Hysteroscopy is a modern endoscopic method for detecting pathology of the uterus. It is a minimally invasive diagnostic and therapeutic procedure. Today, it is rightly called the “gold standard” for identifying pathological processes in the uterus. Depending on the evidence, hysteroscopy can be:
- Diagnostic procedure.
- Medical minimally invasive surgery.
Women of reproductive age are appointed from the 6th to the 12th day of the cycle.
Briefly about the method
In gynecological practice, modern endoscopic equipment is used for hysteroscopy, which is a whole system of lenses with different optical characteristics, which allows to perform the set diagnostic and surgical tasks. Gaseous or aqueous media can be used to expand and increase the volume of the uterus during hysteroscopy. The choice depends on the evidence and the purpose of the manipulation.
Indications and Contraindications
Indications for hysteroscopy are:
- Cyclic hormonal disorders in women of reproductive age.
- The pathological nature of discharge from the vagina, especially after menopause.
- Diagnosis and surgical treatment of fibroids and other benign tumors, adenomyosis, foreign bodies, for histological confirmation of malignant tumors of the uterus.
- Uterine bleeding, in order to identify the source, cause and possibility of stopping.
- The need for sanitation of the uterus from the remaining areas of the placenta, membranes of the ovum, perform sterilization.
- Diagnosis of determining the possible causes of infertility.
- Conducting a routine diagnostic procedure after previous surgical treatment.
- In order to identify anomalies and variants of the structure of the uterus.
Hysteroscopy - minimally invasive surgical intervention, is performed according to plan or according to emergency indications, for therapeutic or diagnostic purposes, has contraindications:
- Acute inflammatory processes of the uterus, requiring therapeutic treatment, inflammatory smear during gynecological examination.
- Pregnancy at any time.
- Period of inflammatory infectious diseases (flu, sore throat, etc.), exacerbation of chronic diseases.
- Menstrual bleeding.
After the intervention, the discharge from the hospital usually takes place either on the day the procedure is performed or the next day. Long stationary stay and supervision, as a rule, is not required.
The duration of the recovery period after the performed hysteroscopy of the uterus is from five days to three weeks and depends on the volume of the intervention performed.
As a rule, diagnostic hysteroscopy does not affect the working ability of patients and a woman can start work in a day or two. After therapeutic hysteroscopy, the disability period can last up to five days.
The postoperative period is characterized by signs caused by the healing of the uterine mucosa injured during the manipulation, the restoration of the former volume of the uterus after artificially increasing it during hysteroscopy. The clinical picture of the postoperative period is due to the following symptoms:
- Pain sensations.
- Vaginal discharge.
- Change cycle
- Stress factor.
Pain after hysteroscopy
The pain is localized in the suprapubic area. As a rule, pain is expressed slightly, pulling, in intensity similar to pain during menstruation. The first hours after the procedure can be cramping in nature, due to the contraction of the uterus and the restoration of its former size. More often, the pain does not require the use of analgesic drugs, or is easily removed by taking nonsteroidal anti-inflammatory drugs (paracetamol, Nimesil, Ketorol, Ketorolac), antispasmodics (No-shpa, papaverine). In duration, moderate or minor, pain in the lower abdomen can be expressed from several hours to three to four days.
Important: it is categorically contraindicated for the purpose of anesthesia to take drugs containing acetylsalicylic acid because of the risk of bleeding!
The serous hemorrhagic nature of the discharge from the genital tract due to damage to the endometrium of the uterus during hysteroscopy. In the first hours after the intervention may be more abundant, then resemble the usual periods. The first two or three days of discharge may contain small clots or scraps of tissue. Continue after the diagnostic procedure up to 4-5 days, and after therapeutic hysteroscopy (removal of education from the uterus) can last up to 10 days.
The next monthly come, as a rule, on time. The first day of the cycle must be counted from the day the surgery is performed. Sometimes the removal of bulky formations can lead to a slight increase in the duration of the cycle.
Purpose of antibacterial drugs in the postoperative period
As a rule, antibiotics are not required in the postoperative period. However, if the pathological process had signs of an inflammatory nature (when removing the left ovum, part of the placenta), antibacterial therapy is prescribed to prevent postoperative endometritis. The duration of admission depends on the specific situation, but on average is from five to seven days.
Period of recovery and rehabilitation
The period of full recovery after hysteroscopy is up to 3 weeks. A prerequisite for this period is the observance of simple but necessary recommendations.
Recommendations to patients after hysteroscopy of the uterus in the postoperative period:
- Observance of sexual rest for at least 3 weeks, as a mechanical injury of the uterus during sexual intercourse can cause bleeding.
- Measurement of body temperature the first 5-7 days after the intervention. This will allow to timely identify and take the necessary measures to treat postoperative inflammation of the uterus.
- Compliance with hygiene measures: twice a day, take a hygienic shower, refrain from bathing. Visiting baths, saunas, heat treatments are contraindicated.
- Follow-up to the recommendations of the attending physician for taking antibiotics, drugs taken for the purpose of pain relief.
- Compliance with the mode of the day, nutrition, limitation of physical activity.
With the appearance of heavy bloody clots, bleeding from the genital tract, the increase in pain, fever - you should immediately consult a doctor.
Types of hysteroscopy of the uterus
Depending on the purpose for which hysteroscopy is performed, it is divided into the following types of uterine hysteroscopy:
- diagnostic During the study, it is possible to determine the degree of uterine enlargement, examine the state of the endometrium, and identify various pathologies
- surgical In the process of examining the organ, excision of the affected tissues is carried out. Such manipulations can be carried out in identifying polyps, endometriosis, fibroids and other diseases of the uterus,
- control. Appointed through a certain period after the start of therapy. Thus it is possible to determine the degree of effectiveness of treatment and, if necessary, make its adjustment,
Regardless of the purpose of the study, after it the body needs time to recover.
The study is conducted to identify myomatous nodes, polyps and other pathologies of the urogenital system. At the same time, a hysteroscope of minimum diameter is inserted into the vagina.
Among the advantages of this method are the following:
- mucous membranes are almost not damaged,
- general anesthesia is not required, thereby reducing the risk of developing complications provoked by the use of anesthesia,
- hospitalization is not needed
- the duration of the procedure does not exceed half an hour,
- the operation is well tolerated.
The procedure is indicated for endometriosis. With the development of this disease, the endometrium grows abnormally. Suspend the pathological process is possible by removing the uterine layer. Also resort to surgery when removing polyps, myomas, adhesions and partitions in the uterus.
Often, during the rehabilitation period, women have a stomach ache, but gradually the pain syndrome subsides. There are also bloody discharge, which after a week and a half completely disappear.
Office hysteroscopy is considered the simplest. It is carried out on an outpatient basis. Often, an endometrium biopsy is performed.
The risk of complications is minimized. There are only minor pain after hysteroscopy and bleeding, gradually decreasing in volume.
There are a number of indications for hysteroscopy. Among them are the following:
- failure of the menstruation cycle,
- appearance of bleeding after menopause,
- endometrial cancer,
- synechiae inside the uterus,
- abnormal development of the body
- complications in the postpartum period,
- preparation for in vitro fertilization,
- evaluation of the effectiveness of drug therapy,
- remnants of the ovum in the organ after abortive activities.
There are certain contraindications, in the presence of which the operation is not carried out:
- infectious diseases that are acute,
- inflammatory process in the genitals
- desirable uterine pregnancy,
- cervical cancer
- cardiovascular diseases,
- pathology of the kidneys and liver,
- atresia of the cervical canal,
- ectopic pregnancy,
- profuse bleeding in the reproductive organ.
In the presence of such problems, research is not conducted. This is due to the fact that in the case of manipulations, the risk of complications is significantly increased.
Minor nagging pains are not considered abnormal. As a rule, pain is localized in the lower abdomen, as well as the lower back. After a couple of days, the discomfort disappears. Their appearance is due to tissue damage as a result of removal of myoma node, polyp, or other manipulations.
If the woman’s pain threshold is low, then the discomfort becomes more pronounced. At the same time resort to the use of anesthetic medicines.
Unbearable pain and fever after hysteroscopy are cause for concern. Alarms should also appear signs of intoxication. In this case, in order to eliminate possible complications, you should immediately seek help from a medical institution.
Antibiotics after hysteroscopy are prescribed to prevent complications. During this period, mucous membranes are damaged and not protected from infection, and as a result of the reproduction of pathogenic microorganisms, an inflammatory process begins.
Sometimes antibiotic therapy is resorted to additionally and before the procedure. Often, a three-day course of treatment is prescribed after hysteroscopy has been performed. Then begin to restore hormones. For this purpose, Duphaston is prescribed.
As a result of the study, complications are sometimes observed. Among the early effects after surgery are the following:
- inflammation of the uterus, as well as the peritoneum. Pelvioperitonitis and endometritis are considered the most common complications.
- hemolysis inside the vessels
- bleeding. Its appearance is due to the fact that during the operation the tissues of the uterus are injured, possibly causing damage to the large blood vessels.
Among the later effects of the following:
- hematometer. This is a pathological condition in which blood accumulates in the reproductive organ due to spasm of the cervical canal,
- deformation of the organ cavity
- exacerbation of chronic inflammation
- re-growth of remote tumors.
Damage to the vagina and mucous membranes of the uterus leads to the fact that the risk of developing a bacterial infection increases. When this occurs, pain in the lower abdomen and there are uncharacteristic discharge.
Pregnancy after hysteroscopy
There are certain recommendations for pregnancy after hysteroscopy, adhering to which the recovery process will proceed much faster. During the first month a woman needs sexual rest. This is due primarily to the fact that the body at this moment is not protected from the negative impact from outside. Genital infection can penetrate into the uterine cavity, and the condition is significantly aggravated.
In addition, vaginal bleeding is observed during the first one and a half weeks. It also makes intimacy impossible. The woman’s well-being during this period is deteriorating.
Pregnancy after elimination of pathology in the uterus is possible. Doctors recommend thinking about conception no earlier than three months after surgery.
Normally, the recovery period lasts about a month. After curettage and hysteroscopy, one should strictly adhere to the following recommendations during this time:
- do not have sex. In addition to the fact that this will manifest soreness, there is also a risk of pathogens entering the organ cavity,
- do not swim in open ponds, pools, or even take a bath. Only a shower is allowed,
- refuse to visit saunas and baths,
- do not neglect the rules of intimate hygiene and wash at least twice a day,
- take antibiotics strictly adhering to the regimen chosen by the doctor,
- measure body temperature twice during the day,
- avoid excessive physical exertion, as well as weight lifting,
- do not use tampons. Preference should be given to gaskets and change them every 3-4 hours. Blood is a favorable environment for the development and reproduction of bacteria,
- properly organize the diet. It is extremely important that the menu has enough vegetables, dairy products and fruits,
- undergo a systematic examination by a gynecologist,
- monitor the timely emptying of the bladder.
Despite the fact that hysteroscopy is considered a minimally invasive surgery, the risk of complications does exist. A woman should properly prepare for this procedure and strictly follow all medical recommendations after it. The manifestation of undesirable consequences due to this is observed much less frequently.
