Hysteroscopy of the uterus. Indications, contraindications, methods. How to prepare for hysteroscopy and what to do after it? Hysteroscopy diagnostic office Office hysteroscopy consequences

Office hysteroscopy is a diagnostic method by which specialists identify various intrauterine pathologies. As practice shows, when using it, more than 50% of patients have pathologies that could not be detected by other methods.

This procedure got its name due to the fact that it is carried out not in a hospital, but in a gynecological office. This is its significant difference from the so-called. classical hysteroscopy, which is an operation performed for medicinal purposes. Another name for office hysteroscopy is diagnostic.

Specialists of the center "For Birth" have extensive experience in carrying out this procedure. Contact us and we will carry out the research at a high professional level.

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When is the procedure performed?

This method is often used when it is necessary to identify the cause of infertility or miscarriage, determine the location of the pathological focus, control hormonal treatment. Office hysteroscopy is performed to confirm or refute suspicions of various pathologies of the uterus: polyps, fibroids, adhesions, etc. Painful or heavy menstruation can also be a reason for such a study.

Currently, this method is often used in the examination of women preparing for the IVF procedure. It allows a specialist to assess the state of the uterine cavity and identify the processes occurring in it.

Office hysteroscopy price

Gynecology

Contraindications

There are a number of contraindications, about which the specialists of the center "For the Birth" necessarily warn the patients. This is first of all:

• inflammatory processes of the pelvic organs;
• infectious diseases, both acute and chronic in the acute stage - for example, influenza or pyelonephritis;
• pregnancy;
• uterine bleeding, the etiology of which is unclear;
• severe diseases of the cardiovascular system, kidneys, liver;
• disorders of the vaginal flora.

Preparation for office hysteroscopy

Before the procedure, you need to undergo an examination, which includes:

• various blood tests, including HIV, hepatitis B and C;
• Analysis of urine;
• chest x-ray;
• a smear to determine the degree of purity of the vagina;
• cytological examination from the surface of the cervix and cervical canal;
• ultrasound examination (ultrasound) of the pelvic organs;
• electrocardiography.

Analyzes can be done in the center "For the Birth". We have a laboratory at our disposal, which allows us to quickly obtain research results. Please note: You must not eat or drink for at least 6 hours before an office hysteroscopy.

Features of the procedure

In most cases, diagnosis is carried out on the 6-10th day of the menstrual cycle.

Office hysteroscopy is performed:

• without anesthesia;
• under local anesthesia;
• under full anesthesia.

The specific option is selected in accordance with the expected scope of intervention and the individual characteristics of the patient. But, as a rule, the doctor does not use anesthesia, since the procedure is not accompanied by significant discomfort.

The diagnosis itself takes 20-30 minutes and consists in the fact that the specialist inserts a small hysteroscope into the uterine cavity through the vagina. The image is transferred to the screen, and the doctor not only sees what he needs to see, but can also demonstrate the research process to the patient, accompanying it with the necessary explanations.

After office hysteroscopy, you must strictly follow the instructions of the doctor. Usually they consist in the fact that for several days it is necessary to refrain from sexual intercourse, not to use tampons.

Specialists of the Center for the Birth conduct office hysteroscopy quickly and accurately. This highly informative diagnostic method provides an opportunity to obtain important information about your state of health.

Patient reviews

We turned to your clinic after a long-term treatment for infertility. It was a huge shock for my husband to find out that it was in him that the reason that I could not get pregnant. But the doctors of your center performed a miracle! They returned her husband's faith in himself, and through the ixi procedure, conception nevertheless occurred. Thank you from the bottom of our hearts for our newborn son!

I want to express my deep gratitude to Irina Gennadievna Torganova. If it weren't for her, she probably wouldn't have gone through with it. I just trusted the doctor, and she told me what to do and how to do it. Sometimes it even seemed that you were left with no choice. But it is not. Irina Gennadievna simply did not give either time or reason for doubt. IVF was done in September 2016. Despite the fact that at that time I was already 40 years old, and the man was 56, everything worked out on the first try and in a fresh protocol. The pregnancy was very easy. Already my Treasure has grown up (we are 1 year and 7 months old) and weighs 17.5 kg and 89 cm. We will grow up a little more and will definitely come to thank all the clinic staff. Thanks to all the staff of the clinic and good luck to those who are now on the way to their happiness or are still doubting whether to carry out the procedure.

