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How to do diagnostic hysteroscopy of the uterus. What is hysteroscopy of the uterus, why and how it is performed

Hysteroscopy of the uterus is a minimally invasive intervention performed under general or local anesthesia. In gynecology, the procedure can perform diagnostic and therapeutic functions. Removal of a polyp using an operating hysteroscope can be carried out on an outpatient basis or in a hospital - it depends on the complexity of the upcoming manipulations.

Hysteroscopy of the uterus is a gynecological technique for examining the inner surface of the organ cavity and the mouths of the tubes using a hysteroscope. The device, inserted through the cervical canal, is a hollow cylinder with a diameter of 7–9 mm.

An optical tube is installed inside the tube to transmit the image; the hysteroscope is also equipped with:

a device for supplying gas or liquid into the uterine cavity - this is necessary to improve visibility and increase the field for surgical manipulations;
a set of instruments for surgical intervention;
lighting system.

Modern devices are compatible with a video camera, which allows you to see the location of the instruments and the area under study on the monitor.

Hysteroscopy refers to minimally invasive endoscopic examinations, allowing:

achieve minimal tissue trauma (compared to diagnostic curettage);
reduce the risk of complications;
take a targeted biopsy;
eliminate the disease simultaneously with diagnosis.

Scheme of hysteroscopy of the uterus in gynecology.

Surgical hysteroscopy is characterized by high precision of manipulations, without requiring open access (incisions).

Types of hysteroscopy

Depending on the purpose of hysteroscopy, various sets of equipment and types of anesthesia can be used.

Among the hysteroscopic manipulations, the following are conventionally distinguished:

diagnostic– designed to identify existing diseases or structural anomalies. The procedure is virtually painless, and in some cases can be performed without anesthesia or under local anesthesia. However, preference is often given to general anesthesia - this allows you to combine diagnosis with surgical treatment (if there are indications and technical capabilities).
surgical(therapeutic) - involve the removal of tumors or tissue growths using surgical instruments inserted through a special channel of the hysterocoscope. Performed under general anesthesia;
control– carried out during observation of treatment or rehabilitation after surgical interventions. The main difference from diagnostic ones is that more attention is paid to examining the selected area or searching for pre-expected changes;
carried out in preparation for IVF(artificial insemination) – allowing to identify obstacles to the implantation of a fertilized egg into the uterus. The procedure practically does not damage the endometrium, which is important for successful pregnancy.

Contact microhysteroscopy should be highlighted separately. To carry it out, devices with an optical system that allows 150x magnification are used. This allows you to see changes in cellular structure and identify malignant degeneration at an early stage.

Indications for intervention

Hysteroscopy of the uterus is a procedure in gynecology that can perform diagnostic or therapeutic functions. A diagnostic study is designed to clarify the doctor’s suspected diagnosis. It is usually prescribed after an initial examination and collection of the patient’s complaints.

Indications for diagnostic hysteroscopy include:

infertility;
disruptions of the menstrual cycle during childbearing years;
suspicion of disturbances in the development of the uterus (presence of internal partitions);
detection during examination of compacted areas (probability of growths, polyps, fibroids);
uterine bleeding (inappropriate to the cyclic phase or diagnosed in postmenopause);
cycle disorders (including prolonged and heavy discharge with dense inclusions);
miscarriage or spontaneous miscarriage (can be caused by diseases of the endometrium - the inner layer of the uterus);
symptoms of the presence of foreign bodies in the organ cavity;
the need to take an endometrial biopsy.

Unlike ultrasound, hysteroscopy can detect very small polyps, scar changes or adhesions.

Indications for control hysteroscopy are:

checking the condition of organs after difficult childbirth, abortion or curettage;
possible changes in the uterus due to hormonal therapy.

If there is an accurate diagnosis or information obtained during diagnosis, it is permissible immediately or in a separate procedure perform therapeutic hysteroscopy to eliminate:

fibroid nodes - benign tumors of the muscular layer of the uterus (myomectomy);
intrauterine septum;
growth of the inner layer of the uterus inside (hyperplasia) and outside the organ (endometriosis);
endometrial polyps;
uterine synechiae (adhesions);
foreign bodies (bone inclusions, parts of the intrauterine device).

There is a technique for performing hysteroscopic sterilization. The use of a hysteroscope when planning IVF is considered to be as gentle as possible and allows you to avoid adhesions, damage and inflammation before artificial insemination.

Preparation for the procedure

Despite its minimally invasive nature, any hysteroscopy is equivalent to surgical intervention and requires a set of preliminary measures of various types.

Training is carried out in the following areas:

psychological preparation;
consultations with specialists – therapist, anesthesiologist;
general research – instrumental and laboratory;
diagnosis of gynecological disorders - instrumental techniques and tests;
medication preparation;
hygienic preparation of the external genitalia.

On the eve of the procedure, a woman should:

Do not consume (starting from lunch) foods that contribute to increased formation of gases (if necessary, such a diet can be followed for a week before the procedure).
In the evening, skip dinner, you can and should drink weak tea and water without gases (the last intake of liquid should be at least 11 hours before hysteroscopy).
At night, cleanse the intestines with an enema.
In the morning, do not eat food, do not drink, and, if possible, do not smoke.

Psychological attitude

The patient should understand the essence of the process in advance and know what result should be expected after the manipulations. Diagnostics (without removal) can be carried out without anesthesia - in this case, the doctor warns the woman about the possibility of slight discomfort.

Medication preparation

At least 7 days before the procedure, you should stop taking any medications internally, topical use of vaginal suppositories and sprays.

An exception will be medications prescribed by a doctor to prevent infection and cleanse the vagina:

antimicrobial drugs for oral administration - dosages and courses are prescribed individually;
local remedies to eliminate fungal or bacterial flora - suppositories or ointments based on metronidazole, clotrimazole;
douching solutions - Octinisept, Miramistin.

All other medications can be prescribed only based on the results of preliminary tests in order to eliminate or compensate for diseases identified during preparation.

Sanitary and hygienic measures

Hysteroscopy of the uterus is a procedure in gynecology that places increased demands on the cleanliness of the vagina and external genitalia.

Therefore, as part of your preparation you should:

3 days before the procedure, avoid intimate contact.
The evening before, take a shower, paying special attention to the hygiene of the external genitalia, perineum and thighs (do not use alkaline intimate hygiene products). Then you should carefully shave the hair in the perineum and pubic area (it is not advisable to use chemical hair removal products).
If in the morning there is a need for additional cleansing of the intestines, perform sanitary and hygienic treatment of the perineum again.

