Hysteroscopy under anesthesia
Under intravenous anesthesia for 10–20 minutes, the doctor expands the cervical canal, inserts a hysteroscope, examines the cavity and performs the necessary manipulations: biopsy, removal of polyps, dissection of thin synechiae, separate diagnostic curettage for hyperplasia and bleeding. The patient stays in the ward for several hours (bed-day included) and is discharged on the same day or the next morning. Tests (blood, coagulogram, ECG) and 6 hours of fasting are required. The method of choice in menopausal women with a narrow canal, with a strong fear of pain, when combining diagnosis with treatment.
Indications
- suspicion of endometrial polyp or submucous fibroid by ultrasound;
- abnormal uterine bleeding, endometrial hyperplasia, bleeding during menopause;
- infertility, unsuccessful IVF attempts, recurrent miscarriage - cavity assessment;
- intrauterine synechia (fusion), septum, developmental anomalies;
- remnants of the fertilized egg, control after curettage, search for an IUD;
- control after uterine surgery.
Advantages of the method
Hysteroscopy is the “gold standard” for assessing the uterine cavity: unlike ultrasound, the doctor sees the endometrium directly with magnification, identifies polyps from 1-2 mm, synechiae, foci of chronic endometritis, accurately takes a biopsy from the changed area, and not “blindly”. Thin modern hysteroscopes allow the examination to be performed on an outpatient basis without expansion of the canal and anesthesia (office hysteroscopy) with minimal discomfort. If large polyps, fibroids, or septum are detected, therapeutic hysteroresectoscopy is performed.