Features of the postoperative period
Rehabilitation after hysteroscopy is rather short. Its duration depends on the purpose of the operation. Most of the women, after this surgical intervention, the very next day, return to their normal life and to their work duties. Recovery from surgical hysteroscopy takes two to three weeks.
At the end of the study, the patient feels a slight spasmodic pain (sensations are similar to those experienced by women with painful periods). In addition, there is a slight weakness, which passes through eight to ten hours after medical manipulations. If the pain becomes even more intense, the doctor prescribes painkillers to the woman.
After a hysteroscopy, in which a polyp was removed, slight blood discharge from the vagina is possible within a few days. After other types of surgery (during hysteroscopy), such discharge may last from two to four weeks. In addition, patients often complain of moderate pain in the lower abdomen and in the perineum. Usually, these symptoms disappear after a couple of days.
If the pain syndrome is more pronounced, then you can take the usual painkillers, for example, "Ibuprofen". If the pain intensifies, there will be bleeding or unusual discharge from the genital tract, you should immediately seek medical help.
In order to prevent the development of complications after surgery, during the time recommended by the doctor, you must give up:
- taking a bath
- tampon use,
- visiting saunas and baths,
After a hysteroscopy, the patient may become pregnant in the future. Hysteroscopy relieves her of endometrial polyps, which often make it impossible to carry a fetus.
Prevention of inflammatory processes
In order to prevent the occurrence of the inflammatory process, the doctor may, at its own discretion, prescribe and give the patient a five to seven day course of antibiotics. This is especially true for patients who have dissected intrauterine partitions (the latter in the past were the cause of repeated spontaneous abortion) and extensive intrauterine synechia. In other cases, antibiotics are rarely prescribed.
Surveillance of patients after hysteroscopy was done, depends on the volume of the performed operation, the initial state of the internal genital organs of the woman and the nature of the pathology that was found in the uterus.
If during hysteroscopy, diagnostic curettage was performed or a simple operation was performed (endometrial tissue polyps were removed, a small myoma submucous node was removed), then there is no need for a special postoperative regimen. In this case, the patient is discharged home on the same day (or the day after the operation).
When a woman is undergoing hysteroscopy with a dissection of intrauterine adhesions (synechia), the doctor introduces an intrauterine contraceptive (IUD) into her uterus for two months. It is better to do this in order to reduce the risk of re-growth (and this risk after surgery is more than 50%). If for some reason IUD cannot be inserted, then a special silicone balloon or a Foley catheter is injected into the uterus for a week. If these devices are entered, a course of antibiotics is required.
After the hysteroscopy, did you begin to bleed heavily, are you worried about a sharp pain in the abdomen and a high body temperature? Immediately contact your doctor to prevent the negative effects of hysteroscopic intervention.
When are patients discharged?
A considerable number of patients who are in hospital for this examination are interested in the question: on what day can you be discharged after the hysteroscopy procedure? If it was planned, the patient can go home the next day. There are also cases when the discharged woman left the hospital after several hours (due to her satisfactory state of health and the presence of usual bloody bleeding after this intervention). The patient is in the hospital for a couple of days (two or three) after undergoing significant surgery (removal of myoma node or multiple endometrial polyps), or if complications have occurred.
Does endometrium grow rapidly after hysteroscopy?
Some patients may complain about the rather slow growth of the endometrium after their hysteroscopy. It is also important for women to know how the uterus is restored after the hysteroscopy procedure. Many of them are interested in how to increase the endometrium. And in general, what is recovery after diagnostic and operative hysteroscopy?
The process of restoring the endometrium and the uterus itself is generally regenerative (not requiring any intervention from the outside). In other words, this tissue will recover on its own, just as it does during menstruation. Because endometrial cells are excreted with blood during each period, new ones grow in their place in the middle of the cycle.
If the research results show that your endometrial growth process is too slow, then be sure to talk to your doctor about it.
Ultrasound after hysteroscopy
It is believed that after performing any operation, a woman may experience some fluctuations regarding the menstrual cycle. Therefore, do not be surprised if your cycle also breaks down after hysteroscopy. Changes can affect the onset of menstruation, and the nature of the discharge, and their duration. Of course, a woman may be disturbed by such violations. To make sure that health is normal, it is worth undergoing ultrasound.
Many patients are interested in how many days after hysteroscopy it is necessary to undergo ultrasound (ultrasound). After surgery, women must do ultrasound at specific intervals (1, 3, 6 months). Sex life resumes within two to three weeks after such a procedure.
Features of the procedure
Modern endoscopic equipment for this study allows you to visualize the internal state of the uterus. With it, you can accurately localize the pathological structures and remove them directly during the manipulation.
Indications for manipulation:
- Diagnosis of benign tumors, myomas, adenomyomas, endometrial polyp, diagnostic search and confirmation of the presence of malignant tumors.
- Bleeding from the uterus, the cause of which is not established.
- Cleansing the uterus from the remaining parts of the placenta.
- Control of the treatment.
- Hormonal disorders.
Hysteroscopy is not performed in the acute inflammatory process in the uterus, during pregnancy, acute respiratory infections or SARS, exacerbation of somatic diseases and also during critical days.
Surgery is performed as a diagnostic and therapeutic measures.
Ultrasound examination of the uterus is often performed before hysteroscopy. It is necessary to do an ultrasound to confirm the preliminary diagnosis, to determine where the tumor is. Ultrasound can also be done to control the treatment, as it helps to monitor how the endometrium grew after performing a certain intervention.
How long is the postoperative period and after how much is allowed to go home
As a rule, the postoperative period when using the method of hysteroscopy is shorter than during abdominal surgery on the uterus, including laparoscopic. The period during which a woman will need to observe a strict postoperative regime and stay in the hospital depends on the objectives of the procedure:
- If a diagnostic procedure was performed in the form of an examination of the uterine cavity, a woman can leave the walls of the hospital within a few hours. The full recovery period after such an operation lasts no more than 3 days.
- If diagnostic hysteroscopy of a small uterus polyp was performed, which did not require extensive intervention and injury to the endometrium, the patient may stay in the hospital for a day, sometimes up to three days. The same period of hospital stay requires a hysteroscopy procedure with endometrial scraping. In this case, the need to monitor the patient's condition after the removal of polyps in the uterus is required for early detection and elimination of bleeding and other probable problems.
- Postoperative follow-up after hysteroscopy to remove uterine fibroids is the longest. After her patient is in the hospital for at least a week after surgery. The full recovery period can last up to one and a half months.
In general, the recovery period lasts much longer than the duration of stay in the clinic. After the woman is discharged from the hospital, her state of health will be restored gradually. Long-term treatment may be required after hysteroscopy with the use of medications and physiotherapeutic methods, gymnastics, diet and other therapeutic and rehabilitation measures.
The end of the recovery period will come when the atypical discharge from the uterus stops, when her condition returns to normal, and this is confirmed by the diagnosis. The terms of full recovery, as well as the period of hospitalization, are variable: if you have done hysteroresectoscopy, the postoperative period and recovery will take at least three weeks, while diagnostic manipulations do not require long rehabilitation.
Important! If hysteroscopy was used as a method of treating infertility, pregnancy is planned after completing a full course of rehabilitation, but not earlier than 3 months after surgery.
Recovery after hysteroresectoscopy
The complexity and duration of the postoperative period after hysteroresectoscopy, that is, the procedure during which surgical manipulations were performed, are caused by trauma to the lining of the uterus mucous membrane, and sometimes the submucosal and muscular layer of the organ. As a rule, the operation is performed to remove a polyp in the uterus or fibroids. These tumors are removed either by electrocoagulation or by direct excision with surgical instruments followed by coagulation of the wound surface.
Since the risk of bleeding after resection of fibroids or polyp remains high enough, a woman should be under the supervision of a doctor for at least 3 days. If after surgery in the uterus are not observed heavy bleeding and signs of inflammation, the woman is discharged home, where she will undergo further treatment (medication).
Within two weeks after a hysteroresectoscopy of an endometrial polyp or uterine fibroid, a woman will have to:
- eliminate physical exertion, jumping, running, bending and squats, cycling,
- give up intimacy
- refuse to visit the pool, baths and saunas,
- observe thorough intimate hygiene,
- Use sanitary pads, not tampons.
In addition, it will be necessary to periodically be monitored by a gynecologist, as well as undergo an ultrasound diagnosis after 1, 3 and 6 months after the intervention.
Recovery after diagnostic surgery
After diagnostic hysteroscopy, the postoperative period usually lasts no more than a day. After the end of this period, the woman is allowed to go home, where she will stay for another 3-5 days. At this time, the patient may receive scanty bleeding from the vagina, which are considered normal, as well as pain in the lower abdomen of medium and low intensity.
To eliminate them, the doctor may prescribe antispasmodics or other drugs.
In most cases, special rehabilitation after diagnostic hysteroscopy is not required. The only thing worth paying attention to the patient is careful hygiene and temporary rejection of sex. If an additional medical procedure was performed (coagulation of the neoplasms, curettage), physical activity and heavy loads should be reduced by at least a week.
When the pains are gone
Unpleasant sensations in the lower part of the abdominal cavity, lower back, and sometimes in the perineum are observed in almost all women who have undergone hysteroscopy. Their appearance is due to the violation of the integrity of the mucous membranes and endometrium of the uterus. Since they have many nerve receptors, there is a spasm and pain that sometimes persists until the tissues heal completely, that is, for about a week or a little longer.
Important! If the pain is regular and unbearable, the doctor may use an injection of analgesics and antispasmodics. However, more often he recommends that patients take pills.
Does endometrium grow rapidly after hysteroscopy?
Full recovery after surgery on the uterus is fixed when the endometrium becomes holistic, uniform and able to perform its functions. In this regard, after hysteroscopy, there are some features of the postoperative period. For example, the healing of the endometrial layer of an organ always takes place by natural regeneration. The tissue recovers itself within a few days or weeks depending on the scale of the surgery and the area of the wound surface.
Forced to restore the original state of the endometrium is very difficult, since the ability of this type of tissue in the uterus to divide and regenerate is influenced by several factors:
- intake of basic nutrients and biologically active substances.
Most women with standard health indicators recover the endometrial layer after 1-2 menstrual cycles.
How to restore the endometrium
Experts say that endometrial restoration after hysteroscopy is a purely intimate and unique affair for each patient. They prefer to interfere in the process if a month after the intervention of the ultrasound scan reveals insufficiently fast tissue regeneration. Most often this occurs during treatment after hysteroscopy of an endometrial polyp, which has a large size and wide base. In this case, the wound surface is extensive and requires the use of additional measures:
- taking drugs to equalize hormonal levels,
- receiving funds to stimulate the immune system and the regenerative abilities of the body,
- taking antibiotics or anti-inflammatory drugs to prevent infection of postoperative wounds,
- carrying out physiotherapy, massage and so on.
A good stimulating effect is given by the observance of the norms of proper nutrition and moderate physical activity. As a rule, the efforts pay off quickly enough - in 2-3 weeks the endometrium begins to recover more intensively.
Note! It is impossible to use stimulating preparations without consulting a doctor, since there is a possibility that instead of normal endometrial tissues, connective or scar tissue will grow instead of normal postoperative wounds.