The use of any sprays and douches is possible only according to indications.

Basic research and testing

Hysteroscopy of the uterus requires an in-depth examination - both general and gynecological.

The objectives of preliminary diagnostics are:

exclusion of existing contraindications to the procedure and/or anesthesia;
reducing the risk of complications;
purpose of vaginal sanitation.

It is convenient to present the list of necessary studies in the form of a table:

Survey group	Scroll
Instrumental (general profile)	Fluorography Electrocardiogram Ultrasound examination of the abdominal cavity
Clinical and laboratory (general profile)	General blood test Coagulability assessment Blood biochemistry Blood glucose test Tests for HIV, RW, hepatitis B and C. General urine test
Gynecological instrumental	Ultrasound of the pelvic organs - using a transvaginal and/or external sensor (according to indications) Colposcopy (examination of the cervix) Examination by a gynecologist and bimanual (two-handed) examination of the uterus
Gynecological laboratory	Vaginal flora smear Cytology smear from the cervix

In addition, the preparation will include consultations with a therapist and anesthesiologist, taking into account the results of the examinations. A woman is considered prepared for the procedure if, based on research, there are no contraindications, and the identified violations have been eliminated or compensated for with medications.

Type of anesthesia

The anesthesiologist chooses the anesthesia technique based on the goals of the intervention and the patient’s health condition, in particular:

presence of chronic diseases;
likelihood of an allergic reaction;
the possibility of complications associated with anesthesia or the medium supplied to expand the uterine cavity (gas or liquid).

Diagnostic procedures can be performed without anesthesia - this is permissible for certain indications (the absence of severe inflammation) and the availability of equipment (a very thin flexible fibrohysteroscope that does not require expansion of the cervical canal).

For hysteroscopic manipulations, the following types of anesthesia are used:

paracervical anesthesia– injection of an anesthetic (Lidocaine) into the cervix. Used for diagnostic purposes only;
mask anesthesia– chosen if there are restrictions for intravenous general use. It is a type of inhalation anesthesia; ether, cyclopropane, pentran, chloroform are used as a gaseous/vapor substance entering the lungs through a mask;
general intravenous anesthesia– optimal for long-term interventions, the presence of respiratory diseases or intolerance to mask anesthesia. In this case, a mixture of several types of drugs is administered through a venous catheter:
analgesics (morphine, ketamine);
sleeping pills (Relanium, Seduxen, Sibazon);
muscle relaxants (listenone, myorelaxin);
medications that support vascular tone and heart rate;
endotracheal (a type of inhalation), spinal (local, injected into the space of the spinal cord) or epidural (similar to spinal, but does not relax the muscles) are types of anesthesia used when it is impossible to use general or mask anesthesia.

Regardless of the type of anesthesia, heart rate and breathing are continuously monitored during surgery.

Technique and sequence of manipulation

Hysteroscopy of the uterus can be performed in an emergency (for bleeding) and routinely.

The planned procedure is carried out on certain days of the cycle:

5–7 day– optimal in the vast majority of cases – endometrial growth and bleeding are minimal;
4–5 days before expected menstruation– if there is a need to assess the condition of the endometrium in the secretory phase;
any day– in postmenopause, when there is no cyclic discharge.

Hysteroscopy is performed on a gynecological chair, the main stages of the procedure are as follows:

Bimanual examination of the vagina to clarify the location of the uterus and its size.
Injection of anesthesia (local or general).
Treatment of the external genitalia and inner thighs with an antiseptic.
Expansion of the cervical canal (except for manipulations with a flexible hysteroscope).
Inserting a hysteroscope with a light source into the uterus and expanding the organ cavity to improve visibility - using liquid (optimal for surgical operations) or gas. The expansion medium is supplied through a special channel of the hysteroscope.
General examination of the endometrium - the hysteroscope is slowly turned clockwise.
Magnification of individual areas for in-depth examination (the optical system of the device allows you to examine individual areas with a magnification of 10 times), taking a targeted biopsy (if necessary).
Performing surgical intervention - if this was intended (at the same time as diagnosis, foreign tissue, fibroids, and small polyps are often removed).
Performing diagnostic curettage under the control of the “picture” obtained from the device (if indicated).
Removing the device from the uterine cavity.
Removal of the patient from anesthesia and observation of her for 1 hour (can occur in the ward).

Therapeutic manipulations during hysteroscopy can be performed using mechanical (cutting), electrical (cutting and sealing) and laser techniques. The procedure takes 10–30 minutes (diagnosis) or up to 1 hour (diagnosis and treatment or extensive surgery).

What diseases can be detected using hysteroscopy?

Hysteroscopy of the uterus is a study in gynecology that allows one to detect (including in the early stages):

proliferation of the uterine mucosa (hyperplasia);
germination of the endometrium into neighboring organs (endometriosis);
submucosal myoma (tumor formed by smooth muscle cells of the organ);
polyps of the mucous layer of the uterus or cervical canal;
malignant degeneration of endometrial cells;
adenomyosis (degeneration of endometrial glands);
inflammation of the endometrium;
intrauterine adhesions;
intrauterine septum or uterine division - here, in addition to hysteroscopy, a laparoscopic examination is required;
foreign bodies in the organ cavity (remnants of the coil, fertilized egg or placenta and surgical threads);
damage to the uterine wall (perforation) can either be detected or be a complication of hysteroscopy.

For small polyps, adhesions and the presence of foreign bodies, hysteroscopy is the optimal, and sometimes irreplaceable, examination.

