Hysteroscopy - a modern method of accurate diagnosis and treatment of the uterine cavity

Prolonged menstruation, irregular bleeding, pain in the lower abdomen and infertility can be associated with various gynecological pathologies. Although such complaints are common, their cause is not always hormonal changes. In some cases, these symptoms are hidden by a pathology in the uterine cavity, such as a polyp or submucosal myoma.

There are cases when a woman has no complaints, but the pregnancy does not occur or ends early. In such cases, one of the important stages is a detailed assessment of the uterine cavity, as changes there may hinder the normal development of the pregnancy.

Hysteroscopy is one of the most accurate methods of assessing the uterine cavity in modern gynecology. The procedure allows for direct visualization of the uterine cavity, detection of pathological changes, and, if necessary, treatment within the same procedure.

What is hysteroscopy?

Hysteroscopy is a modern, minimally invasive endoscopic procedure in which a special thin optical system, a hysteroscope, is inserted into the uterine cavity. Using the camera, the doctor can assess in detail the inner surface of the uterus, the endometrium, and any changes in the uterine cavity.

The procedure is performed without any incisions, as the hysteroscope is inserted through the cervical canal. This reduces tissue trauma and makes the procedure more comfortable for the patient.

Hysteroscopy is used for both diagnostic and therapeutic purposes. This is one of its main advantages - often an additional operation is not required between diagnosis and treatment. If polyps, submucosal myomas, or other intrauterine pathologies are detected, they are removed during the same procedure.

When is hysteroscopy recommended?

The need for hysteroscopy is determined by the gynecologist based on the patient's complaints and research results.

Hysteroscopy is recommended in the following cases:

• Prolonged, excessive or irregular bleeding during the menstrual cycle;
• To determine the cause of bleeding during menopause;
• In case of suspicion of the presence of a polyp, submucosal myoma, or other formation in the uterine cavity;
• For a detailed assessment of changes in the endometrium (inner lining of the uterus);
• To clarify suspicious changes detected by ultrasound examination;
• When investigating the causes of infertility, when an assessment of the uterine cavity is required;
• To determine the causes of repeated spontaneous abortions;
• For the diagnosis of uterine cavity pathologies and, if necessary, their treatment.

Although ultrasound is an important diagnostic method, hysteroscopy provides an additional opportunity to determine the nature of changes in the uterine cavity through direct visual assessment.

What diseases can hysteroscopy detect?

During hysteroscopy, the doctor directly sees the uterine cavity, which significantly increases the accuracy of diagnosis.

The procedure can reveal:

• Endometrial polyps;
• Submucosal myoma;
• Intrauterine synechiae (adhesions);
• Uterine septum and other congenital anatomical features;
• Endometrial hyperplasia (thickening);
• Other pathological changes of the endometrium.

If necessary, a biopsy can be taken, which allows for laboratory examination of the tissue and helps us determine the diagnosis more accurately.

Uterine diagnosis and treatment in one procedure

One of the important advantages of hysteroscopy is that in many cases, diagnosis and treatment can be performed in a single procedure.

If a polyp, small submucosal fibroid, or other intrauterine pathology is detected during the procedure, it is often possible to remove them during the same procedure.

Such an approach often eliminates the need for an additional procedure, reduces the need for repeated anesthesia, and makes the treatment process simpler.

Hysteroscopy in the diagnosis of infertility

The assessment of the cause of infertility is not limited to hormonal studies or ultrasound examinations. One of the important prerequisites for a successful pregnancy is a healthy uterine cavity, which facilitates the implantation and development of the embryo.

Polyps, submucosal fibroids, adhesions, or anatomical features of the uterine cavity may prevent embryo implantation, even if a woman has no other complaints at all.

Hysteroscopy is particularly beneficial in such cases, as it allows the doctor to directly assess the uterine cavity and detect changes that are not always visible with other examinations.

When evaluating infertility, hysteroscopy additionally allows us to examine the uterine lumens of the fallopian tubes. During the procedure, when the uterine cavity is expanded with a special fluid, in some cases it is possible to visualize their natural opening and closing, which provides additional information about the functional activity of the tubes.

How is hysteroscopy performed?

The procedure is usually performed under short-term intravenous anesthesia.

The hysteroscope is inserted into the uterine cavity through the cervix, and the cavity is carefully dilated with a special sterile fluid for better visualization. The image obtained on the monitor allows the doctor to assess all areas of the uterine cavity in detail.

If necessary, special micro-instruments are used to remove polyps, submucosal myomas, or other small pathological formations.

The procedure lasts an average of 15-20 minutes, although the duration of the procedure may vary depending on the specific case.

Recovery period

After the hysteroscopy is completed, the patient quickly recovers from anesthesia and is monitored for several hours.

In most cases, the patient is discharged from the clinic on the same day. During the first few days, there may be mild discomfort or slight bleeding, which is usually normal and will subside within a few days.

It is essential to follow the recommendations regarding hygiene, physical activity, and routine check-ups that your doctor gives you. Following the recommendations will help ensure a quick and safe recovery.

Advantages of hysteroscopy

Hysteroscopy is widely used in modern gynecology because it has several important advantages:

• Assesses the uterine cavity with high accuracy;
• It is performed without any surgical incision;
• It is a minimally invasive method;
• In many cases, it allows for simultaneous diagnosis and treatment;
• Reduces the need for repeat surgery;
• It is characterized by rapid rehabilitation;
• In most cases, the patient is discharged from the clinic on the same day;
• Helps in timely detection and treatment of intrauterine pathologies.

In properly selected clinical cases, hysteroscopy allows the patient to receive fast, accurate, and effective medical care.

When is hysteroscopy not recommended?

Although hysteroscopy is considered a safe procedure, it is not recommended in all cases. The procedure is usually not performed during pregnancy, acute pelvic inflammatory disease, active genital infection, or other conditions that make it unsafe to perform the procedure.

It may also be temporarily postponed in cases of severe uterine bleeding, when a full assessment of the uterine cavity is not possible. In each case, the decision to perform the procedure is made by the gynecologist based on the assessment of the patient's condition and clinical indications.

What complications can occur with hysteroscopy?

Complications after hysteroscopy are rare. However, as with any medical procedure, there are some risks associated with the procedure. These include:

• Infection;
• Bleeding;
• Damage to the uterine wall (perforation);
• Complications related to anesthesia.

During therapeutic hysteroscopy, when polyps, fibroids, or other growths are removed, the risk of complications may be slightly higher than in the case of a purely diagnostic procedure. However, assessment of the patient's health status and appropriate preparation before the procedure significantly reduce these risks.

In case of severe pain, heavy bleeding, high fever, or foul-smelling discharge after the procedure, the patient should immediately consult their doctor.

Conclusion

When assessing a woman's reproductive health, a correct diagnosis is one of the main foundations for successful treatment. When a detailed assessment of the uterine cavity is required or existing changes need to be clarified, hysteroscopy allows the doctor to make decisions based on accurate visual information. Timely diagnosis helps to detect problems in the uterine cavity early and prevent possible complications.