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Surgical hysteroscopy is an endoscopic surgical procedure that allows you to remove polyps, fibroids or intrauterine adhesions from the inside of the uterus in a minimally invasive way. Preparation, course and complications after operative hysteroscopy.

Surgical hysteroscopyis performed in the treatment of abnormalities detected during diagnostic hysteroscopy. The procedure can be performed immediately after the diagnostic hysteroscopy or at a different time if any additional tests or preparation of the patient are necessary. Surgical hysteroscopy, like all intrauterine surgeries, is performed in an antibiotic shield, and anticoagulant prophylaxis and sometimes also anti-growth prophylaxis are also used.

When is operative hysteroscopy used?

Surgical histoscopy is used for:

  • removal of endometrial polyps
  • removal of submucosal fibroids
  • treatment of heavy periods or uterine bleeding using endometrial destruction methods
  • treatment of benign mucosal hyperplasia with the technique of endometrial resection
  • removal of intrauterine adhesions
  • removal of the uterine septum and other rare uterine defects (T-shaped uterus)

Surgical hysteroscopy: preparation for the procedure

Before surgery hysteroscopy, hormone treatment is usually used for 2 to 4 weeks to reduce the thickness of the uterine walls and / or to reduce the volume of the myoma. In addition, a cytological examination and vaginal cleanliness test are performed before the procedure - afterwards, the doctor may recommend using vaginal globules for several days before the procedure in order to reduce bacteriological contamination of the vagina. Operative hysteroscopy is performed at the beginning of the cycle, but after the menstrual bleeding has stopped. 6 hours before the procedure, you must not eat, drink, chew gum or take any medications.

Surgical hysteroscopy: course

Surgical hysteroscopy is performed under general anesthesia. The patient is put in a cannula through which the agents necessary during the procedure will be administered. The hysteroscope used during surgery has a larger diameter than the one used in diagnostic hysteroscopy. He isequipped with a channel through which the doctor introduces the microtools. A resectoscope is used to remove polyps, fibroids, adhesions or septum. Usually, you can leave the hospital within 3 hours after the procedure, although in justified cases this time may be extended to 24 hours.

Surgical hysteroscopy: complications

Surgical hysteroscopy, like any other method, carries the risk of complications, although in its case they are really rare. The risk of complications increases in the case of the removal of large fibroids penetrating deep into the uterine muscle, as well as congenital uterine defects or deformities after previous surgeries and procedures. These may be bleeding, infections, or rupture of the uterus, requiring laparoscopic intervention or even opening of the abdominal wall.

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