Results and transcript

The correspondence between the “picture” obtained from the hysteroscope and the identified disease is presented in the table:

Screen image	Diagnosis
Thin pale pink endometrium, with small hemorrhages, the mouths of the fallopian tubes are visible	Normal for days 5–9 of the cycle
Swelling yellowish mucosa, the mouths of the tubes may not be visible, closer to menstruation the endometrium may be bright red	Normal for the secretory phase of the cycle
Pale thin endometrium, possible folds and adhesions	Normal for postmenopause
Thickening of the mucous membrane - general or in the form of polyps	Overgrowth (hyperplasia)
Dense spherical knots	Myoma
Round whitish smooth neoplasms with a diameter of 1.5–1 cm on a stalk, fluctuating with changes in the speed of fluid movement in the uterus	Fibrous polyp
Pale pink neoplasms on a stalk with a diameter of 5–6 cm	Glandular cystic polyp
Small neoplasms with a diameter of 0.5–1.5 cm on the fundus of the uterus and the mouths of the tubes are gray in color	Adenomatous polyps
Loose tissue with ulcerations, growths, uneven with a noticeable pattern of blood vessels	Malignant degeneration of the endometrium
Black dots or crevices oozing blood, uneven terrain with local compactions	Degeneration of the endometrial glands
Reddened walls with noticeable whitish gland ducts. The mucous membrane bleeds when touched and has pinpoint hemorrhages. The wall is flabby, thickened in places	Inflammation of the mucous membrane
Whitish cords connecting the walls of the uterus	Spikes
Ingrowth of fragments of the spiral into the endometrium, possibly with rupture of the wall	Remains of the intrauterine device
Plates or coral-shaped white fragments, when removed the wall bleeds	Bone fragments (may appear during late pregnancy termination)
Yellowish or purple tissue at the bottom of the uterine cavity, mucous and bloody clots	Remains of fertilized egg or placenta
White threads against the background of scarlet edematous mucosa	Remnants of surgical threads
Unexpected failure of the device, an increase in the amount of fluid supplied to the cavity and a decrease in the fluid output	Rupture (perforation of the uterine wall), including during an ongoing procedure

What can happen after the procedure

Hysteroscopy of the uterus is a gynecological procedure, after which the patient can, in some cases (diagnosis, removal of small polyps), immediately go home. If the procedure is more extensive or there is a risk of infection (determined during preparation for the procedure), it is necessary to spend 1–3 days in the hospital.

After completing the procedure, the norm is:

bloody and mucous discharge for 1–3 days, gradually disappearing (if a single polyp/fibroid was diagnosed or removed);
bleeding reminiscent of menstruation for 4-6 days - if curettage has taken place;
slight pain in the lower abdomen, gradually disappearing;
increased temperature immediately after therapeutic hysteroscopy;
the first menstruation after the procedure is more scanty or heavy than usual.

Possible complications and consequences

Hysteroscopy extremely rarely (up to 1%) leads to negative consequences.

There are 4 groups of complications:

arising directly during the operation - perforation of the wall with surgical instruments or bleeding due to damage to the muscle layer or blood vessels;
caused by anesthesia - in case of an allergy to the drug;
developing after the procedure (immediately or within several days) - infectious inflammation, bleeding, adhesions, blood clots in the organ cavity;
provoked by the expansion of the uterus with liquid or gas - blockage of the arteries (embolism), increased pressure, decreased blood sugar, pulmonary edema or anaphylaxis.

Prevention of complications is to follow the technique of performing the procedure and adequate preparation (including preliminary antibiotic therapy).

Contraindications

Among the restrictions for the procedure, absolute and relative ones are distinguished. One of the absolute contraindications is pregnancy - manipulations can lead to miscarriage.

Also, hysteroscopy is not performed if:

systemic infection– examination can be carried out only after the source of inflammation has been eliminated;
cervical cancer– due to the risk of spread of malignant cells throughout the abdominal cavity;
inflammatory processes in the reproductive organs– acute or chronic relapses;
woman in serious condition– the disease that caused it must be eliminated or compensated (for example, high blood pressure must be brought back to normal by taking appropriate medications);
bleeding disorder– creates a risk of blood loss during and after the intervention.

Relative contraindications are menstruation or uterine bleeding - the procedure is permissible only in an emergency.

Postoperative period and rehabilitation

After hysteroscopy, you should avoid intimate contact for a period of 5 days to several weeks (as recommended by your doctor).

use of tampons (pads should be used);
douching;
visiting the pool, taking a bath (it is better to give preference to a shower);
overheat - in a bathhouse or in the sun.

After the procedure (unless otherwise instructed by the attending physician), you can take the following groups of medications:

painkillers (Baralgin, Ketorol) – if pain occurs immediately after recovery from anesthesia;
hemostatic agents (Ditsinon, Etamzilat) - for extensive interventions;
drugs that accelerate uterine contractions (Oxytocin).
antibacterial agents - for women at risk of postoperative infection (as prescribed by a doctor).

Regardless of the scope of the intervention, hospitalization rarely lasts longer than 3 days, but further (at least 10 days) It is advisable to monitor your condition and immediately consult a doctor if:

increasing pain in the lower abdomen;
high temperature;
an increase in the volume of discharge - bloody and purulent;
nausea, vomiting, dizziness, decreased blood pressure.

Scheduled visits to the doctor are required, regardless of the presence of discomfort.

Where to perform the procedure

Hysteroscopy is carried out by private clinics (specialized and general) or government health care institutions with a developed sector of paid services in large cities and regional centers. The cost in Russia ranges from 4,000 to 9,000 rubles.

Analogues of hysteroscopy

Among the procedures performed with similar diagnostic purposes, it should be noted:

hysterosalpingography(x-ray of the uterus with contrast) – the procedure is less informative and does not allow for surgical intervention or taking a biopsy. Does not require anesthesia, affordable;
Ultrasound– like the previous study, it does not detect small tumors or foreign bodies. Tissue sampling or treatment is not possible. The procedure is carried out almost everywhere;
diagnostic laparoscopy– the manipulation requires a puncture of the abdominal cavity and strictly general anesthesia, and has a greater risk of complications. Combination with surgery is acceptable. The cost of laparoscopy is 1 or more times more expensive than hysteroscopy;
diagnostic curettage– affordable, more traumatic and more likely to cause complications in the form of bleeding or damage to the uterine wall.

Among the analogues of operative hysteroscopy:

surgical laparoscopy and therapeutic curettage - the disadvantages are similar to diagnostic types of interventions;
operations with open access (through incisions) are traumatic and require recovery.

Hysteroscopy of the uterus is a modern method for diagnosing and treating gynecological diseases.

The procedure is unique (in terms of accuracy) for identifying small polyps, adhesions or foreign bodies, as well as checking the readiness of the organ for artificial insemination. Surgical interventions using a hysteroscope are low-traumatic and precise, and extremely rarely lead to complications.

Useful videos about hysteroscopy of the uterus, the features of this procedure and the rules for its implementation

What is hysteroscopy:

Preparation, conduct and rehabilitation after hysteroscopy:

Currently, clinical, laboratory, instrumental and endoscopic research methods are used for full diagnostics in gynecological practice. All this helps specialists determine the condition of the female body, identify serious pathologies and provide timely assistance that can save the patient’s life.