Nutrition after hysteroscopy
Recommendations on nutrition after hysteroscopy for endometriosis, myoma or uterine polyp are standard: on the first day it is necessary to gently load the digestive tract with liquid food, and then gradually load the intestines to restore peristalsis.
The list of things you can eat on the first day after uterine hysteroscopy includes:
- clear broths,
- liquid porridges on water or milk,
- fermented milk drinks
- grated cottage cheese with cream,
- soft vegetable purees.
On the second and third day after hysteroscopy, you can add soups in vegetable or lean chicken broth, steam cutlets from dietary meats, steamed fish, porridge (millet, buckwheat, oatmeal) into the diet. You can also eat steamed and boiled vegetables, omelets, casseroles with meat and vegetables. It is advisable to drink lightly brewed black or green teas, compotes, fruit drinks, natural juices and mineral water without gas.
Important! To reduce the risk of constipation, it is recommended to drink at least 2 liters of water per day.
It is strictly forbidden to consume alcohol, coffee, dishes with an abundance of spices, as well as fried vegetables and meat, sauces and mayonnaise. Products with high fat content is desirable to exclude from the menu until full recovery.
When can you play sports
After hysteroscopy, it is allowed to play sports no earlier than a week after the procedure. Particular attention should be paid to the choice of physical activity, because not all sports can be useful. What you should pay attention to:
- training should not bore or provoke the occurrence of discomfort,
- physical exercises should not contain jumps, running, weight lifting and other loads that are prohibited during the recovery period,
- full loads should not start earlier than allowed by the doctor.
Despite the fact that hypodynamia after hysteroscopy is contraindicated, almost all sports can be potentially dangerous. The only exceptions are yoga, breathing exercises and walking.
General recommendations on how to behave after hysteroscopy
In general, the lifestyle after the hysteroscopy should be subject to the principles of healthy lifestyles, but with the amendment that the woman underwent surgery. The most stringent restrictions describe the recommendations regarding hygiene and water procedures. The anatomical structure of the female genital system predisposes to the easy penetration of infection from the external environment, so it is important to reduce to a minimum or completely eliminate the following aspects of the usual life:
- in the first month after the intervention you should not take a bath, it is better to give preference to the soul,
- going to the swimming pool should be replaced with a shower - in artificial reservoirs you can overcool or catch an infection,
- it is not recommended to go to the bath for 1-2 months, since an increase in body temperature can cause bleeding,
- sex life after surgery is excluded for at least 4-6 weeks,
- after hysteroscopy it is allowed to load yourself with a maximum of three kilograms of burden, so the prerogative to lift weights, even if it is a small child, leave it close,
- To reduce the risk of thrombosis it is worth wearing compression stockings.
If, after the operation, the woman decided to go to the sea, she would have to give up swimming on public beaches, and would have to lie down to get a tan only in the shade in the morning and evening. To spoil the rest can other expert advice.
For example, you should observe the daily regimen: sleep at night, as well as rest during the day, avoid the bright sun, heat or cold. During the recovery period, you cannot drink alcohol, drinks with artificial flavors, energy and other not always healthy drinks, as well as many exotic dishes.
As a rule, after hysteroscopy, in accordance with the recommendations, the majority of women manage to behave. However, rehabilitation may be overshadowed by cramps and heavy bleeding, which are considered normal. To relieve them, a woman can enroll for a massage or undergo a course of physiotherapy. Magnet therapy, electrophoresis, galvanotherapy and other procedures will help to recover faster.
Important! The classic way to get rid of abdominal pain “like a woman”, which advises keeping cold on the lower back and abdomen, can result in inflammation of the uterus and appendages. Therefore, it is worth giving up. Drinking alcohol to reduce pain is also not worth it, because it is not compatible with many medications that a woman will take several days after the operation.
What not to do after hysteroscopy
Almost all the restrictions after hysteroscopy relate to situations that can trigger the development of infection, inflammation or the occurrence of bleeding from the uterus. These include:
- activities that require physical effort and weight lifting,
- water sports, as well as relaxing on the beach and in the pool,
- staying in hot, stuffy rooms, including saunas, baths, unventilated residential and non-residential premises, places open to the sun,
- classes and activities that are accompanied by a strong vibration - driving on rough roads, driving special vehicles, cycling, equestrian sport.
In addition, it is strictly forbidden to use and ingest drugs with heparin and its analogues, foods that thin the blood, irritate the mucous membranes. First of all, it is alcohol, carbonated drinks, spices, fatty spicy dishes, coffee.
What is prescribed after hysteroscopy
Hysteroscopy is almost never used as an independent method of treating myomas and endometriosis, polyps and uterine synechia. For the complete elimination of these pathologies, after the manipulations, various medical preparations are prescribed. With their help, it is possible to achieve maximum effectiveness of therapy. It is based on hormonal pills and drugs that exclude infection of wounds in the uterus, stimulate the regeneration of the endometrium.
The first drug that the doctor recommends taking after hysteroscopy is Duphaston. It helps to normalize progesterone, thereby restoring hormones and the menstrual cycle. As a rule, “Duphaston” after hysteroscopy is started from the first day after surgery, or after the start of the first cycle. A gynecologist may advise him to take hormone pills “Norkolut” instead, which contain the same substances, but in a different dosage.
Important! Before the appointment of hormonal drugs must be tested for sex hormones. Based on the results of laboratory diagnostics, the doctor will calculate the required dosage.
If a large wound was formed as a result of an operation on the endometrium of the uterus, estrogen preparations are prescribed for 3-4 weeks. Their dosage is also calculated individually.
In addition to hormonal drugs, it is recommended to take drugs from other groups:
- "Tranexam" - to prevent bleeding,
- "Wobenzym" - to speed up the regeneration of the endometrium,
- "Longidase" - to reduce the risk of postoperative adhesions,
- suppositories "Hexicon" - to prevent inflammation.
If the woman has not been prescribed hormonal contraceptives, and during the recovery period unprotected sexual intercourse has occurred, the doctor may advise you to take Postinor. However, this tool is used very carefully, as the combination of an open wound on the endometrium with its forced rejection can provoke profuse bleeding from the uterus.
Do I need to drink antibiotics and which ones are better
Taking antibiotics after hysteroscopy is indicated to all patients without exception. Drugs in this category are necessary for the prevention of postoperative infections and inflammations. How long and in what dosage antibiotics should be drunk is determined on the basis of the volume and complexity of the intervention, the current state of the woman and the existing health problems.
In most cases, antibiotic therapy after hysteroscopy of the uterus uses broad-spectrum antibiotics:
- "Amoxiclav" or "Azithromycin",
- "Klacid" and their analogues.
These antimicrobials are used in standard dosages. Sometimes it can change in accordance with the characteristics of the patient. Antibacterial effects are supported by taking NSAIDs, which minimizes the risk of postoperative complications.
Can I put anti-inflammatory candles
After hysteroscopy of the uterus, candles are often placed that help to deliver drugs to problem areas without loss of effectiveness. In most cases, vaginal suppositories have precisely anti-inflammatory action. They are effective even in the presence of abundant vaginal discharge, so their use is welcomed by many gynecologists.
Discharge and pain after removal of the polyp
The recovery period may be accompanied by pain of a different nature in the lower abdomen. As a rule, the patient is bothered by the pulling or aching pains that a woman usually experiences during menstruation. Such sensations are relieved with ordinary painkillers.
The condition of the woman after hysteroscopy is normal, the general state of health of the patient does not suffer. Basically she finds in her symptoms associated with the operation. For example, after removing polyps from the uterus, spotting is observed. This is because the hysteroscope damages the endometrium of the uterus (its inner membrane), causing minor bleeding. But there is very little blood, moreover, it quickly collapses, which explains the brown color of the discharge. No need to think that such a discharge occurs in every woman after surgery. Far from it. It all depends on the individual characteristics of the patient.
Discharge from the uterus after surgery may be normal!
After surgical removal of the endometrial polyp, discharge from the uterus is usually abundant and often prolonged. In this case, the doctor will prescribe drugs that have a hemostatic effect.
If after the removal of the polyp in the hospital more than three days have passed, and the bleeding does not stop, this is a reason to consult a doctor. This is especially important if there are blood clots, the discharge of which is accompanied by pain. The integrity of large vessels may have been damaged.
Hysteroscopy postoperative period
Any woman undergoes hysteroscopy. However, not everyone undergoes resectoscopy. What is the difference between these concepts?
- In the definition. Hysteroscopy is a study of the uterus to identify tumors. A resectoscopy is a surgical procedure performed in connection with the detection of these same formations.
- In the way of carrying. In the first version, only a gyroscope is used, and in the second, additional tools: a scalpel, forceps, and much more.
Thus, these two procedures have their similarities and differences. However, the reasons for conducting them are about the same:
- The presence of polyps.
- Soreness during the menstrual cycle.
- Non-compliance with basic hygiene.
One way or another, after diagnostic hysteroscopy, it is often necessary to perform a resectoscopy.
Pain syndrome after hysteroscopy
After a hysteroscopy operation, some so-called side effects may occur. Among other things, the first symptom that disrupts the general condition of a woman and affects her psychological well-being is pain syndrome.
Let us consider what constitutes a hysteroscopy procedure, based on this, the origin of the pain syndrome will be understood.
Hysteroscopy is a diagnostic operation for confirming or refuting one or another diagnosis, as well as clarifying the causes of long-term infertility problems and their elimination.
Most often, this research method is carried out on an outpatient basis, that is, without the occurrence of long-term disability, and the duration can be from one to three days. At the same time there is a standard preparation for this type of surgery. The woman is informed about the routine examination, blood sampling. Next, explain the procedure for performing hysteroscopy, in which the woman is located on a gynecological chair, of a slightly different type than usual for examination, anesthesia is performed by intravenous anesthesia.
Next, perform a two-handed examination to determine the localization of the uterus and its size, the external genitals and the cervix are treated with iodine solution or alcohol, and then the cervix is fixed with special forceps to the front lip. Then, using a probe, determine the length of the uterine cavity, and after pre-expansion of the cervical canal, the uterine cavity is filled with gas or a special liquid solution, which allows the uterus to expand and make it accessible to the hysteroscope for examination. After that, the hysteroscope itself is used, and a full diagnosis of the uterine cavity is performed on the image on the screen, an examination of the mouths of the fallopian tubes, and possibly their passage, the cervical canal of the uterus is examined. In conclusion of the entire operation, the doctor produces fractional curettage of the uterine cavity and the cervical canal (RDV), the resulting biological material is sent for histopathological examination, for the final diagnosis.
Pain after hysteroscopy of the uterus
Considering all aspects of the operation of hysteroscopy, anesthesia, it can be noted that the pain that occurs after the procedure is associated with some points of its implementation. When patients complain that after hysteroscopy, the lower abdomen and lower back are sore, this is quite a physiological response of the body to surgery. This occurs as a response to the use of gas or liquid in order to expand the uterine cavity for a better view. As a result, the uterus is reduced, which is accompanied by pain in the lower abdomen.
