Hysteroscopy Of The Uterus (polyp Removal): Preparation, Postoperative Period

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Hysteroscopy of the uterus to remove the polyp: indications, preparation, complications

The content of the article:

Preparation for hysteroscopy
1. Required examinations
2. General recommendations
Methodology
1. What is a hysteroscope
2. How is the removal of polyps
3. Methods for removing polyps
4. How long does the procedure take
Postoperative period after hysteroscopy of the uterus (polyp removal)
Complications
Indications for hysteroscopy
Contraindications
Video

Hysteroscopy of the uterus to remove a polyp is a modern minimally invasive examination method that allows you to diagnose a neoplasm and get rid of it. As a result of the manipulation, healthy tissues are practically not damaged, which reduces the risk of complications.

Hysteroscopy detects and removes uterine polyps

Polyps are benign neoplasms that appear on the inner lining of the uterine cavity or inside the cervical canal. In appearance, they resemble a mushroom on a leg. They are especially often diagnosed in women after 40 years.

Preparation for hysteroscopy

Required examinations

Before carrying out hysteroresectoscopy of polyps, the patient must pass the following tests:

general blood analysis;
general urine analysis;
blood chemistry;
coagulogram (determination of blood coagulation);
blood glucose test;
examination of a gynecological smear.

The purpose of the preliminary examination is to detect contraindications to hysteroresectoscopy

The doctor preliminarily conducts a gynecological examination using a mirror and, if necessary, colposcopy. Transvaginal ultrasound is also commonly prescribed.

If the examination of vaginal smears reveals the III or IV degree of its purity, then before the manipulation, sanitation is required (treatment with antiseptic agents).

General recommendations

Removal of polyps is usually performed during the early follicular phase on the 3rd-7th day after the end of menstruation (6-11th day of the cycle). During this period, the endometrium is thin and even the smallest neoplasms can be seen. In the secretory phase of the menstrual cycle, the procedure is not carried out, since the examination is less informative, and the risk of complications is increased.

In the evening on the eve of the operation, a light dinner is recommended for the woman. On the day of the procedure, you must refuse to eat and limit fluid intake. Two days before hysteroscopy, a woman should exclude sexual intercourse. In case of persistent constipation the evening before the procedure, you need to cleanse the intestines.

The patient needs to carry out hygiene procedures (shave hair in the groin area). Immediately before carrying out the manipulation, she must empty the bladder.

Methodology

What is a hysteroscope

The procedure is carried out using special equipment - a hysteroscope.

For the procedure, special equipment is used - a hysteroscope

It is an optical system consisting of the following parts:

metal case;
telescope;
taps for the inlet and outlet of liquid or gas;
channel for instruments;
camcorder;
instruments (probes, forceps, endoscopic catheters, scissors, electrical and laser guides).

Depending on the purpose for which the device is used, hysteroscopes are either operating or diagnostic. They differ in size and equipment.

How is the removal of polyps

Based on the course of the disease and the patient's health, the procedure can be performed under intravenous or mask anesthesia. In some cases, intracervical anesthesia is used (the area around the cervix is treated with anesthetics).

The patient is placed in a gynecological chair. The genitals are treated with an antiseptic solution. One-tooth uterine forceps fix the lower segment of the uterus, pulling her body and aligning the position of the cervical canal.

The cervical canal is bouled with the Gegar's dilator. An antiseptic-treated hysteroscope is inserted into the uterine cavity enlarged with liquid or gas.

Methods for removing polyps

Cervical polyps, which are detected by hysteroscopy, are immediately removed using a laser, or mechanically or electrosurgically. Before the procedure, the doctor examines the walls of the cervical canal and determines the type of neoplasm, size and location.

The choice of a method for removing a neoplasm is determined by its type, size and localization

Large growths with the help of special tools are unscrewed and removed. At the next stage, the cervical canal is scraped and treated with antiseptics.

To remove the endometrial polyp, its leg is fixed, the instruments are brought to the base of the growth and cut off. If the growth is large, mechanical loosening can be performed. Additionally, the leg is excised with a resectoscope or special scissors.

If the growth is localized in the area of the mouth of the fallopian tubes or the parietal region, it is removed by electrosurgery. After the procedure, the endometrium is cauterized at the location.

How long does the procedure take

The duration of the procedure depends on the number of polyps and their localization and can range from 15 minutes to 1 hour. To monitor the effectiveness of the treatment, repeated hysteroscopy is performed after a while.

Postoperative period after hysteroscopy of the uterus (polyp removal)

The length of the rehabilitation period depends on the anesthesia and the amount of surgery. With single small polyps, the patient can be discharged from the hospital immediately after the operation.

For several weeks after manipulation, a woman may experience a discharge resembling menstruation. Over time, their number decreases and they become more transparent, which is a variant of the norm and does not require treatment. Blood that has accumulated in the uterine cavity can come out in the form of dark clots.

Also, after hysteroscopy, a small amount of scarlet blood may be released, as a result of damage to the blood vessels.

During this entire period, a woman should carefully monitor her health, carry out all medical appointments and adhere to the following recommendations for a month:

observe the rules of personal hygiene, wash twice a day, change linen and pads on time;
stop using tampons;
give up intimacy with a partner;
do not douche;
refuse to visit baths, saunas;
do not swim in open bodies of water or pools;
wash only in the shower, do not take a bath;
observe the daily routine.

Complications

You should immediately consult a gynecologist when the following vaginal discharge appears after surgery:

Type of discharge	Description
Large amount of scarlet blood	Normally, scarlet blood can be released in a small volume no longer than a few days after the procedure. In other cases, in order to avoid the development of bleeding, you should consult a doctor
Brown discharge with black streaks	This could be a sign of incorrectly selected hormone therapy.
Cloudy yellow discharge with a greenish tint and an unpleasant odor	Discharge may indicate an inflammatory process caused by staphylococcus or streptococcus
Viscous mucous discharge with a strong unpleasant odor	They appear during bacterial infection with Clostridium

Other complications of the operation include cervical stenosis, infertility, recurrence of polyps, or the development of malignant neoplasms.

Indications for hysteroscopy

Hysteroscopy is performed in the following cases:

identification and removal of polyps in the cervical and uterine cavity;
bleeding during postmenopause;
violation of the menstrual cycle;
endometriosis;
spontaneous termination of pregnancy in the early stages;
suspicion of the presence of foreign bodies in the uterine cavity;
suspicion of perforation of the walls of the uterus;
complications after childbirth.

Contraindications

Hysteroscopy is not recommended in the following cases:

infectious inflammatory diseases of the genital organs;
exacerbation of chronic inflammatory processes in the pelvic area;
systemic diseases in the acute stage;
malignant neoplasms in the cervical region or in the uterine cavity;
severe uterine bleeding;
menstruation;
diseases in which blood clotting is impaired;
narrowing of the cervix (stenosis).

According to women, hysteroscopy is a fairly effective procedure, but it is not cheap. Depending on the clinic, its price can vary significantly.

In the diagnosis and treatment of polyps, hysteroscopy occupies one of the main positions, since during one procedure it is possible not only to identify a neoplasm, but also to remove it.