Any patient has encountered an examination using gynecological speculum, but endoscopic examination methods can raise a number of questions in women. So, a woman may be puzzled by what hysteroscopy is, how hysteroscopy is performed and what complications it can bring.

Types of procedure

Hysteroscopy is divided into 2 types: diagnostic (office) and surgical (resectoscopy). Each of them has significant differences.

Office hysteroscopy

The procedure involves the following steps:

during the process, a visual inspection of the uterine cavity occurs;
the condition of the uterine mucosa is examined;
a sample of biological material is taken for histological examination;
minor surgical procedures are performed (removal of polyps, dissection of adhesions and septa).

local anesthesia is used or completely dispensed with;
procedure duration is 10–15 minutes;
After hysteroscopy, a woman does not need to stay in a medical facility for a long time.

Thanks to hysteroscopy, you can carefully examine the cervical canal and the uterine cavity from the inside.

Hysteroresectoscopy

The main actions during hysteroresectoscopy: removal of pathological formations of various nature (large polyps, fibroids, adhesive cords), ablation of the endometrium (excision of the entire thickness), elimination of abnormal bleeding from the uterus. Features of the procedure: it is carried out under general anesthesia (intravenous anesthesia), the duration of the procedure is from 30 minutes to 3 hours, the patient’s hospitalization can last 2–3 days. The position of the patient during diagnostic (office) hysteroscopy does not differ from the position during hysteroresectoscopy. In both cases, manipulations are performed on a gynecological chair.

Indications and contraindications

Hysteroscopy is used against the background of such pathologies:

with endometrial hyperplasia;
benign growth of endometrial glandular tissue;
neoplasms arising in the myometrium;
adhesions in the uterus;
oncopathology;
malformations of the body and cervix.

Surgical hysteroscopy allows you to perform the following manipulations: excision and removal of connective tissue cords, elimination of pathology of the bicornuate uterus, removal of benign growths of endometrial glandular tissue and myometrial neoplasms, removal from the uterine cavity of the IUD, the remains of an incompletely evacuated fertilized egg, as well as the baby's place, taking a biopsy sample .

Office hysteroscopy allows you to diagnose the impossibility of bearing a child, malformations of the reproductive organs, perforation of the uterine wall after termination of pregnancy and cleansing. In addition, office hysteroscopy is performed in case of unstable menstrual cycle, gynecological bleeding of various nature, and also if necessary to confirm or refute any diagnosis.

There are a number of serious contraindications for hysteroscopy:

inflammatory and infectious diseases of the reproductive organs during the period of exacerbation;
bearing a child;
cervical oncopathology;
pronounced narrowing of the cervical canal;
the general serious condition of the patient against the background of serious somatic diseases.

Endometrial hysteroscopy is considered a fairly gentle manipulation and actively displaces traumatic and dangerous interventions in the female reproductive system.

Preparation

During the preparatory period, the patient should do a number of studies:

Standard gynecological examination using a speculum, as well as palpation of the uterus and its appendages.
Vaginal smear. By collecting biomaterial from the urethra, cervical canal and vagina, the state of the flora can be determined.
Clinical blood test, determination of group and Rh factor, blood test for RW, hepatitis and HIV. Determine blood clotting (coagulogram).
Macroscopic and microscopic examination of urine, which can detect renal failure.
Ultrasound of the pelvic organs (through the anterior abdominal wall or transvaginally).
Electrocardiogram and fluorogram.

Before the planned hysteroscopy, the patient will be required to consult with related specialists: therapist, cardiologist, anesthesiologist. In addition, she should inform her doctor about the presence of any drug allergic reaction, suspicion of pregnancy, and medications taken on an ongoing basis.

Before undergoing hysteroscopy, a woman should adhere to the following recommendations: 2 days before the study, exclude sexual contact, a week before the scheduled procedure, do not douche and do not use store-bought gels and foams for washing.

A week before hysteroscopy, do not use medicated vaginal suppositories (with the exception of those prescribed by the gynecologist); in case of persistent constipation, the day before the examination, clean the intestines with an enema. 2 days before the procedure, start taking sedatives if prescribed by a doctor, 5 days before hysteroscopy start taking antibiotics if prescribed by a gynecologist.

On the morning of the procedure, you should refrain from eating and drinking. The patient must perform hygiene procedures, shave the pubic and groin area, and empty the bladder immediately before entering the examination room. All unnecessary items (jewelry, mobile phone) remain in the room. To the hospital, the patient must take with her slippers, socks, a change of underwear, a robe, as well as sanitary pads, which will be needed after the procedure due to heavy vaginal discharge.

In order for the uterine cavity to be better visualized, it is expanded using some medium

Carrying out the procedure

It is of great importance on what day the hysteroscopy is done. Planned hysteroscopy is optimally done from 5 to 7 days of the cycle. At this time, the endometrium is thin and bleeds slightly. But sometimes the condition of the endometrium is assessed in the luteal phase (after ovulation), approximately 3–5 days before the end of the cycle. In mature patients, as well as in emergency situations, the time for hysteroscopy can be any.

After the patient is placed on the gynecological chair, her thighs, external genitalia and vagina are treated with an antiseptic agent. A two-manual vaginal examination is performed to determine the location of the uterus and its size. The lower segment of the uterus is fixed with uterine single-tooth forceps, which pull back the body of the uterus, align the direction of the cervical canal and determine the length of the uterine cavity. And then the cervical canal is bougiened with a Hegar dilator.

The hysteroscope is treated with an antiseptic and carefully inserted into the uterine cavity, enlarged with gas or liquid. During the examination, its contents and size, shape and topography of the walls, and the condition of the area of entry into the fallopian tubes are studied. If any foreign bodies are detected, they are removed using instruments inserted through the hysteroscope channel. If necessary, a targeted biopsy is performed. The tissue sample taken is sent for histology.

According to indications, at the end of the procedure, the inner layer of the cervical canal and the uterine cavity can be removed. The anesthesiologist performs the final phase of anesthesia - brings the patient to consciousness. If there are no complications, the patient is under the supervision of specialists for another 2 hours, and then she is transferred to the general ward. Hysteroscopic surgery lasts on average 30 minutes, and if laparoscopy is performed, the manipulation can last up to 3 hours.

Patients are often interested in how long after hysteroscopy can IVF be done? Experts say that these periods fluctuate and depend on the data obtained during hysteroscopy. Some people are prescribed IVF on the 10th day after hysteroscopy, while others have to wait another six months for this moment. It all depends on the identified pathology, requiring varying degrees of surgical intervention and therapeutic measures.