We want to express our deep gratitude to the entire staff of the clinic For birth. After an unsuccessful IVF attempt at another clinic, we decided to go to this clinic for compulsory medical insurance. Unfortunately the first attempt was unsuccessful. But we did not give up, we still had cryoshes. Thanks to Irina Gennadievna Torganova, the cryo protocol went well. In March 2018, we had a wonderful son and daughter. You are doing a miracle! And give happiness to be parents! God bless you!!!

You know, I can say with confidence that first-class specialists work in the Origin, who appreciate and love their work and take care of their patients. I happened to get acquainted with this clinic in 2017. Before, I could not even think that something like this was possible. I am not a small girl, I turned 30, I heard about eco, but I didn’t go into details. But 30 years crept up unnoticed, and my husband and I have been living for 5 years. We were overtaken by a conversation about children. After talking, we realized that both are ready for procreation. Apparently, at that time, fate laughed very loudly, because in the hospital they told me something like “hey, no, honey, you won’t be able to have children anymore.” I am a positive person by nature and not an alarmist at all. Therefore, having considered this phrase sensibly, I went directly to the Origin, it so happened that it turned out to be the closest one at that time, and I just needed a paid clinic. It was there that they told me everything in detail about the eco procedure, about additions and varieties. The next day I dragged my husband there. He listened and agreed. Our doctor: Mazur Sergey Ivanovich. Very cool, given to work to the maximum. I am so glad that after all the torment we found a way out and now we are waiting for the birth of our baby.

Origin in Moscow is the best clinic that came across on my way. To begin with, in the struggle for the opportunity to have children, I was far from one medical center and far from one clinic. She went through all possible and impossible procedures and studies. I was also treated with traditional medicine, in Russia and abroad, I even went to holy places and kissed the relics. The effect is zero. At first, my ex-husband actively supported me in everything, and then he left and went to a colleague who was pregnant from him. I decided not to give up and keep trying. Finally, the turn came to IVF. The first attempt in one very famous center in Moscow was a flight. The second attempt in the same place - span. The third attempt, on the advice of a friend in Ivanovo, was a success, and the fourth in Origin was a success. Finally, I sighed calmly, I will have children!

I tried to get pregnant for five years. In all respects, my husband and I were absolutely healthy. As a result, she was diagnosed with idiopathic infertility. The doctors of your center decided to carry out eco + ixi procedures. My husband and I were carefully prepared and everything went at the highest level. I got pregnant with twins and now we are happy parents. Low bow to you!

Modern gynecology uses a lot of ways to study the female body. During the course of life, every representative of the weaker sex has to undergo manipulations such as ultrasound examination and Deeper diagnostics can be carried out using operations such as office hysteroscopy, laparoscopy, hysterosalpingography, and so on. In today's article we will talk about one of them. You will learn what an office hysteroscopy is and how it is performed. It is worth mentioning the indications for the study and cases when it should be abandoned.

What is office hysteroscopy of the uterus?

This is a study of the genital organ, which is performed in the doctor's office. Manipulation does not require prior anesthesia. However, testing is required.

Office hysteroscopy involves the use of a thin hysteroscope tube. The introduction of such a device is painless, it does not require the expansion of the cervical canal. Manipulation is very rarely performed in Russian clinics. Abroad, this diagnosis is more common.

Indications for the procedure

Office hysteroscopy involves the study of the inner mucous layer of the uterus. Many women mistakenly believe that they have no indications for this manipulation. But every third representative of the weaker sex needs this intervention.