Also, when pulling the lower abdomen after hysteroscopy - this moment is triggered by the expansion of the cervical canal before the procedure. The same pain is characteristic after fractional curettage, which completes the hysteroscopy.
The pains are of a pulling character, most often localized in the lower abdomen, possibly in the lumbar region, causing discomfort. In the case when the pain threshold of a woman is lowered, and her sensations violate her general condition, the doctor may also prescribe nonsteroidal anti-inflammatory painkillers, such as Ketorol, Dexalgin, and so on. At the same time, after the use of drugs, the intensity of pain in the lower abdomen after hysteroscopy should decrease, and the general condition of the woman will improve.
Too much pain
If the pain becomes unbearable, acute, cramping or constant with a tendency to increase pain such pain is not permissible after such a type of intervention as hysteroscopy or hysteroresectoscopy, and require emergency medical care. Since it can be caused by possible complications of the intervention, which include surgical (uterine perforation, bleeding), anesthesiology, as a result of the application, to expand the uterine cavity, gas (gas embolism). Such cases, fortunately, are rare, but they cannot be insured. Therefore, in the event of the above described pains, it is better to additionally spend another day in the hospital, another, for dynamic round-the-clock observation.
Duration of pain
The frequently asked question is: how much does the stomach ache after hysteroscopy? The answer will be for each individual, it all depends on the pain threshold of a woman. But there is a generally accepted framework for the duration of discomfort. The most intense pain occurs on the first day after the operation, but after the expiration of the time of influence of narcotic analgesics, which were used during the operation. Then, every day it will weaken. Normally, after the performed hysteroscopy, the lower abdomen hurts for about two - three days, or even less. This is due to the occurrence of tissue trauma and rapid recovery. As the uterus contracts, it pulls up the abdomen after hysteroscopy. In the period when the uterus has decreased and assumed the same size - the pain subsided.
However, there is a perception that pain after hysteroresectoscopy is more intense, since it is not only a diagnosis - an inspection, but also a removal of a pathological focus than after diagnostic hysteroscopy. There will be no exact answer, so everything is purely individual. Because of the invasiveness of the method, when, during the implementation of hysteroscopy, a pathological focus is found and its removal is performed in violation of the integrity of the tissues, the pain can be argued stronger. But, considering the fact that even in the case of a diagnostic procedure, curettage of the uterine cavity occurs, which also injures the endometrial tissue and, as a result, the lower back hurts after hysteroscopy.
In any case, regardless of the reasons, the attending physician should know about all the painful sensations. And in this case, he will be differentiated the origin of the pain and, accordingly, prescribed anesthetic therapy or other medical assistance will be provided in order to improve the patient's general condition.
But the symptom of pain is not the only manifestation after hysteroscopy. Let us consider in more detail in the next article the duration and nature of the discharge.
Bleeding after hysteroscopy
The method of instrumental investigation of the cavity of internal organs with the help of an endoscope in the gynecological field of modern medicine is called hysteroscopy. For the first time, this manipulation was successfully performed in 1870 by the Italian doctor Pantaleoni to determine the state of the uterine cavity using a tube with an external lighting device similar to a cystoscope.
Modern hysteroscopy is considered the most informative among all the other instrumental methods for diagnosing and treating all intrauterine pathologies. There are two types of research:
- Diagnostic - allows you to identify the pathological process inside the uterus.
- Surgical - performed for topical diagnosis, biopsy or surgical intervention in the uterine cavity.
As with any invasive procedure (associated with penetration through the skin or mucous membranes), performing hysteroscopy requires a high surgical qualification of a specialist and he follows all the rules of the procedure. Violation of these requirements may entail serious consequences that are not only a danger to the woman’s health, but sometimes also to her life.
Indications for hysteroscopy
The diagnostic procedure is prescribed for:
- violations of the cycle of menstruation in different periods of the woman’s life (juvenile, reproductive, perimenopausal),
- postmenopausal bleeding,
- differential diagnosis of adenomyosis, endometrial cancer, uterine malformations, intrauterine adhesions, submucous (submucosa) uterine fibroids,
- the presence in the uterus of a foreign body,
- not carrying pregnancy,
- control study of the uterine cavity after surgery,
- evaluating the effectiveness of hormonal treatment,
- complicated period after childbirth.
Complications during hysteroscopy
During diagnostic and surgical hysteroscopy, complications may develop, they are divided into several types:
- Anesthetic type - on anesthetic drugs used, possible anaphylactic shock.
- The group of complications caused by the means for the expansion of the uterine cavity - most often occur when using carbon dioxide and liquids. Possible heart rhythm disturbances, metabolic acidosis and the development of a gas embolus.
- Surgical group of complications - perforation (perforation) of the uterus, bleeding.
It is important to know: immediately after the end of the procedure, the woman may feel a strong and sharp pain that does not stop for a long time. Do not rush to panic, this is not a sign of any violation. The pain is due to the fact that hysteroscopy is a serious surgical intervention.
What are the feelings after the procedure?
Hysteroscopy is a fairly simple and completely painless procedure, but each woman has a certain sensitivity threshold and it is rather difficult to assume what the patient feels during the procedure.
The process of preparing for the procedure
- First of all, the patient is placed on a permanent basis in the inpatient unit of the hospital, where the procedure itself will take place.
- Before going to the prescribed study, she needs to pass all tests prescribed by the attending physician. This includes: a vaginal smear, as well as a general blood and urine test.
- Next, you will need to go through a therapist to identify possible inflammatory processes or diseases of other organs.
After passing through all the above points, the patient may be allowed to undergo hysteroscopy (of course, if all the indicators are normal).
It is important to know: before you begin the procedure, you will definitely need to do an enema and completely empty the contents of the bladder to avoid unpleasant surprises during the hysteroscopy process.
So, if all analyzes are within the normal range, and the procedure itself was quite useless and successful, then no surprises and consequences should happen. Но, что делать, если что-то пошло не так? – запомните, безусловно, есть шанс того, что даже при успешном проведении исследования могут быть отклонения от установленной нормы. Так, что давайте, разберемся подробней.
Discharge after hysteroscopy
Most often the cobweb is disturbed by an implicit discharge from the vagina. There may also be blood, but this will be discussed below. What can be associated with the selection? - you ask. Virtually all medical devices can compromise the integrity of the vagina and cause minor mechanical damage due to which various secretions may appear.
Bleeding after hysteroscopy is a very serious situation, which in no case should not be left without proper treatment and surgical treatment. First of all, find out if this is really a deviation from the norm or just typical consequences after the procedure. If your fears were confirmed, the doctor will clarify the nature of the bleeding orders, and then prescribe the necessary treatment. In order to eliminate mechanical damage, a technique for eliminating abnormalities with a laser is used, and during infection, a course of antibiotic therapy is prescribed.
Nature of discharge
After the diagnostic hysteroscopy has already been performed, the discharge after the operation will be bloody. This is due to separate curettage of the uterus, completing the procedure of hysteroscopy, in order to obtain histological material. In the process of how curettage was performed, an acute surgical object “cut off” the uterine mucosa, as a result of which the vessels feeding it are also damaged. Everything happens almost the same as during standard menstruation. Violation of the integrity of the vascular wall leads to bloody discharge, which lasts until the lumen of the vessel is thrombosed.
As a rule, on the first and second day after surgery, hysteroscopy or hysteroresectoscopy, bleeding, can be quite abundant, of a dark color. Pink discharge after hysteroscopy of the uterus is characteristic of the third - fourth day, but they are rather not completely pink, but with streaks of mucus. Further, secretions from the genital tract are becoming brighter, and, with rare exceptions, contain scanty veins of the blood-containing component.
How many days after hysteroscopy are the selection
The duration of the discharge depends on their characteristics. If it is bleeding after hysteroresectoscopy of an endometrial polyp, for example, then their duration will be about two to three days. Then bleeding is replaced by succinic, which already contain blood to a lesser extent, but are composed of its veins, a component of coagulated blood (but not a clot!). This type of discharge takes place within a week. The rest of the time, which takes about a week, and a total of two to three weeks turns out, the ichor appears, transparent, yellowish discharge without foreign smell. This is due to the expansion and trauma of the cervical canal during the operation.
When discharge is alarming
The presence of discharge in women after such an operation as hysteroscopy, how much discharge lasts and the nature of their manifestations as described above is the norm. But if the clinical picture does not fit into the framework of the norm. There is always a risk of complications of the postoperative period. At the same time, changes in the characteristics of secretions can judge the occurrence of a particular state, suspect the complication that has arisen.
In the case when the bleeding becomes bright scarlet, or have the appearance of dark clots, and their intensity and volume increase so that not only personal hygiene is impregnated with secretions, but also bloody spots appear on the bed, this indicates uterine bleeding, which urgently needs to be fixed.
It is also possible not abundant, but prolonged for the duration of the allocation of bloody nature - this is also a reason to seek urgent medical attention.
There are parameters of discharge, which also may indicate the urgent state of a woman. This is a yellow, greenish discharge with an unpleasant smell, but, as a rule, this condition is accompanied by severe pain in the lower abdomen. Such symptoms may suggest the development of endometritis - inflammation of the uterine lining and the addition of a secondary infection.
If daub is present after hysteroscopy. How much are the selection of this nature? This is a frequently asked question. The spotting is characteristic on the third day after the operation and continues approximately until the seventh day. But if the timing of spotting is delayed, then it is worth contacting your doctor.
Discharges in various pathologies after hysteroscopy
It happens that the questions are: what kind of discharge after hysteroscopy of the endometrial polyp? Or: how much excretion after a hysteroscopy with scraping should continue? The fact is that regardless of the pathological focus that was removed (endometrial polyp, cervical polyp, or myoma node), the nature and period of discharge does not change. Another thing, if we are talking about diagnostic hysteroscopy without curettage. When a normal endometrium is found during inspection with a hysteroscope and without pathological structures in other organs of the reproductive system, no curettage is performed. And then, accordingly, the discharge will be less, their duration will be reduced.
When to wait for the next menstruation
In the case where diagnostic hysteroscopy is performed without subsequent curettage, the next menstruation will begin on the day planned by the calendar. If, however, a separate curettage of the uterine cavity was performed, then the date of the month can be shifted by several days from the date previously calculated by the patient according to the regularity of her menstrual cycle. But if menstruation came much earlier, or much later, or the discharge became more abundant and prolonged after the previous hysteroscopy. This is a reason to contact your doctor.
In this article, we reviewed some moments of hysteroscopy surgery, how much the discharge goes, their nature, rate and pathology. Discharge is one of the stages of recovery of the body (endometrium to a greater extent) after the intervention. And how exactly is the regeneration of the endometrium after hysteroscopy, and which stages are divided, consider in the next article.
Endometrium after hysteroscopy
The operation of hysteroscopy, most often, ends with curettage of the uterus. After that, conditionally, there are two stages in the restoration of the endometrium.
The first stage begins immediately after the operation and consists in the healing of microdamages of the uterine mucosa, the restoration of the muscle layer, in case of its damage, the resumption of functions. At the same time, the restoration of the endometrium after hysteroscopy occurs completely, and its functionality is confirmed by the onset of the planned menstruation. Normally, the endometrium, outside of any intervention, regenerates monthly in a similar way. Therefore, the answer to the question: after hysteroscopy, does the endometrium grow rapidly? - quite simple - just as much time as he needs to recover from the usual regular menstruation and it all depends on the individual cycle time of each woman (on average, three to four weeks).