With the advent of mini-hysteroscopes, which are very small in diameter, hysteroscopy and even minor surgical procedures without dilating the cervical canal have recently become increasingly common.

The medium used to expand the uterine cavity can be gas or liquid

Recovery period

After a hysteroscopic examination or surgical manipulation has been performed, complications cannot be ruled out. In the postoperative period, the uterine mucosa and the natural volume of this reproductive organ, which was disrupted by artificial enlargement during hysteroscopy, should be restored. Against this background, after hysteroscopy, a woman may observe the following symptoms.

Pain syndrome. The pain is usually felt primarily above the pubis. The sensations are mild and somewhat reminiscent of pain during menstruation. In the first hours after the manipulation, the woman experiences pain, as during labor contractions, as the uterus contracts and returns to its previous size.

Vaginal discharge. Due to damage to the endometrium, in the first hours after the procedure, abundant bloody and mucous discharge may be observed. After a diagnostic procedure, discharge can be observed for 5 days, and after surgical procedures - up to 2 weeks.

A woman may experience general weakness and malaise. If a febrile condition appears, you should immediately seek medical help. How long it takes to fully recover from hysteroscopy can vary greatly for each patient. As a rule, this takes up to 3 weeks on average. There are those who became pregnant naturally after hysteroscopy - this happened due to the removal of a polyp or atrophied endometrium.

If the patient follows simple recommendations, the recovery period can be significantly reduced:

To avoid causing bleeding, the patient should abstain from intimacy with a man for 14 days.
Monitor your body temperature throughout the week so as not to miss any complications that may arise.
Of the water procedures, only a hygienic shower is allowed. Taking baths, visiting baths, saunas, and swimming pools is contraindicated.
Conscientiously take medications prescribed by your doctor - antibiotics, analgesics, sedatives, vitamins.
Follow a daily routine, eat right, and exercise limitedly.

When a patient experiences severe pain, bleeding begins and the body temperature rises sharply, this is all a serious reason to urgently seek help from a doctor.

Hysteroscopy itself does not affect the ability to conceive after the procedure

Inserts a tiny hysteroscope through the cervix and into the uterus. A hysteroscope allows the surgeon to visualize the inside of the uterine cavity on a video monitor. The uterine cavity is then checked for any abnormalities. The doctor examines the shape of the uterus, uterine tissue, and looks for any evidence of intrauterine pathology (fibroids, or polyps). The doctor also tries to visualize the openings in the fallopian tubes. The advantage of this method is that the recovery time is very fast. Almost all patients return home the same day after hysteroscopic surgery. There is no abdominal wound, so postoperative pain is minimal and there are no wound infections.

How is hysteroscopy performed?

After general anesthesia (this procedure can also be done in a doctor's office with local anesthesia, but is usually limited to diagnostic purposes only), the hysteroscope is inserted into the uterus using a saline solution (NaCL) or a sugar solution (sorbitol) to stretch the uterus and provide visualization of the uterine cavity.

A local anesthetic cervical block is often performed first to provide local anesthesia. Once the examination of the uterine cavity is complete, several different instruments can be inserted through the hysteroscope to treat uterine fibroids, heavy menstrual bleeding (periods), and polyps.

Contraindications to hysteroscopy

Systemic health problems, especially cardiopulmonary problems, which may be aggravated by general anesthesia, may be a contraindication to hysteroscopy. Anesthesia consultation is recommended if there is any uncertainty regarding women's surgical status. Often this procedure can be performed without general anesthesia, but rather with regional anesthesia (epidural/spinal) or local anesthesia. The anesthesiologist will help you choose the safest method of anesthesia.

What procedures can a gynecologist perform using a hysteroscope?

Many gynecologists will use a hysteroscope to examine the inside of the uterus and look for intrauterine abnormalities, such as fibroids or polyps, that may be causing abnormal or heavy menstrual bleeding. Cavity assessment is also done for women who are having difficulty getting pregnant.

Other conditions suitable for hysteroscopy include:

removal of polyps in the endometrium or cervix;
removal of fibroids;
biopsy of endometrial tissue;
cannulation (opening) of the fallopian tubes;
removal of intrauterine adhesions (scars);
removal of a lost intrauterine contraceptive device;
endometrial ablation – destruction of the uterine endometrium, treatment of irregular or heavy menstrual bleeding;
removal of cervical polyp.

When can hysteroscopy be performed?

Hysteroscopy can be used for:

Research into symptoms or problems - such as heavy periods (periods), abnormal vaginal bleeding, postmenopausal bleeding, pelvic pain, recurrent miscarriages, or difficulty getting pregnant.
Diagnosis of conditions – such as fibroids and polyps (non-cancerous growths in the uterus).
Carrying out curettage.
Treatments for conditions and problems such as removal of fibroids, polyps, displaced intrauterine devices (IUDs), and intrauterine adhesions (scar tissue that causes missed periods and decreased fertility).

A procedure called dilation and curettage was commonly used to examine the uterus and remove abnormal tumors, but hysteroscopy is now being performed.

Preparation for the procedure

Before the procedure, you need to tell the doctors about all the medications the patient is taking. Some may increase the risk of bleeding or interact with anesthesia. If the patient is taking medications such as Warfarin (Coumadin), Clopidogrel (Plavix), or Aspirin, it is important to talk to the doctor, as the doctor will definitely advise whether to stop taking these medications before the procedure. You may need to stop taking certain medications a week or more before your procedure. Before the procedure, anesthetic options can be discussed, including the risks, benefits, and alternatives to each.

On the day of the procedure:

8 hours before the procedure you should not eat or drink; if you need to take medication, this can only be done with a small sip.
Before undergoing hysteroscopy, you need to take a bath or shower in the morning.
Do not use lotions, perfumes, or deodorants.
All jewelry, piercings, and contact lenses must be removed.
At least one hour before the procedure, it is recommended to avoid emptying the bladder.

Before hysteroscopy, you should undergo the following tests:

coagulogram;
testing for HIV and sexually transmitted diseases;
blood type and Rh factor;
smear on vaginal microflora;
fluorography;

What happens during hysteroscopy

Hysteroscopy is usually performed in outpatient or day hospitals. This means that the patient does not have to stay in the hospital overnight. Hysteroscopy is routinely performed on days 7-9 of the cycle, and menstrual bleeding (periods) is a relative contraindication to the procedure

It may not be necessary to use an anesthetic for the procedure, although local anesthesia (where medications are used to numb the cervix) is sometimes used. General anesthesia (narcosis) may be used if the patient is scheduled for hysteroscopy for treatment during the procedure.