Office hysteroscopy differs from conventional diagnostic hysteroscopy in that it cannot turn into a medical one. In the gynecologist's office, there are not always devices and preparations for such manipulations. Despite this, the operation is considered necessary and useful. Indications for carrying out will be the following situations:

• incomprehensible breakthrough bleeding from the genital tract;
• frequent pain in the lower abdomen;
• menstrual irregularities;
• preparation for in vitro fertilization or cases of its failure;
• infertility;
• control after abortion, cancer treatment, inflammatory processes;
• neoplasms (polyps, fibroids, cysts) and so on.

Limitations: what every patient needs to know

Not all women can carry out this manipulation. There are a number of contraindications. Before the appointment of the study, the doctor must exclude them. Ignoring these leads to unpleasant consequences. So, it is forbidden to carry out office hysteroscopy in the following cases:

• inflammation of the genital organs (adnexitis, metritis, salpingitis);
• diseases of the vagina (vaginosis, colpitis, candidiasis);
• acute viral and bacterial pathologies (influenza, SARS);
• fever of unknown origin;
• 3 and 4 degree of purity of the vagina;
• severe diseases of the liver, kidneys and cardiovascular system;
• uterine bleeding of unknown origin;
• pregnancy.

Diagnostic and therapeutic hysteroscopy, which involves dilation, is not performed for cervical cancer and stenosis. However, office research is acceptable in these situations. You just need to properly prepare for it.

Preparation for the study: analyzes

What preparation does the office provide is filled with many private clinics, in which the study involves only half an hour of preparation. If you contact them, then experienced doctors will quickly take the necessary tests and after a short time you can already start the study (if you get good results). If you apply to government agencies, it will take about 2-3 days to prepare. It includes the following studies:

• blood test for Rh, clotting and infections;
• a smear to determine the flora and purity of the vagina;
• ultrasound examination of the uterus;
• gynecological examination and interview of the patient.

Please note that in private clinics in Moscow and other cities you will have to pay for the examination and the actual office hysteroscopy, while contacting public institutions does not involve any fees (except for the absence of documents from the patient).

How is diagnostic manipulation performed?

Office hysteroscopy of a polyp and other pathological conditions is performed in the doctor's office, you already know about this. The patient is located on as for a standard examination. With the help of mirrors, the doctor expands the vaults of the vagina and disinfects the cervix.

Next, a thin tube of the hysteroscope is inserted. Preferably, this is controlled by ultrasound. But not all clinics practice this. Using the image displayed on the screen, the gynecologist examines the uterine cavity and, if necessary, notes its defects. After that, the tube is removed, and the woman can return to her business. The study continues for no more than 10 minutes.

Consequences of the procedure

After an office hysteroscopy, the patient can go home. There is no need to stay within the walls of a medical institution. However, if you feel unwell, it is better to stay under the supervision of doctors.

On the day of the manipulation, there may be pulling pains in the abdomen and slight spotting. This is not a pathology. Most likely, the doctor will prescribe you antispasmodics, which will help to cope with discomfort. After the study, it is recommended to refrain from sexual intercourse for several days. It is also worth taking antimicrobial formulations prescribed by the doctor to prevent the infectious process.

Negative consequences of office hysteroscopy are very rare. But they do exist. the walls of the uterus, inflammation, bleeding, scarring of the cervix in case of damage, and so on.

Office hysteroscopy: reviews

There is an erroneous opinion that this manipulation is very painful and is performed only under anesthesia. In fact, everything is far from it. Doctors say that office hysteroscopy does not involve the expansion of the cervical canal. This means that the woman will not feel pain. Patients who were examined in the study claim that they felt slight discomfort in the lower abdomen. Unpleasant feelings persisted for several hours after the diagnosis. Therefore, it would be right to postpone all the things planned for this day and stay at home.

Office hysteroscopy allows you to accurately diagnose without hospitalization and the use of anesthetics. Most often, the study is carried out about infertility or unsuccessful in vitro fertilization. Modern devices, equipped with the latest image screens, show a clear and precise picture of what is happening inside the uterus. Therefore, in the formulation of the correct diagnosis after such a study, there is no doubt.

There are a few negative opinions about this study. Women say that after the manipulation they developed severe abdominal pain, unpleasant discharge with a strange smell began. All this speaks of infection. Therefore, it is so important to follow all the rules of preparation for the study and take the necessary tests.

