"Surgical hysteroscopy can be done on an outpatient basis if the lesion to be resected is especially small, with little risk of complications".
DR. JOSÉ ÁNGEL MÍNGUEZ CODIRECTOR. GYNAECOLOGY AND OBSTETRICS DEPARTMENT
Hysteroscopy is a diagnostic procedure that allows direct visualization of the cervical canal and uterine cavity.
In-office or outpatient hysteroscopy is a technique that allows the diagnosis and treatment of a large part of intracavitary uterine pathology in a single act, leaving very selected cases for the operating room.
Diagnostic hysteroscopy consists of introducing a lens (hysteroscope) through the cervix to visualize the uterine cavity.
A camera can be adapted to the lens and connected to a monitor to make the exploration easier. A video can also be adapted to record the images that are obtained.
When the same hysteroscopic technique is used to take samples, resect endometrial formations or intervene, it is called surgery.
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When is hysteroscopy indicated?
Hysteroscopy is used to study the endometrium, morphologically and functionally.
It is indicated:
- When there are alterations in the menstrual cycle and metrorrhagia.
- For the study of sterility or infertility (repeated miscarriages).
- For the diagnosis of morphological alterations of the uterine cavity (polyps, myomas, hyperplasia).
- To locate foreign bodies or placental remains.
- To carry out the study and control of uterine malformations (septa).
Most frequent indications of this test:
- Infertility or sterility studies.
- Uterine fibroids.
Do you have any of these diseases?
You may need to have a hysteroscopy
How is hysteroscopy performed?
The patient lies down in the gynecological position and a speculum is placed to widen the vaginal opening. The vagina and cervix are then cleaned with an iodine solution and the cervix is clamped.
The hysteroscope is then adapted to the canal through the external cervical opening and slowly introduced, causing the gas or distension medium to dilate the internal cervical opening.
Since the uterine cavity is a virtual space (it is closed, unless something is distending it), it is necessary to use a distending medium during the hysteroscopy.
Currently, two types of media are used: gaseous (CO2) or liquid (saline, 3% glycine solution, Dextran). For diagnostic hysteroscopy, CO2 or saline is generally used.
Sometimes it is necessary to administer anesthesia in the cervix by means of injections in it.
- Being pregnant.
- Recent history of acute pelvic infection or reactivated recurrence by some similar diagnostic technique.
- Recent uterine injury (perforation or presence of malignant tumour inside the uterus).
These are rare risks:
- There may be some vasovagal reaction (lowering of blood pressure) due to the pain produced during the exploration.
- If it is especially difficult to enter the uterus cavity due to stenosis (narrowing) of the internal cervical orifice, it may lead to a false path, that is, the hysteroscope is introduced through an area other than the internal cervical orifice. It is difficult to do this when it is done without anaesthesia or with little local anaesthesia.
- A hole may occur in the uterine wall (uterine perforation).
- CO2 embolism. This consists of the passage of the gaseous distension medium into the general circulation. It usually occurs when there is significant bleeding during the exploration and the gas pressure is high. It can be a major complication that requires hospital admission and oxygenation of the patient.
- Endometrial infections or endometritis (late and infrequent complication).
Where do we do it?
IN NAVARRE AND MADRID
The Department of Gynecology and Obstetrics of the
of the Clínica Universidad de Navarra
Comprehensive care that includes a wide range of consultation and treatment options from regular preventive screening to the most advanced diagnostic and treatment options for obstetric and gynecological problems at all ages.
The department also offers routine pregnancy monitoring that includes a variety of diagnostic and screening procedures to identify potential problems of the fetus as well as its proper growth and development.
Why at the Clinica?
- Highly specialized team of doctors, nurses and midwives.
- Reproduction and Fertility Unit.
- Pregnancy follow-up with a personalized delivery.
- All the comfort, with the guarantee and safety of a hospital with the most advanced equipment.