During hysteroscopy:

the patient lies on a chair;
an instrument called a speculum may be inserted into the vagina to keep it open (the same instrument used for the cervical screening test), although this is not always necessary;
The hysteroscope is placed into the uterus and fluid is gently pumped inside to make it easier for the doctor to see inside;
the camera sends images to a monitor so the doctor can detect and/or treat any abnormalities.

A hysteroscopy can take up to 30 minutes, although it may only last 5-10 minutes if it is only done to diagnose a condition, or investigate symptoms.

During the procedure, patients may experience some discomfort, similar to periods of cramping, while it is performed, but it should not be painful.

Recovery after hysteroscopy

Most women feel able to return to their normal activities the next day, although some women return to work the same day.

During the recovery period:

you can eat and drink immediately as usual;
You may experience cramping-like pain during your period and some spotting or bleeding for a few days - this is normal and nothing to worry about;
sex after hysteroscopy should be avoided for a week, or until bleeding has stopped, to reduce the risk of infection.

Recovery tends to be very fast since there are no incisions. Most patients will require some pain medication in the immediate postoperative period, but an anti-inflammatory drug is often sufficient. Sexual intercourse should be postponed, as well as active sports for two weeks. It is advisable not to insert anything into the vagina for at least 2 weeks, including tampons. Most women can return to work within two weeks.

You should see a doctor if any of the following symptoms occur:

heavy vaginal bleeding;
inability to urinate;
increase in abdominal pain.

Risks of hysteroscopy

Hysteroscopy is generally very safe, but like any procedure there is a small risk of complications. The risk is higher in women who undergo treatment during hysteroscopy.

Some of the main risks associated with hysteroscopy are as follows:

Accidental injury to the uterus - this is very rare, but may require treatment with antibiotics in hospital or, in rare cases, other surgery to repair it.
Accidental injury to the cervix is a rare complication and the injury can usually be easily repaired.
Excessive bleeding during or after surgery - this may occur if the treatment was carried out under general anesthesia; very rarely, the uterus may need to be removed (hysterectomy)
Uterine infection – can cause smelly vaginal discharge, fever and heavy bleeding; it is usually treated with a short course of antibiotics.
Feeling weak – affects 1 in every 200 women who have a hysteroscopy, done without anesthesia or with local anesthesia only.

Bleeding or infection can occur after any surgery. Sometimes the surgeon cannot complete the procedure safely due to excessive bleeding, fluid absorption, or the size of the fibroid. Complications common with hysteroscopy include uterine perforation and disproportionate fluid retention. The liquid is used to stretch the uterine cavity during hysteroscopy. Sometimes this fluid can be absorbed into the general circulation (lungs and brain). If excessive fluid absorption occurs, the procedure should be discontinued.

Emboli and death are rare but potential complications of any surgery.

Alternatives to Hysteroscopy

Hysteroscopy will only be performed if the benefits are considered to outweigh the risks.

The uterus can also be examined using:

pelvic ultrasound – where a small probe is inserted into the vagina and uses sound waves to create an image of the inside of the uterus;
endometrial biopsy – where a narrow tube is passed through the cervix into the uterus, with suction used to remove a sample of uterine tissue.

These alternatives can be performed alongside a hysteroscope, but do not provide as much information and cannot be used to treat problems in the same way as hysteroscopy.

Types of hysteroscopy

Office hysteroscopy

Office hysteroscopy is one of the options for performing hysteroscopy, it is performed in the gynecologist’s office, which is where its name comes from, and differs from the classical one in that it is mainly a diagnostic procedure, rather than a surgical intervention.

Hysteroscopy before IVF

Before IVF, hysteroscopy is a recommended procedure to ensure that the uterus is healthy and ready to bear a child. Failed IVF attempts are usually due to embryonic factors such as genetic problems or problems with the woman's uterus. In the past, many fertility clinics routinely performed hysteroscopy on women who had not had IVF cycles to look for abnormal uterine growths or scar tissue and remove them. There are other, non-invasive methods to evaluate the uterine cavity, including hysterosonography, where a small amount of salt water is injected into the uterus and an ultrasound is performed to evaluate the uterus. Hysteroscopy is usually performed in cases where the abnormality has already been identified during other studies.

Hysteroscopy and laparoscopy

Sometimes, when indicated, patients undergo laparoscopy and hysteroscopy at the same time; these two procedures are endoscopic and are performed with minimal intervention. Used to treat endometriosis, uterine polyps, and tubal obstruction. Laparoscopy is often performed simultaneously with hysteroscopy, especially in women undergoing infertility treatment. Endometrial ablation

Endometrial ablation is an outpatient surgery that can reduce or stop heavy uterine bleeding and is performed using hysteroscopy. During ablation, the endometrium is destroyed. The endometrium is destroyed using a gentle electrical current or heat. This process inhibits tissue growth. Endometrial removal may be an alternative to hysterectomy in patients with severe and irregular uterine bleeding. The gynecologist must first rule out any intrauterine pathology that may contribute to this bleeding. An endometrial biopsy is often done to make sure there is no cancer. Ablation is not recommended if: the uterine cavity is very large (more than 12 centimeters), endometrial cancer or hyperplasia (precancerous condition) is present, a submucosal polyp or fibrosis is detected, the patient has severe dysmenorrhea (menstrual cramps).

After ablation, bleeding should decrease. For some women, it may stop altogether. Even if the bleeding does not stop completely, it will likely be much easier. Rarely there is no improvement in bleeding after ablation.

There are many methods for instrumental examination of the uterus. One of the high-tech methods of diagnosis and microsurgical intervention is hysteroscopy.

Description and features

Hysteroscopy of the uterus is a highly informative way to visualize the uterine cavity using a hysteroscope. The latter is a device consisting of several elements: an optical tube, an LED connector, and an eyecup. There are several types of hysteroscopes: operating (equipped with a special barrel for attachments, used for simple surgical interventions) and outpatient (for examination and diagnosis of pathologies).

