scissors;
  • after manipulation, the fluid from the uterus is taken out, the woman is transported to the ward.

Contraindications

Hysteroscopy is contraindicated in:

  • pregnancy;
  • severe uterine bleeding and menstruation;
  • cervical stenosis;
  • inflammation in the genitals;
  • severe pathologies of the liver, kidneys, or heart;
  • acute infections;
  • cervical cancer in the last stage.

Hysteroscopy results

Hysteroscopy results

In the results of endometrial hysteroscopy, the surgeon describes in detail:

  • condition of the uterus - its shape, size;
  • the thickness and color of the mucous membrane;
  • relief, tensile properties and wall density;
  • found formations - polyps, myoma, synechiae;
  • patency of the fallopian tubes;
  • the intensity of the vascular pattern;
  • condition of the mucous membrane of the cervical (cervical) canal.

During the examination, hyperplasia or inflammation of the endometrium, adhesions, polyps, myoma, fetal egg remains, cancer, anomalies in the structure of the organ can be detected.

Postoperative period

A few days after hysteroscopy may be pain in the lower abdomen and scanty discharge of blood from the vagina - they go away on their own. If the pain is very pronounced, then painkillers are shown.

Within 3 days after surgery, the doctor prescribes antispasmodic drugs so that the muscles of the uterus and her cervix relax and there is no accumulation of blood in it.

If a polyp appears on the background of inflammation, then after its elimination for the purpose of prevention, a short course of anti-inflammatory drugs is indicated. When the formation of glandular and the reason lies in the hormonal imbalance, the doctor prescribes hormonal means - contraceptives and gestagens.

To reduce the risk of complications in the postoperative period with hysteroscopy of the uterus to remove a polyp, during the time recommended by the doctor you should avoid:

  • intimacy;
  • baths, saunas and baths;
  • weight lifting and high physical exertion;
  • taking aspirin and other blood thinners;
  • douching and tampon insertion.

Hysteroscopy does not adversely affect the reproductive function; on the contrary, the removal of endometrial polyps prevents the development of a cancer and returns the possibility of becoming pregnant and bearing a child.

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