Summarize

From the presented article, you learned what office hysteroscopy is. Removal of a polyp found during diagnosis is usually scheduled after a few days. For this, a woman is hospitalized in the gynecology department and stays there from several hours to three days. Treatment of detected formations in the gynecologist's office through office hysteroscopy is not practiced. Perhaps in the near future such therapy will be carried out immediately (during office hysteroscopy). If you are assigned such a study, then do not worry and follow all the doctor's recommendations. Good results to you!

In the practice of office hysteroscopy, two schools have emerged: some doctors prefer to use flexible hysteroscopes, other doctors prefer rigid ones. Consider the pros and cons of each type:

1. Rigid office hysteroscope- the most common and frequently used type of hysteroscope. This design has the best resolution, contrast and clarity both on the periphery and in the center of the field.

2. Do flexible office hysteroscope (hysterofiberscope) the inserted working part is flexible and adapts to the uterine cavity.
The disadvantage of a flexible hysteroscope is the principle of image transmission - through the fiber-optic bundles of the endoscope. And the number of tourniquets is limited by the small diameter of the hysteroscope. As a result, the image on the monitor screen has a grid structure.
Both flexible and rigid office hysteroscopes solve their main task and the choice remains only for the doctor.

Office hysteroscopy - surgery without anesthesia

Many specialists are still afraid to perform hysteroscopy with an office hysteroscope without anesthesia.
However, the safety of this procedure has been fully proven:

In 2000, the Italian S. Betocchi and colleagues, using the experience of 501 office hysteroscopy operations, concluded that it is possible to use office hysteroscopes with 5 Fr. instrument in an outpatient setting.

4 years later, in 2004, having already performed 4863 outpatient hysteroscopy procedures by that time, S. Betocchi et al concluded that office hysteroscopy is associated with high patient satisfaction with correctly prescribed indications for this procedure.

The use of the hysteropomp in office hysteroscopy

For washing the uterine cavity during the office hysteroscopy procedure, both simple devices and special hardware units - hysteropumps are used.

1. Without using a hysteropomp:

• The solution can be injected with Janet's syringe.
• Liquid injection can be created by placing a bag or jar of physical. solution to a height of 1 m (74 mm Hg) or 1.5 m (110 mm Hg) above the patient.
• Attaching a rubber bulb or pressure cuff to a container with liquid. This creates sufficient pressure inside the uterus, and excess fluid flows through the dilated cervical canal.

These methods allow you to create a good view inside the uterus, but intrauterine pressure cannot be controlled, which can lead to complications.

2. To avoid serious complications today it is preferable to use a hysteropomp- a special device that:

• automatically delivers the solution into the uterine cavity;
• controls intrauterine pressure;
• controls the speed of the supplied liquid;
• with the help of scales controls the volume of liquid flowing out.
• creates optimal visibility inside the uterus.

Hysteroscopy- this is an examination of the walls of the uterine cavity with the help of an optical device - a hysteroscope.

Today, hysteroscopy is one of the main methods for diagnosing and treating pathology of the uterine cavity.

Hysteroscope It is a thin tube equipped with a video camera, the image from which is displayed on a monitor with multiple magnification (8-20 times). The hysteroscope is also equipped with a light source and a fluid supply system. The light source is necessary to ensure good visualization of the uterine cavity, and the supply of fluid is necessary to expand the uterine cavity in order to carefully examine all its departments. The liquid medium is usually 0.9% NaCl solution (physiological solution), during intrauterine electrosurgical operations, the liquid medium is 5% glucose solution, in patients with diabetes mellitus who cannot be administered glucose, a solution of rheopolyglucin is used.

Hysteroscopy is divided into:

Diagnostic- only inspection - diagnostics is carried out.

Operational- an examination (diagnosis) and therapeutic manipulations are carried out (biopsy taking, removal of polyps, removal of the IUD, dissection of the intrauterine septa, removal of submucosal fibromatous nodes).

The operating hysteroscope is additionally equipped with a working channel through which special thin instruments are inserted - biopsy forceps, clamps, scissors, loops, etc.