In gynecology, hysteroscopy is carried out for several purposes:

Diagnostics. Hysteroscopy is performed to identify various pathologies and conduct a detailed examination of the uterine cavity. Diagnostic hysteroscopy of the uterus allows you to detect various neoplasms, determine the size, location and structural features of pathological areas, assess the condition of the organ in case of endometrial diseases, etc.
Surgical intervention. In addition to visualization, surgical hysteroscopy involves the use of special instruments. Hysteroscopy of the uterus allows for polyp removal and curettage. Hysteroscopy is also performed for uterine fibroids (benign formations from muscle tissue) and other tumors.
Treatment control. Hysteroscopy of the uterine cavity allows you to evaluate the effectiveness of the treatment, monitor the course of the pathological process, and also promptly identify complications.

Depending on the indications, diagnostic hysteroscopy and curettage can be performed simultaneously or separately.

Office hysteroscopy

In medical practice, the process of examining the uterus is sometimes called “office hysteroscopy.” It is not much different from the classical (surgical) one. The main difference is that the latter is performed in a hospital setting, using anesthesia. Office hysteroscopy is performed without anesthesia, on an outpatient basis.

Indications

Indications for diagnostic hysteroscopy:

Suspicions of uterine pathologies (for example, hysteroscopy is performed if there are suspicions of uterine polyps, fibroids, oncology, perforation of the uterine wall, etc.).
Infertility.
Spontaneous miscarriages.
Uterine bleeding.
Clarification of the presence of foreign objects in the uterine cavity (for example, a spiral).
Monitoring therapy after surgery, taking medications, etc.

Indications for hysteroscopy with separate diagnostic curettage:

Removal of endometrial polyps. Hysteroscopy is a highly effective method of treating this pathology. Endometrial polyps are easily injured, which can lead to infection; in this case, hysteroscopy allows you to completely get rid of the formations and control the recurrence of the pathology.
Hysteroscopy is indicated for endometriosis. Very often, for more effective diagnosis and treatment of this pathology, hysteroscopy is combined with laparoscopy.
Submucosal myoma.
Intrauterine adhesions, septa.
Cauterization of blood vessels.
Incomplete miscarriage, frozen pregnancy.
Expansion of a narrowed canal.
Removal of tumors.
Carrying out sterilization, etc.

Hysteroscopy and RDV also involve taking material from the uterine cavity (hysteroscopy with endometrial biopsy). This procedure is performed when a malignant process is suspected. The resulting tissue sample is sent for histological examination.

In some cases, laparoscopy and hysteroscopy are performed. The combined technique is used in the presence of cysts, tumors, endometriosis of the ovary, uterus, ovarian apoplexy, etc.

Contraindications

Despite the fact that the procedure is considered safe, there are still contraindications to its implementation:

The period of bearing a child.
Heavy uterine bleeding.
Low blood clotting.
Acute infectious and inflammatory processes in the pelvic organs.
The patient's serious condition.
Age up to 15 years, virginity.

Preparation

Preparation for hysteroscopy is necessary in order to maximally protect the woman’s body from all kinds of complications during and after the procedure.

List of tests before the procedure:

Vaginal smear.
General blood and urine analysis.
HIV test.
Blood test for sugar, bilirubin, blood clotting, Rh factor.
Fluorography.
Electrocardiogram.
Ultrasound of the pelvic organs.

The last meal before the procedure should be at least 12 hours before. It is recommended to exclude fermented milk products the day before. Fluid intake should also be limited 10 hours before the procedure. This will prevent possible vomiting during and after anesthesia.

The patient's bowels and bladder should be emptied. A woman should observe the rules of personal hygiene and get rid of hair in the genital area before the procedure. In addition, the patient must notify the doctor about the medications taken.

When is it carried out?

On what day of the cycle should hysteroscopy be done?

On what day of the menstrual cycle is hysteroscopy performed for women of reproductive age? – Usually prescribed 7-9 days from the start of the menstrual cycle. During this period, the endometrium is thin, practically not covered with vessels, which increases the accuracy of diagnosis.
On what day is the procedure performed for women during menopause? – At any time, in the absence of intense bleeding. This option is also possible in emergency cases for urgent indications, the main thing is that hysteroscopy is performed not during menstruation.

Progress of the procedure

How is hysteroscopy performed? Before starting the procedure, the woman’s thighs and genitals are treated with an alcohol solution. A hysteroscope is inserted into the uterine cavity for a panoramic view of the organ. At this point, the doctor injects a small amount of air or fluid into the uterus to straighten the walls of the organ and improve imaging accuracy.

During the examination, the data obtained is displayed on the screen, thanks to which the doctor can assess the features of the position of the uterus, identify deviations from the norm and make the correct diagnosis. The duration of the procedure depends on the purpose of its implementation. Diagnostic manipulation takes on average 20-30 minutes. If hysteroscopy with diagnostic curettage is performed (for example, hysteroscopy of uterine fibroids), then after a thorough examination the doctor removes the pathological formation. The duration of the procedure usually does not exceed 1 hour.

The procedure may seem unpleasant for a woman. If it is carried out for medicinal purposes (for example, removal of polyps and other formations in the uterus), then various painkillers are used: local or general anesthesia.

Sick leave

How many days of sick leave? As a rule, sick leave is not issued, because the procedure is considered a minimally invasive surgical intervention, after which no long recovery is required. The patient is usually sent home on the day of the operation. But some paid clinics, after hysteroscopy of the uterus, performed for therapeutic purposes (with surgery) and the use of anesthesia, can offer sick leave for 3-5 days.

Postoperative period

Consequences

Possible consequences after hysteroscopy:

After the procedure for therapeutic purposes, minor bleeding in the vagina is possible, because blood vessels are injured. They usually last no more than 5 days.
Also, after the operation, pain in the lower abdomen of mild to moderate intensity may appear (may radiate to the lumbar region). They usually last no more than the first 10 days.
After anesthesia, the patient may also be bothered by: general muscle weakness, depressed state, depressed mood. These are the consequences of anesthesia, which may also include chills, fever, and headache.
Possible perforation of the uterus - puncture of the wall of the organ with a surgical instrument.

To reduce the manifestations of discomfort after hysteroscopy of the uterus, it is recommended to follow simple recommendations for the postoperative period.

Any surgical intervention is associated with the risk of infection. Therefore, if a doctor prescribes antibacterial, anti-inflammatory, antimicrobial drugs, then you should follow the recommendations and observe the frequency, dosage and duration of use. This helps reduce the likelihood of an inflammatory process to a minimum.

If you are very concerned about painful sensations, then it is appropriate to take a drug from the NSAID group, for example, Ibuprofen, Tenoxicam, Nimesulide, Diclofenac, etc. The drugs have a combined effect on the body: they reduce inflammation, reduce temperature, and relieve pain.