But, unfortunately, it happens when a thin endometrium appears after hysteroscopy of the uterus. This is a big problem for women wanting to get pregnant. This condition is not typical and is most likely associated with impaired production of certain hormones.
You should contact your doctor with this problem, conduct a series of laboratory tests to determine the synthesis of all the necessary hormones, on the appropriate days of the menstrual cycle, and further control the growth of the endometrium through ultrasound research.
Performing hysteroscopy, especially in order to combat infertility, is only part of the story. It is very important to monitor the state in the future. For this purpose, further tactics are developed for the management of patients after surgery, which we will describe in detail below.
Management tactics after hysteroscopy
The important point is the understanding that the performed hysteroscopy and further control over the state of the woman are not separate stages. Since on the way to treatment, rehabilitation, and in the fight against infertility, every detail is important. Maintaining the patient after a healing or diagnostic operation includes a set of measures aimed at consolidating the effect and achieving the goal, for example, such as motherhood.
Recommendations after hysteroscopy
Since hysteroscopy, though minimally invasive, but still an operation, and like after any intervention, especially on the uterus, there are rules of conduct and recommendations that must be followed.
- Exclude sex life for four weeks, which is associated with an open wound surface in the uterus and the risk of infectious complications.
- Do not use tampons after hysteroscopy, all for the same reason for the risk of infectious complications due to impaired drainage of secretions from the genital tract.
- Exclude sport after hysteroscopy. It is impossible to lift weights more than three kilograms. A wellness exercise should be postponed for three to four weeks. These restrictions are due to increased intra-abdominal pressure, which can increase bleeding or even lead to bleeding.
- Observe the prescribed antibacterial treatment by the attending physician after hysteroscopy of the uterus, in order to avoid infectious complications.
- For a period of one month, baths, saunas, swimming pools, steam rooms and so on, which can provoke bleeding and endanger the health and life of a woman, will be excluded.
- Do not use vaginal suppositories, tablets for the same reason as when banning the use of tampons.
- Do not use aspirin, as it is an anticoagulant and reduces blood clotting, which can also trigger bleeding.
- It is necessary to control the body temperature by measuring and fixing it in the daily observations list.
The above recommendations do not include the question: is it possible to drink after hysteroscopy? Given that alcohol contributes to the expansion of blood vessels, it can cause bleeding. And the property of alcohol to dull the reaction rate can damage an adequate assessment of the resulting increased blood excretion from the genital tract, and timely treatment for medical help.
Maintaining the early postoperative period
The early postoperative period includes the period after the end of the operation until discharge from the hospital. His management is to control the general condition of the woman, blood loss, when symptoms aggravate the state after hysteroscopy. What cannot be done or taken from medicines is also controlled from this side. So how many are in the hospital after hysteroscopy? If the condition of the woman is not in danger, and the hysteroscopy was only diagnostic, the discharge is carried out on the day of the operation. Normally, even in the case of hysteroresectoscopy, the patient’s discharge from the hospital takes place on the second day, but only if there are no complications.
Maintaining the late postoperative period
The late postoperative period is the period from the moment of discharge of the woman from the hospital to recovery. Sometimes, especially in the case of combating infertility, the recovery period lasts up to six months. This is due to hormonal training and the restoration of all endometrial functions for possible fertilization. The main question after hysteroscopy is when can IVF be done? This procedure requires a multifaceted examination, and does not depend only on the performed hysteroscopy. But IVF is possible in this case no earlier than six months.
After a hysteroresectoscopy of a polyp or myomatous submucosal uterus node, rehabilitation takes place in the same way as rehabilitation after diagnostic hysteroscopy, the patient receives the same general recommendations. But there are nuances. After surgical treatment, hormone therapy is further prescribed medication, in order to fully restore reproductive function and prevent relapse.
Unfortunately, there is a possibility that a relapse will occur after a polyp hysteroscopy. No matter how much the abnormal tissue revealed during hysteroscopy of a polyp is removed, its recurrence can be triggered after three months already by inflammatory diseases of the pelvic organs, frequent curettage of the uterus in the history (frequent abortions) and familial predisposition. The reappearance of the polyp does not depend on the quality of the hysteroresectoscopy, since this operation provides for the complete removal of the pathological tissue. A recurrence of such a formation is considered if the polyp appeared in the same place three months after its removal, the occurrence of multiple polyps, or the histological type of tumor formation has changed. In order to prevent recurrence, the patient needs drug therapy and dynamic follow-up after hysteroresectoscopy.
Pregnancy after surgery
Many women going for surgery are interested in whether it is possible to start conceiving after hysteroscopy? Considering all the above recommendations, which are given to all patients who have undergone diagnostic hysteroscopy or pregnancy hysteroresectoscopy, you can begin to plan no earlier than six months from the date of the operation. In this case, the onset of sexual activity can be accomplished in about a month, preferably after menstruation is complete. But sex life should be protected from pregnancy, the method of contraception is chosen individually for each woman by the attending physician, taking into account all the features of the body and the conditions of the operation, especially if complications have arisen after hysteroscopy. What are the complications, and how they threaten the life and health of the patient, we will describe in detail in the next article.
Types of hysteroscopy complications
Due to the fact that hysteroscopy is an operation, with the penetration of the instrument into the uterus and the impact on the uterine mucosa and vessels located in it, expanding the cavity of a liquid or gas, complications may arise related to these moments. As well as the use of narcotic anesthesia can also provoke a deterioration of the condition of a woman with a threat to life and health. Complications can be divided into:
- Provoked by the medium to expand the uterus,
- Long-term consequences.
Hysteroscopy is dangerous perforation of the uterus. This condition can occur when the hysteroscope, being already in the uterus, injures the wall of the uterus, partially or completely disrupting the integrity of the organ. In the case when the integrity of the uterine wall is violated, nearby organs to the uterus may also be damaged. In this case, if trauma is detected, the doctors performing the operation immediately stop it, determining the further tactics of the action and finding out the area of tissue damage.
This condition is primarily threatened by bleeding from the uterine vessels of the damaged area of the myometrium. And also, perhaps, in the presence of a through hole in contact with the abdominal cavity, trauma to the intestine, the development of intra-abdominal bleeding, and, in consequence of peritonitis.
In the case when the perforation of the uterus is carried out, the operation is urgently terminated. At the same time, the instrument that damaged the uterus wall is not removed, and, most often, a laparotomy (entry into the abdominal cavity by a median approach) is performed in order to revise all abdominal organs, check the integrity of organs, eliminate bleeding surgically, by sealing or ligating the vessels, suturing perforation hole. There are, rarely, cases where the wall of the uterus is damaged extensively, or it is not possible to stop the bleeding from the formed hole. In this case, the uterus is removed after hysteroscopy. But these situations are more casuistic, since in all conditions the doctor always struggles for the genital organ and full women's health. And only when the patient's life is at stake, then they resort to removing the source of the bleeding. Most often, these complications occur after uterine hysteroscopy with curettage, where there is an acute surgical instrument. But in any case it is a rarity.
Complications when using uterus-widening media
As it is known, hysteroscopy is impossible without expansion of the uterine cavity with a liquid or gas for a better view of all structures. However, the introduction of gas into the uterine cavity can provoke a very serious condition like a gas embolus. It results from the entry of gas bubbles into the lumen of damaged vessels, which, with the blood flow, can enter the blood vessels of the lungs or the heart, thereby disrupting the hemodynamic process (blood circulation). Данное состояние сопровождается снижением артериального давления, одышкой, цианозом (синюшным цвет кожных покровов). Это состояние возникает резко, в процессе операции и лечится только врачами анестезиологами.For this purpose, in any operating room there is everything necessary to provide emergency assistance in the face of the appearance of any complications.
Also, a sharp deterioration in the condition is also possible when using fluid during hysteroscopy of the uterus. Complications, in this case, manifest as a result of the absorption of fluid into the bloodstream, the development of pulmonary edema, or hypervolemia - overloading of the vascular bed. In this situation, diuretics are used to remove excess fluid from the body and resume the cardiovascular system. And in the case of pulmonary edema, oxygen therapy (oxygen inhalation) is performed.
This type of complications happens very rarely and the most frequent cause of occurrence is an individual intolerance to drugs, which the patient herself did not know about, since they had not been used before. Any other complications are practically excluded from the anesthetic management. As a condition of the patient who is under the influence of anesthesia, it is monitored by an anesthesiologist, nurse, and special equipment, which dynamically demonstrates all vital signs (pulse, pressure and so on).
Long-term complications of hysteroscopy
When the operation of hysteroscopy or hysteroresectoscopy has passed, and the rehabilitation period has begun, the long-term consequences of its implementation may appear. Synechiae may occur after hysteroscopy - the appearance of peculiar adhesions in the uterus, which depend on the individual characteristics of the organism, and more often appear in women who often underwent interventions on the uterus (abortion, curettage).
Inflammation after hysteroscopy is not characteristic only for this type of surgery. Inflammation of the uterine mucosa is possible with any surgery on the uterus, especially when the patient does not take antibiotics properly. This type of complication may have an odor after hysteroscopy (unpleasant-smelling discharge), itching after hysteroscopy, bloating - all those symptoms that may accompany the inflammatory process. However, these symptoms have endometritis after hysteroscopy. The legs hurt - as one of the complaints after the operation, it is more related to the complications caused by the dilating uterus media. And in more detail about the remote consequences we will tell in the next article.
Consequences after hysteroscopy
Not always diagnostic or therapeutic hysteroscopy ends with full recovery and the achievement of the desired effect. Not often, but it happens when after the operation, remotely, there are consequences that disrupt the normal functioning of the female reproductive system and can cause discomfort.
Endometrial hysteroscopy. Consequences as a recovery period
There are symptoms associated with the hysteroscopy procedure itself, which brings discomfort. Such consequences of hysteroscopy of the uterus as bleeding from the genital tract, moderate pain in the lower abdomen or lower back are "integral" because they are caused by penetration of the instrument into the uterus, dilatation of the cervical canal, expansion of the uterine cavity with liquid or gas, and so on. These effects after hysteroscopy of the uterus cannot be prevented or excluded. They can only be influenced to some extent, or rather, for example, to reduce pain by using nonsteroidal anti-inflammatory painkillers. The bleeding is a consequence of surgical intervention in the endometrium and cannot be eliminated with hemostatic preparations in order to avoid infectious processes in the uterine cavity, as well as in order to fully restore a normally functioning endometrium.
Therefore, some of the discomfort that is caused by discharge and pain is considered to be a recovery period after hysteroscopy, as a normal reaction of the body to the intervention. These symptoms should go away on their own, as a result of which the former cyclical nature of the life of the female body will be restored. At the same time, before performing the operation, hysteroscopy, the consequences of the manipulation are announced by the doctor beforehand. Also, the doctor must explain the duration of discharge, pain, and that you can apply.