Diagnostic and operative hysteroscopy is carried out in the position of a woman on a gynecological chair, under intravenous anesthesia. The duration of the manipulation is about 10-20 minutes.

The venue is a specially equipped operating room or manipulation room.

Through the vagina and cervix, after its preliminary expansion, a hysteroscope is inserted into the uterine cavity, the uterine cavity is carefully examined, a biopsy of the mucosa is taken from the cervical canal and uterine cavity, and the identified pathology is eliminated - removal of polyps, removal of the IUD, removal of remnants of placental tissue after childbirth, curettage of the mucosa cervical canal and uterine cavity, etc.

Office hysteroscopy

The essence of this method lies in its name. This is a hysteroscopy, which is carried out directly in the doctor's office.

The office hysteroscope has a very small optical tube diameter: 2.5-3.0 mm, moreover, the optical tube of the office hysteroscope is flexible.

Since the office hysteroscope has such a small diameter of 2.5-3.0 mm, office hysteroscopy does not require dilation of the cervical canal, which is always painful for patients, and does not require intravenous anesthesia.

Indications for hysteroscopy

1. Menstrual irregularities in different periods of a woman's life

2. Bloody discharge from the genital tract in menopause

3. Suspicion of the following diseases:

4. Clarification of the location in the uterine cavity of the intrauterine device or its fragments

5. Infertility

6. Miscarriage (spontaneous miscarriages, non-developing pregnancies)

7. Control examination of the uterine cavity after operations on the uterus

8. Complicated course of the postpartum period (bleeding after childbirth, remnants of placental tissue after childbirth, placental polyps)

9. Evaluation of the effectiveness of ongoing hormonal therapy

Cost of a doctor's appointment?

Contraindications for hysteroscopy

1. Infectious diseases (tonsillitis, influenza, SARS, pyelonephritis, pneumonia, etc.)

2. Acute inflammatory diseases of the genital organs

3. III-IY degree of purity of vaginal smears

4. Severe condition in diseases of the cardiovascular system and other organs (liver, kidneys, etc.)

5. Pregnancy

6. Cervical stenosis (sharp narrowing of the cervical canal)

7. Advanced cervical cancer

8. Uterine bleeding is a relative contraindication, because in some situations, to establish the cause of bleeding and choose a way to stop it, hysteroscopy is the main method of diagnosis and treatment

9. Menstruation (relative contraindication)

Pain relief during hysteroscopy

Hysteroscopy itself is painless, so the choice of anesthesia depends on the need to expand the cervical canal and perform manipulations and operations.

Since the cervical canal is not dilated during an office hysteroscopy, anesthesia is not required.

Preparation for hysteroscopy

No special preparation is required for office hysteroscopy. The gynecologist appoints a specific date, a specific day of the menstrual cycle, on which hysteroscopy will be performed.

When planning a hysteroscopy under intravenous anesthesia, patients should completely exclude food and liquids (absolutely all - tea, coffee, water) 5 hours before the appointed time.

Examination before hysteroscopy

Since diagnostic and operative hysteroscopy are invasive medical interventions and are carried out mainly in a planned manner, the correct examination of patients helps to avoid the development of complications.

Standard set of surveys:

According to the indications and prescriptions of the doctor, the scope of examinations can be expanded

Equipment:

Doctor Stolet Clinic uses office hysteroscopes and cystoscopes from the world's leading manufacturers Karl Storz (Germany) and Pentax (Japan).

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Where to undergo hysteroscopy in Moscow?

In the multidisciplinary medical center "DoctorStolet" you can always take hysteroscopy. Our medical center is located between the metro stations "Konkovo" and "Belyaevo" (South-West Administrative District of Moscow in the area of ​​the metro stations "Belyaevo", "Konkovo", Tyoply Stan, "Chertanovo", "Yasenevo", "Sevastopolskaya", "New Cheryomushki" "and" Trade Union "). Here you will find highly qualified staff and the most modern diagnostic equipment. Our customers will be pleasantly surprised by quite affordable prices.