If the patient has been bothered by elevated body temperature for more than 5 days, acute pain that is not relieved by painkillers, discharge mixed with pus or an unpleasant odor, excessive bleeding and other alarming symptoms, you should immediately go to the hospital.

What should not be done after hysteroscopy of the uterus?

Use tampons. It is better to give preference to sanitary pads.
Have sex. To exclude infection, you should limit sexual activity for the first 2 weeks after surgery.
Take hot water treatments.
Use vaginal suppositories.
Perform intense physical activity.

Pregnancy

When is pregnancy possible after hysteroscopy? Depending on the purpose of the procedure and the established diagnosis, there may be several options regarding the timing of pregnancy:

If the procedure was carried out for diagnostic purposes, then a healthy woman can become pregnant immediately after it.
If the procedure was carried out for therapeutic purposes, then the onset of pregnancy is regulated by the characteristics of the pathological process, the volume of surgical intervention, as well as the recommended recovery time (usually 3-6 months).

The time when you can plan a pregnancy without fear for your health and the health of the child is individual in each case and can only be determined by a doctor, having previously assessed all the risks for the woman and child.

Hysteroscopy of the uterus - what is it and why is it performed? How dangerous is it and what could be the consequences? Information and preparation for this event will help you get rid of worries and prevent complications after hysteroscopy of the uterus.

What is hysteroscopy?

Uterine hysteroscopy is a gynecological procedure in which a probe equipped with LEDs and a small video camera (hysteroscope) is inserted into the uterine cavity. There are diagnostic and surgical hysteroscopy, the differences of which are in the manipulations performed by the doctor.

When diagnosing, the doctor examines the condition of the mucous membrane in order to substantiate or refute the proposed diagnosis. The purpose of surgical manipulation is to scrape out polyps (growths) or other pathological neoplasms.

Indications for diagnostics using a hysteroscope are:

suspicion of endometriosis (proliferation of the mucous membrane);
assumptions about the presence of fibroids (tumors);
suspicion of malignancy;
fragments of the fetal membrane remaining in the cavity (after childbirth);
irregular or excessive menstruation;
vaginal bleeding outside of term;
repeated miscarriages or infertility.

This manipulation is also prescribed to identify pathologies in the structure of the uterus or its appendages.

Surgical hysteroscopy of a polyp involves removal of a growth on the mucous membrane. Also, an operation with curettage of the cavity may be prescribed if there are intrauterine septa, fused walls or thickening of the endometrium (inner layer of uterine tissue). A surgical hysteroscopy is performed to remove fibroids or, if necessary, to remove the intrauterine device.

How is the procedure performed?

Considering that there are two options for the procedure, let's look at the differences between one and the other.

Diagnosis using a hysteroscope

It is carried out in a antenatal clinic or clinic that has a gynecologist’s office. The procedure is performed without general anesthesia and does not require a long postoperative period. The woman sits down in the gynecologist's chair. The doctor opens the neck of the organ and injects a special drug (liquid or gas) into it. This is done so that the organ opens and does not interfere with the necessary manipulations.

After inserting the device, the gynecologist begins a step-by-step examination of all parts of the uterus. The image through the camera is displayed on the monitor in an enlarged form, which allows the doctor to draw correct conclusions about the patient’s condition. In some cases, during the diagnostic process, tissue is collected for laboratory analysis. The session lasts no more than 20 minutes. Due to the fact that it is performed without anesthesia, the woman may experience discomfort or minor pain.

Surgical procedure

Hysteroscopy of the uterus to remove a polyp or for other indications is carried out using a stationary method, in the operating room. The patient's hospitalization can last up to two to three days, and the operation is performed under general anesthesia.

The first step is a thorough examination of the organ with a hysteroscope. Then the doctor removes the pathological tumors. In some cases, the device can be replaced with a more complex instrument (hysteroresectoscope). The session in most cases takes no more than half an hour. In this case, the woman does not experience pain or discomfort due to general anesthesia.

How to prepare for hysteroscopy of the uterus

In order for hysteroscopy with curettage or for diagnostic purposes to take place with minimal negative consequences, it is necessary to prepare for it. It is mandatory to conduct laboratory tests, and those for which a referral is provided by a doctor.

Necessary tests before hysteroscopy of the uterus:

general biochemistry for blood and urine;
vaginal smear;
tests for gonorrhea;
cytology of the uterine cervix;
Ultrasound of organs related to gynecology;
electrocardiogram;
fluorography.

All tests should be carried out two weeks before the scheduled date. In addition, hysteroscopy of the uterine cavity requires a physician’s opinion.

Preparation for hysteroscopy of the uterus involves abstaining from sexual intercourse for three days before the appointed date. During this period, you should not use sanitary tampons or vaginal sprays. For a week you need to stop visiting the sauna or taking too hot baths. It is imperative to refrain from taking any medications that are not approved by your doctor.

The day before the session, the patient needs to reduce the amount of fluid consumed. An hour before the examination, the woman may be given premedication, when she takes sedatives. Temperature and pressure are measured simultaneously.

Women who are interested in how hysteroscopy of the uterus is done and what the consequences may be are advised to prepare themselves mentally. The procedure, especially one performed without anesthesia, is associated with discomfort. Being in tension, the patient will not be able to relax, which will negatively affect the diagnostic results.

A video that describes in detail what kind of event this is and how hysteroscopy is performed will help with moral preparation.

Contraindications and consequences of hysteroscopy of the uterus

This type of diagnosis or surgical intervention is a minimally invasive operation and has a number of contraindications. Examination and treatment are not carried out for inflammatory processes in the organs of the genitourinary system (cystitis, urethritis, vaginitis).

Acute infections and heavy uterine bleeding are also contraindications. The procedure is not prescribed for heart or kidney failure, impaired blood clotting, or a history of severe heart attack. Cancerous formation in the last stage on the neck of the organ is also an obstacle to this manipulation. Hysteroscopy is not recommended if the patient has a normally developing pregnancy.

As with any intervention, hysteroscopic examination can provoke some negative consequences. The nature, duration and intensity of these phenomena largely depend on the physiological characteristics of the patient. To prevent complications, the doctor may prescribe antibacterial drugs after the session.

The consequences of hysteroscopy are:

Bloody discharge.
Vaginal bleeding after manipulation with a hysteroscope is normal, as injured blood vessels bleed. After the diagnostic procedure, they are minor and last no more than two days. If surgery has been performed, blood may be released for up to 5 days, sometimes giving way to yellow or bloody discharge.