Consequences of Polyp Hysteroscopy
Quite often, women, in the presence of a polypus of the uterus, are recommended to carry out hysteroscopy both as diagnostics with taking a biopsy, and as a treatment, where fractional curettage or removal of the polyp by a “laser” will be carried out, as well as further histological examination of the obtained biological material. In this case, the patient expects to receive as a result a complete recovery, to preserve reproductive function. But it happens that after a short time after removal, symptoms reappear - signs of a polyp of the uterus, such as hemorrhagia, bleeding, inability to become pregnant. As a result of the examination, a polyp is detected in a woman - a relapse occurs. In this case, recurrence is considered to be the occurrence of one or many polyps or other histology-like formations that appeared three or more months after the hysteroresectoscopy was performed. In this case, the formation may occur not only in the place of localization of the previous polyp.
Unfortunately, such situations are taking place. Endometrial polyp recurrence after hysteroscopy can occur for various reasons: hereditary predisposition, hormonal disorders, uncontrolled use of combined hormonal contraceptives, frequent undertreated inflammatory diseases of the reproductive organs. If a polyp recurs again and again, even when hysteroscopy is done, removal of the polyp, the consequences can be varied (malignancy, inflammation of the endometrium, the appearance of synechiae), so in such cases it is necessary to understand the causes directly and eliminate them. And in itself, hysteroscopy of the endometrial polyp, the consequences that bring discomfort to a woman, does not cause.
Endometrial hyperplasia as one of the consequences
Endometrial hyperplasia is an overgrowth of the tissue of the uterine mucosa, which is benign in nature and is accompanied by changes in the vessels and glands inside the membrane. This pathology is accompanied by symptoms of heavy menstruation, or prolonged bleeding from the genital tract during menstruation or after a long delay. In such cases, patients are prescribed to undergo a hysteroscopy procedure in order to diagnose and treat this condition. It happens that endometrial hyperplasia recurs after hysteroscopy, but this moment is not associated with the operation itself, the method of its implementation, and others. This condition is resumed again due to hormonal imbalance, or rather, with increased estrogen production, hyperestrogenism. By itself, curettage hysteroscopy is a diagnosis and does not eliminate the cause, but the consequence that occurs due to hormonal disorders.
One of the possible complications or consequences of hysteroscopy may be an inflammatory process in the uterine cavity - endometritis. But here it is necessary to understand the reasons for its occurrence. After the operation, the doctor must prescribe a course of antibacterial drugs. In case of violation of antibiotics, their self-cancellation, as well as non-compliance with recommendations about maintaining personal hygiene, prohibiting the use of tampons, the exclusion of sexual acts for a certain period and so on, an infection process in the uterus may occur. Which will be accompanied by a violation of secretions, there may be discharge with an unpleasant odor, a sharp or increasing pain in the lower abdomen, an increase in body temperature. Therefore, endometritis, as a direct consequence of hysteroscopy, is a rare phenomenon, and most likely is associated with a violation of these recommendations. In the event of such a condition, you should immediately consult a doctor.
Other "consequences" of hysteroscopy
Other consequences of the intervention include women's complaints of itching, discomfort and white cheesy discharge from the genital tract, the so-called thrush after hysteroscopy. This symptom occurs due to, nevertheless, the intervention, albeit a sterile, but foreign body that violates the vaginal microflora. Also taking antibiotics, and the operation itself as a stress factor fails in the local immune response, with the result that there is a "thrush". But this disease is easily treatable and further correction of microflora.
In any case, the operation of hysteroscopy aims to restore women's health and carry out pregnancy.
Pregnancy and hysteroscopy
Planning for pregnancy, especially if there are any problems with its implementation, begins with a thorough examination of the woman. Naturally, in addition to the state of health of all organs and systems, special attention is paid to the reproductive health of women. And there may be obstacles in the implementation of the goal of becoming parents. For a complete approach to this issue, among other things, the method of hysteroscopy is used.
Can I get pregnant after hysteroscopy
Hysteroscopy is carried out in order to diagnose a particular state preventing pregnancy.
In the case when, under the conditions of this diagnosis, the cause (polyp, myoma node, synechia) is identified, it is immediately eliminated. And, of course, in the absence of mechanical and other obstacles, the chances of becoming pregnant increase. Hysteroscopy is not a panacea in the treatment of infertility, but allows for the onset of pregnancy by increasing the percentage at times.
How much after hysteroscopy can you become pregnant
As a rule, when no complications are observed and the postoperative period runs smoothly, following the recommendations, you can proceed to the planned conception no sooner than after six months. Since it is during this period, a fairly complete restoration of the endometrium and the functional readiness of the hormonal background after hysteroscopy to ensure the conception and physiological course of pregnancy occurs.
There are cases when the patient became pregnant after hysteroscopy in two - three months, earlier than the recommended period. In such a situation, gestation is under constant dynamic observation, since the reproductive functions of the reproductive system that are not fully restored may not cope with the resulting load in the form of pregnancy.
In any case, the approach to each patient is different. And if the recovery period is normal, the cycle has normalized in regularity and in duration, the symptoms that the woman may have worried about before have gone, and ovulation has been established after hysteroscopy - you can become pregnant in the third month. But it is better to consult directly with your doctor.
The period of time when hysteroscopy has already been performed, after how much you can get pregnant directly depends on the gynecological pathology, and not on the operation itself. Since different types of diseases that prevent pregnancy, in addition to surgery, and in medical treatment.
Hysteroresectoscopy and pregnancy
In situations where pregnancy is prevented by endometrial polyp, or myomatous node, adhesions, and so on, they resort to hysteroresectoscopy, which allows not only to see the intended diagnosis and confirm it, but also to undergo surgical treatment, eliminating the cause of infertility. During the operation, a microsurgical power tool, under the control of the image on the monitor, removes the pathological tissue site by excision and shredding (in the case of a large myomatous node), and then removes the removed tissue from the uterine cavity. In the case of the presence of adhesions (synechia) in the uterine cavity, they are dissected with the same tool, and then the cavity is treated with a special gel that prevents further formation of adhesions.
In these cases, the desired pregnancy after hysteroscopy of a polyp can be planned no earlier than six months, or maybe a little more. Since such a condition, though eliminated surgically, there is a need to treat the underlying cause. And for the prevention of relapses, hormone therapy with oral hormonal contraceptives is prescribed for a period of three months or more, and only then it is recommended to plan for conception after discontinuation of the drugs.
If the woman had a myoma node that was removed by hysteroscopy of the uterus, pregnancy cannot be planned immediately. This is due to the fact that there are stitches at the site of the remote site, which need a period of healing, as well as, in order to treat a hormonal disorder that caused the appearance of the site, a long course of hormonal preparations is prescribed. And all this is aimed at restoring the reproductive health of the uterus for carrying a full-fledged healthy pregnancy.
Hysteroscopy and pregnancy through IVF
This operation is not mandatory in the list of examinations for the upcoming in vitro fertilization, but its diagnostic value is very high. And this affects the early detection of pathologies that are not visible through ultrasound research, treatment and rehabilitation of the genital organ. According to the observation of reproductive physicians after hysteroscopy, pregnancy occurs more often with the condition of using assisted reproductive technologies. And those who underwent hysteroscopy, who became pregnant, are proof of that.
Very often the question from patients is heard: “If a hysteroscopy is performed, how long does it take to get pregnant?”. This is especially interesting for patients directly targeted to IVF. Also, as in the case of a physiologically occurring conception, IVF is recommended to carry out hysteroscopy after surgery no earlier than six months. And after a successful attempt to implant the embryo into the uterus, the woman is kept under close observation, and this observation is more associated not with the performed operation, but with possible gynecological pathology in the past, and, of course, with the use of assisted reproductive technologies.
In any case, pregnancy planning after hysteroscopy or hysteroresectoscopy should be carried out under the strict guidance of the attending physician, who takes into account all aspects of the postoperative period. And what exactly includes the postoperative period, we analyze in the next article.
Early postoperative period
This stage takes a period of time from the end of the operation to the discharge of the woman from the hospital. Since the discharge from the hospital is a purely individual question and depends on the patient's condition after the operation, as well as on the presence or absence of complications, this period is different for each patient.
The early postoperative period is characterized by bloody discharge from the genital tract, may be accompanied by pain in the lower abdomen and lumbar region of a pulling character. The patient is prescribed a treatment regimen and recommendations are given. Since during this period sexual intercourse is excluded in order to prevent complications, after hysteroscopy of the uterus it is possible to become pregnant only no earlier than in a month. But it is risky, because it can threaten the physiological carrying of pregnancy.
Late postoperative period
This period begins after discharge and lasts approximately six months. During this time, restorative processes take place in the uterine cavity, cervix, vagina. Against the background of drug therapy, ovarian function is restored. All these processes lead the female reproductive system to a "form", with the goal of the full functioning of the genitals and the reproductive task. The bleeding is replaced by the succinic, the abdominal pains go away, and the woman can begin to maintain the usual rhythm of life, including sex life and begin to plan the desired pregnancy.
Cryoprotocol after hysteroscopy
Often, women are worried about the feasibility of performing hysteroscopy before cryopreference. Of course, the procedure is very successful with infertility and subsequent in vitro fertilization, although it is not a panacea for the fight against infertility. As one of the points of basic examination before IVF, hysteroscopy is not, but reproductive specialists often recommend it. Назначается это с целью диагностики гинекологической патологии и своевременного ее лечения посредством либо гистерорезектоскопия, либо медикаментозной терапии, в целях исключения возникновений осложнений после криопереноса и дальнейшего вынашивания беременности. В этом случае цель оправдывает средства. Так как процедура ЭКО требует длительной подготовки и немалых финансовых расходов, то гистероскопия повышает его результативность.
Not rarely, during diagnostic hysteroscopy, pathology is detected, for example, uterine adhesions, or endometrial polyps, which cause infertility. This operation allows you not only to diagnose a pathological condition, but also to immediately get rid of the cause of a possible conception, by removing polyps and dissecting adhesions, and so on.
How long does it take to become pregnant?
The most interesting question for women who decide to undergo hysteroscopy is: after what time can you become pregnant? After all, this result is the most desirable. Given all this, it can be noted that there are those women who became pregnant after hysteroscopy in just a month or two. But there may be problems that can delay the onset of pregnancy, even in the period allowed for planning after surgery. As already mentioned, sex life is allowed to begin already after three to four weeks, after hysteroscopy, but it is recommended to use contraception.
A pregnancy planning should be in six months to avoid problems with its bearing.
So, the time after which the patient of the clinic, in particular, Altrawita, became pregnant after hysteroscopy, ranged from three to six months to a year (as a result of using assistive technologies and natural conception). At the same time, both medical and diagnostic hysteroscopy of the uterus was performed. Those who became pregnant from women had no complications in the postoperative period, and their gynecological problem preventing pregnancy, was eliminated.
Is hysteroscopy possible for abortion?
Hysteroscopy for missed abortion or for the purpose of abortion for short periods is not performed. To do this, there is an interruption through curettage of the uterus or in a medicamental manner, depending on the duration of pregnancy. A hysteroscopy can be prescribed by a doctor only in the case when, after a medical abortion, there is a suspicion of a delay in the parts of the ovum, and also to diagnose the causes of the termination of the development of pregnancy and its fading.
