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Hysteroscopy

What it is

This is a modern endoscopic method to test the endometrial cavity using a special thin telescope (a camera 2-5 mm in diameter).

In cases of infertility, or repeated miscarriages, hysteroscopy supersedes hysterosalpingography by promptly evaluating the condition of the endometrial cavity and diagnosing endometrial adhesions, septa, fibromyomas or polyps.

When to apply it

It is combined with laparoscopy and it is required in cases of unexplained infertility, failed IVF, and miscarriages.

It is applied in cases, where a thorough investigation of the uterine cavity, the morphology (size and shape), nature, and development of the endometrium and the cervical tube is required.

Hysteroscopy may be performed solely for diagnosis (no intervention), therefore this is a “diagnostic hysteroscopy” of abnormal endometrial conditions (polyps, fibromyomas, adhesion, hyperplasia, septum etc), or concurrently as an "interventional hysteroscopy" to treat abnormal conditions (bicornuate uterus, uterine septum, adhesion section, removing polyps or fibromyomas, metrorrhagia, etc).

Procedure

The hysteroscope is introduced in the endometrial cavity through the vagina and cervix and it is connected with a telescopic tube (2.8-10 mm) at an angle of 0 or 30 degrees.

“Diagnostic hysteroscopy” uses CO2 or normal saline, general anaesthesia is not required, and it may also be performed in an outpatient clinic or under local anaesthesia.

In “Interventional hysteroscopy”, upon introduction, non-electrolyte and non-conductive fluid are concurrently administered through the camera’s pipe to extend uterine walls and have a better view of its interior. Local anaesthesia or mild general anaesthesia, or epidural anaesthesia is applied.

Post-surgery pain may be neglected and it is treated with ordinary painkillers. There are no surgical incisions because the hysteroscope is introduced into the vagina and the cervix.

The patient will remain in the clinic from a short while up to one (1) day as necessary.

Complications (uterine injury, bleeding, excessive fluid, and inflammation) have been seen only at a rate of 1%.

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