In any case, hysteroscopy is a diagnostically important operation, and can be prescribed only by a doctor and only for medical reasons.
Depending on the purpose of the procedure, one of the stages of hysteroscopy is an increase in cervical patency through the phased introduction of Gegar extenders into the cervical canal. In this case, purely diagnostic manipulations can be carried out without prior expansion of the neck with a hysteroscope having a thickness of not more than 3 mm. The use of a hysteroscope, having in its structure an operating channel for the insertion of surgical instruments, requires significant dilatation of the cervical canal (up to 9-10 mm).
Depending on the type of equipment used, surgery can be carried out in the following ways:
- resection - in this case, the growth or neoplasm is cut using so-called “scissors” or cutting tools of a different shape,
- electric resection - provides a fairly large set of tools (loops, rollers, balls), whose action is based on the electro-steaming of tissues, which allows you to purposefully remove pathological formations,
- laser resection with coagulation - a significant advantage of such instruments is coagulation of tissues after resection, which significantly reduces the risk of bleeding.
The temperature after hysteroscopy should not exceed the threshold of 37º-37,2º. As a rule, such an organism's response to an intervention occurs in a fairly large percentage of women and differs from the temperature associated with complications in that it occurs on the same day and repeats in the evening for 2-3 days. The temperature caused by inflammatory processes or other complications is characterized by exceeding the threshold of 37.2 º, lack of reference to the time of day and usually occurs 2-3 days after hysteroscopy.
How long after pregnancy can I plan for hysteroscopy? If the procedure was carried out for the purpose of diagnosis, then it is likely that you can become pregnant next month. However, if even small surgical procedures were performed, the body needs much more time to recover.
When planning a pregnancy should consider the following facts:
- regularity of the menstrual cycle
- lack of inflammatory diseases
- no recurrent development of pathological lesions removed during surgery.
With positive results, pregnancy is possible within 3 months. However, the optimal period to fully restore the reproductive functions of the body after hysteroscopy is 6 months.
The need for hysteroscopy before IVF is controversial. Due to the fact that the IVF procedure is quite complex in terms of material sampling and patient preparation, the risk of abortion due to the occurrence of possible injuries from a previous diagnostic procedure is quite high. However, taking into account the fact that women resorted to IVF who had unsuccessfully tried to get pregnant for quite a long time, going through hysteroscopy will allow identifying and eliminating any structural deformities of the uterus (adhesions, septum) that prevent the introduction of the ovum into the endometrium and its subsequent development.
According to statistics, a much higher percentage of women who did not undergo hysteroscopy (12%) have experience of unsuccessful IVF, while women who have undergone surgical treatment of intrauterine devices using hysteroscopy and have performed IVF have only 5% of failures.
In all cases, after a certain period of time, an ultrasound scan must be done and a full examination is carried out to minimize the risk of premature abortion.
It is impossible with 100% certainty to guarantee a positive outcome of the IVF procedure, but if after hysteroscopy, the chances of a woman to have her own child increase significantly, this chance has a right to exist.
Today histoscopy is the most informative method for identifying intrauterine pathologies, the average cost of which varies in the price range from 3,000 to 60,000 rubles, depending on the equipment used, the purpose of the procedure and the prestige of the clinic. Compliance with the recommendations after hysteroscopy will help avoid the development of complications, minimize the consequences and restore health in a short time.
This type of modern research in diagnostic and therapeutic purposes.
Diagnostic hysteroscopy consists of an internal examination of the uterus with the help of specialized probes with an integrated microvideo camera. Diagnostic study is necessary to establish or clarify the gynecological diagnosis.
Surgical intervention in the form of hysteroscopy is used in the following cases:
- removal of benign neoplasms, such as uterine fibroids,
- there is an excessive growth of the endometrium, which is a polyp of the uterus,
- if endometrial cancer develops,
- removal of residual particles of the placenta after childbirth,
- there are foreign bodies in the uterus,
- perforation of uterine walls.
As a diagnostic study, this procedure is often used to clarify or confirm the following factors and diagnoses:
- to identify the causes of uterine bleeding,
- violation of the monthly menstrual cycle in women, including during the premenopausal period,
- various excretions in excessive amounts
- spotting during menopause,
- the inability to endure a child, permanent miscarriages or suspected infertility,
- to clarify the consequences, as well as a control diagnosis after previously transferred gynecological surgical interventions,
- clarification of results and obtaining more accurate information during the course of hormone therapy,
- if it is difficult or with the development of negative consequences and complications, the postpartum period proceeds.
Despite the fairly wide range of indications for the procedure, there are factors that can be an obstacle to the use of such a diagnostic method.
- various infectious diseases (sore throat, flu, pneumonia),
- the presence of a third or fourth degree of purity smear vagina of the patient,
- serious diseases and pathological processes of the cardiovascular system, as well as renal or hepatic diseases,
- normal pregnancy,
In addition, the number of contraindications includes the presence of uterine bleeding of the profuse type.
Preparatory activities and medical intervention
Before performing surgery, a woman must undergo a gynecological examination at the attending physician in order to ensure that there are no infectious processes.
It is imperative to pass the following tests:
- bacteriological vaginal smear,
- smear for diagnostics on oncocytology.
In order for a procedure such as hysteroscopy of the uterus (as well as the subsequent postoperative period) to pass normally and without negative consequences, there are a number of preparation rules:
- on the eve of the operation, you should refrain from food and water in the evening (after about 22 hours) and until the completion of the procedure,
- sexual intercourse should be abandoned 2-3 days before the procedure,
- about a week before the appointed day of diagnosis, it is necessary to stop using specialized means of intimate hygiene, and also to suspend (if available) any vaginal douching,
- The use of vaginal medicines (suppositories), as well as other gynecological medical products (tablets or ointments), is stopped about a week before the study.
The appointment of the date of hysteroscopy should occur in accordance with the patient's menstrual cycle. Basically, the procedure is carried out a few days after the end of menstruation.
Hysteroscopy of the uterus for medicinal purposes is carried out under general anesthesia. About an hour before the surgery, the nurse makes an intramuscular injection with a sedative effect. Served by intravenous anesthesia. After these actions, gynecologists begin the operation by introducing a special fluid into the cervical canal so that the uterine cavity expands and opens.
Using a special device, the gynecologist removes polyps or other third-party bodies, and also takes biological material for diagnosis.
Upon completion of surgery, fluid from the cervix is removed. In general, the duration of such an operation should not exceed 30 minutes (depending on the level of complexity).
What can be negative consequences and complications after surgery?
The procedure of such surgical intervention is among the safe methods. Nevertheless, in some cases, there may be various kinds of complications or the development of negative consequences.
The negative effects of the surgical type include:
- Perforation of the uterine walls, this organ may be punctured with an acute medical instrument.
- Bleeding of the uterus, which occurs as a result of traumatic damage to the organ of a woman or vessels of the uterine walls. Symptomatology manifests itself in the form of heavy bleeding in the first 2 days after the intervention. To eliminate such a sign, medications that have a hemostatic effect are prescribed.
- The development of inflammatory or infectious processes. As a rule, the first signs begin to appear as early as 3-4 days after the procedure. The most common diseases can be adnexitis, endometritis or salpingitis.
- The formation of blood accumulations in some parts of the endometrium.
- The development of synechiae inside the uterus.
- Burns to other organs, such as the bladder or rectum.
Among non-surgical complications include manifestations of allergic reactions to certain groups of medical devices (narcosis or painkillers), the development of arrhythmias, sudden drops in blood pressure, nausea, vomiting, and severe dizziness.
Hysteroscopy is different from laparoscopy technique. A hysteroscope is inserted into the uterus through the vagina. Laparoscopy is an invasive method for examining the uterus and adjacent organs by puncturing the abdominal wall. Laparoscopy is always carried out under general anesthesia, and hysteroscopy under local anesthesia.
Hysteroscopy is an internal examination of the organ, and laparoscopy allows examining the external surface of the uterus and adjacent organs.
Note! Hysteroscopy is performed without incisions and punctures of the organs.
When do the internal and external examination of the uterus?
Hysteroscopy (internal diagnosis) is prescribed for:
- detection of papillomas and growths on the mucous membrane,
- identify the causes of failure in the menstrual cycle,
- removal of the old spiral and remnants of the mucous after cleaning,
- identifying the causes of miscarriages,
- endometrial studies
- complications of pregnancy,
- study of the causes of other pathologies.
Also, the diagnosis is prescribed after an unsuccessful IVF protocol, periodic uterine bleeding, congenital anomalies of the genital organs.
Laparoscopy is prescribed for:
- diagnosis of ectopic pregnancy
- research into the causes of ovarian disease,
- studies of tumors on the outer shell of the body,
- organ perforation,
- other gynecological problems.
After the operation is completed, the area of the punctures is sewn up, the sutures must be removed after 12-14 days in the hospital. Both procedures are carried out after examination tests in the laboratory. Since laparoscopy involves the introduction of anesthesia, preliminary preparation is necessary - refusal of food on the eve of diagnosis.
Contraindications for laparoscopy and hysteroscopy:
- malignant neoplasms,
- severe obesity
- adhesions after previously performed abdominal operations,
Is there a risk of complications after surgery? Complications can occur after any operative manipulation of the internal organs, it depends on the severity of the existing pathology and the characteristics of the woman's body. However, the statistics of complications is small.
In order not to provoke a nuisance after performing both procedures, you should not use tampons during menstruation, take hot baths and take a steam bath in the sauna. Prohibited douching and any manipulation of the genital organs without the approval of the gynecologist. These restrictions must be adhered to until full recovery of health.
Possibility of replacement
Many patients are interested in, is it possible to replace one diagnosis with another? Since the technique of conducting and the field of study of both procedures are not similar, interchangeability is excluded. In gynecological practice, alternate or simultaneous carrying out of both procedures is used.
For example, hysteroscopy allows you to take a piece of tissue for laboratory analysis, quickly remove tumors on the inner walls of the uterus. Laparoscopy can replace classical abdominal surgery, only without dissecting the abdominal wall and adjacent organs with the uterus.
With the help of hysteroscopy, you can clarify the diagnosis of pathology, laparoscopy eliminates any pathology of the reproductive organs. Therefore, it is impossible to give an answer, which is better - hysteroscopy or laparoscopy.
Differences between hysteroscopy and laparoscopy:
- during laparoscopy, they make punctures in the abdominal cavity, hysteroscopy is performed without cutting the tissue,
- hysteroscopy is less traumatic for the woman’s body, since it does not damage the organs adjacent to the uterus,
- laparoscopy is used to treat all gynecological diseases, hysteroscopy examines only the uterus and the pathology inside it,
- laparoscopy has many contraindications, the only obstacle to hysteroscopy is poor blood clotting.
After hysteroscopy, there may be no complications if the patient adheres to the recommendations of the gynecologist. Maximum belly bottom, and then not for a long time. The bleeding occurs not in all patients, and they are not connected with the study, but with the characteristics of the body's response to the intervention.
After laparoscopy requires a long recovery period, the development of inflammatory processes in the abdominal cavity is not excluded. The patient must follow the diet and other postoperative restrictions, as well as follow the postoperative stitches.
In what cases are both manipulations carried out simultaneously? This is done when necessary diagnostic studies in conjunction with the conduct of surgical procedures.
Is there laparoscopy and hysteroscopy for infertility, is there a chance to restore reproductive function using these methods? Causes of infertility can be very diverse. Например, спаечные процессы в трубах препятствуют продвижению сперматозоидов в яичники. С помощью проведения гистероскопии можно убрать спайки, что освободит путь для сперматозоидов.
Hysteroscopy allows you to establish an accurate diagnosis, on the basis of which the gynecologist prescribes a course of therapeutic procedures that corresponds to the clinical picture. Also, hysteroscopy helps to get rid of many pathologies that prevent successful fertilization:
- ovarian cysts,
- adhesive obstruction,
- tumors, cysts, polyps,
Conception after laparoscopy
Patients are interested in the question of the timing of a possible pregnancy after surgical procedures. The chance of becoming pregnant depends on the individual characteristics of the patient’s body, the severity of the pathology and the complexity of the surgery performed. His contribution is made by: age, existing chronic inflammatory processes of the reproductive organs and complications after surgery.
Note! Premature pregnancy after laparoscopy always ends with undesirable consequences. Conception time must be coordinated with the local gynecologist.
When is pregnancy planning desirable? It takes three months or six months for the body to fully recover from surgical procedures. After a thorough examination of the patient, the gynecologist makes a conclusion about the possibility / impossibility of conceiving a child. The operation of an ovarian cyst postpones the time of the planned fertilization for six months instead of three months.
Removal of polycystic ovaries does not require a long recovery period, so after 28-30 days you can think about conceiving a child. Restoration of women's health after ectopic pregnancy requires a long period of rehabilitation - at least six months. Doctors are wary of planning conception after ectopic, recommend giving rest to the body for about a year.
How is labor after laparoscopy? This operation does not leave behind a scar on the body of the uterus, so a woman can give birth in a natural way. If doctors find it necessary, the patient will be given a cesarean section. We should not think that a weak labor activity was provoked by the operation preceding the childbirth - it depends on the characteristics of the female body.
Briefly about hysteroscopy
Hysteroscopy is the name of such a diagnostic and treatment procedure that allows you to visually evaluate the uterus from the inside, identify pathological formations or anomalies of its structure and, if necessary, remove them quickly, that is, without penetrating the abdominal cavity. This method refers to endoscopic and is carried out using a special optical device - a hysteroscope by a trained specialist.
Translated from the Greek hysteroscopy means "examine the uterus." Manipulation is diagnostic and therapeutic. Diagnostic hysteroscopy is carried out not only to examine the internal uterine surface, but also to take material (endometrium) for histological examination (biopsy). During therapeutic hysteroscopy, surgical interventions are performed, for example, removal of tumors or foreign bodies.
Preparation for the procedure
Since hysteroscopy refers to invasive procedures and is akin to surgical intervention, before it is performed, the patient is prescribed an examination (excluding emergency cases):
- blood and urine tests (general tests),
- vaginal and cervical smears to clarify microflora,
- blood for syphilis and hepatitis,
- blood for HIV infection
- blood biochemistry (especially blood glucose in overweight patients),
- blood per group and Rh factor.
From instrumental methods are assigned:
- Pelvic ultrasound,
- Abdominal ultrasound (if indicated),
- blood coagulation test,
- ECG (if indicated).
If the patient has chronic extragenital diseases, consultation of a doctor of the appropriate profile is shown with corrective therapy. When detecting colpitis, reorganization of the vagina is assigned (up to 1–2 degrees of purity).
The examination is carried out on an outpatient basis. After admission to hospital, the patient is prescribed a cleansing enema (preparation of the intestines) before the procedure, and immediately before hysteroscopy, it is necessary to empty the bladder. Eating on the day of manipulation is prohibited due to intravenous anesthesia during hysteroscopy. Hysteroscopy is planned on the 5th - 7th day of the cycle, that is, in the first (proliferative) phase, when a new functional layer of the endometrium has just begun to grow, and the inner surface of the uterus is available for inspection.
It is also necessary to abstain from sexual intercourse 3 days before the procedure, and stop douching for a week. The use of spermicides and vaginal suppositories 7 days before hysteroscopy is not recommended.
The recovery period after the manipulation conditionally divided into 2 stages. The first stage consists in the primary restoration and normalization of the structure and functioning of the damaged tissues of the uterus (mucosa and muscle layer). At the first stage, microdamages and surgical incisions are completely healed, and the cervical canal is restored and regenerated. This stage lasts about 2–3 weeks and ends with the complete regeneration of operative injuries and the formation of cicatricial tissue.
The second stage of recovery is aimed at the formation of a new, newly formed tissue, that is, a new endometrium after hysteroscopy. The new uterine mucosa should have a normal structure and all its inherent functional properties (growth and rejection of the endometrium according to the phases of the menstrual cycle). The second stage of recovery requires more time and lasts up to 6 months.
Discharge after the procedure
Blood and moderate bleeding will occur in the first 2 to 3 days after the manipulation. This is due to traumatic damage to the uterine lining tools. Subsequently, the secretions become succinic or yellow, which can last up to two weeks. The duration of blood-like secretions is due to the expansion of the uterine cavity by the liquid during hysteroscopy, the liquid penetrates the vessels, damaging their walls, which results in the release of the "blood". But in the event of abundant blood secretions and blood clots, you should immediately consult a doctor.
Menstruation after hysteroscopy
When do menstruations come after hysteroscopy? It all depends on the purpose for which the procedure was carried out. In the case of diagnostic, especially office hysteroscopy, menstruation occurs according to the schedule of the usual cycle, but slight delays are possible (2 - 3 days). This is explained by the fact that the endometrium is practically not injured during the diagnostic procedure, so a long time is not required for its restoration. But in the case of therapeutic hysteroscopy, especially after completing the procedure of curettage of the uterus, a longer delay of menstruation is possible. In this situation, the first day of the menstrual cycle should be considered the day of the operation and wait for menstruation in about a month. It is important to follow the nature of the first menstruation after the procedure. At change of color and a consistence, and also increase in quantity of blood discharges it is necessary to consult with the gynecologist.
Pain after the procedure
Pain after hysteroscopy is considered absolutely normal, if it is minor or moderate, localized in the lower abdomen or in the lower back / sacrum and lasts a couple of days. Painful sensations are explained, firstly, by stretching the uterus during the procedure by gas or liquid, and secondly, by traumatization of the cervical and uterine tissues with instruments. Women with a low pain threshold complain of marked pain, in such cases, the doctor may recommend taking NSAIDs with a good analgesic effect (ketorol, indomethacin, nise). But if the stomach hurts unbearably, the nature of pain is cramping, dagger or shooting, the temperature rises significantly and the symptoms of intoxication increase, the pains go to the perineum or leg, then you should immediately seek medical help to rule out possible complications.
IVF after hysteroscopy
When a patient is preparing for IVF, she must undergo a rather complicated examination, which also includes hysteroscopy. But not in all clinics for IVF this procedure is mandatory. IVF after hysteroscopy can end unsuccessfully (miscarriage) in the case of undetected and untreated intrauterine pathology, so most reproduction specialists consider it necessary to undergo the procedure. What can be detected and removed (if necessary) by a doctor on hysteroscopy before IVF:
- excise polyps
- remove hyperplastic endometrium,
- dissect intrauterine adhesions,
- excise the intrauterine septum,
- remove foci of endometriosis,
- correct the shape of the uterus in case of its abnormal development,
- remove submucous myoma node,
- check the patency of the tubes (insertion of a catheter into the tubes).
After operating hysteroscopy, pregnancy planning is permitted no earlier than six months. In case of successful fertilization and implantation of an egg, a woman is put on a dispensary account from the moment of the establishment of pregnancy and is carefully monitored. The course of pregnancy depends not only on the intrauterine surgery, but also on other factors:
- hormones before pregnancy,
- the number of births and abortions,
- condition of the cervix (ICN)
- extragenital pathology.
Cost of hysteroscopy
The cost of hysteroscopy depends on the purpose for which it is performed. Diagnostic or office hysteroscopy, respectively, is cheaper because its implementation does not include surgery. The prices for operating hysteroscopy vary according to the level of complexity of the operation, the qualifications and experience of the doctor and the quality of the equipment. Increases the cost of the procedure and the need (in some cases) of hospital stay. But, of course, the price of the service depends on the region and the level of the clinic.
For example, in Moscow, diagnostic hysteroscopy will cost 15,000 - 35,000 rubles, and the price for an operating theater reaches 60,000 - 65,000 rubles. In the provinces, the price of office hysteroscopy ranges from 2500 to 9000 rubles, and the procedure for the surgical treatment of intrauterine pathology costs from 3,500 to 25,000 rubles. The average price for an inpatient stay is 1500 - 4000 rubles.
From the early postoperative complications it should be noted:
- inflammation of the uterus and pelvic peritoneum (endometritis, pelvioperitonitis) - makes up 90% of all complications,
- intravascular hemolysis, due to the duration of the operation and the use of distilled water or non-electrolyte media, or an increase in intrauterine pressure,
- bleeding - no more than 5% of all complications (observed after resection of myoma, resection or ablation of the endometrium).
Late complications include:
- pyometra formation in postmenopausal patients (in the case of rough manipulation),
- hydrosalpinx formation, especially in chronic adnexitis,
- deformation of the uterine cavity (after resection of the endometrium or removal of large myomatous nodes),
- exacerbation of chronic inflammatory processes,
- incomplete removal of intrauterine devices.
Menstruation after surgical hysteroscopy
It should be understood that the postoperative period of hysteroscopy of the uterus lasts a long time. After intervention in the body, the menstrual cycle may not immediately recover.
Endometrium should grow under the influence of hormones, but surgery also has a direct effect. Changes in the structure of the endometrium due to hysteroscopy leads to the fact that the menstrual cycle will be restored within six months. In most cases, this happens quickly, and many patients note that the regularity of the cycle is restored immediately.
Changes in the cycle affect not only its duration, but also the duration of uterine bleeding, their profusion. The nature of menstruation can change to exactly the opposite: if they were abundant, they can become scarce.
It is possible to consult a doctor if menstruation does not stop at 7-10 days and is accompanied by severe pain. The specialist must guide the patient who performed the operation.
Unfortunately, recently the number of women suffering from endometrial polyposis is increasing. They pass through the mandatory surgical intervention, the impressions of which are shared with friends. Some of them even gave certain recommendations to a particular clinic where they had surgery. Many patients gave positive reviews regarding the treatment of polyps with this method.
Women who have undergone such surgery, say that the postoperative period is calm.
According to the patients, there is no particular difference between the level of provision of benefits for paid and public clinics. Of key importance is the qualifications of specialists performing the operation. You can contact the most expensive clinic, but not get the desired result. But in the hands of a competent surgeon, the health of a woman is protected.
Recovery from hysteroscopy takes a little time. In addition, the undoubted benefits of the operation performed are obvious.