Hysteroscopy – removal of polyps of the uterus, postoperative period
Hysteroscopy is a diagnostic examination of the uterus using a special optical instrument (hysteroscope) which is inserted into it through the cervical canal in the cervix. During the procedure, visible growths of the uterine lining, which can be easily removed. For example, when the reins hysteroscopy polyp can be removed immediately upon detection. Surgery to remove the polyps or glandular-cystic polyps perform with the help of a special device – hysteroresectoscope. Therefore, the correct but seldom used name for such surgical treatments – hysteroresectoscopy.
In addition to the suspicion of the presence of polyps in the uterus or the cervical canal of the cervix, hysteroscopy is done in the following cases:
- removal of endometrial polyps;
- excision of tumors, which cause uterine bleeding;
- the removal of cysts or fibroids growing into the cavity;
- excision of pathological adhesions and abnormal partitions.
- the observation of benign tumors with the aim of a quick response in their malignancy;
- assessment of the quality of the performed curettage, abdominal operations on the uterus and the post-control recovery of the endometrium;
- evaluation of hormonal treatment.
In the primary detection of small polyps or polyp of the cervix hysteroresectoscopy not immediately appointed, and after a one month cycle, the repeated diagnostic hysteroscopy. As if the polyps arose from the occasional hormonal failure, restoring the normal balance of hormones they disappear.
Despite the safety and low invasiveness of the technique, hysteroscopic surgery to remove polyps from the uterus or the cervical canal is not carried out in the presence of the following diseases or conditions:
- narrowing (stenosis) of the cervical canal;
- infection and inflammation of the genitourinary system;
- excessive bleeding;
- cervical cancer in the later stages;
- disease of an infectious nature in the acute phase;
- severe diseases of the cardiovascular system, liver or kidneys;
The timing of
On what day of cycle do the hysteroscopy of the uterus? To perform a hysteroscopy when endometrial polyp better in 7-10 days from the onset of menstruation. It was at this time the endometrium will recover faster, which will help to keep the rhythm of menstruation.
Time for hysteroscopic removal of polyps from the cervical canal are the same. But some doctors presume to do such surgery as early as from the 4th day of the cycle. Everything is very individual and depends on the duration of monthly themselves and their abundance.
Preparing for a surgical hysteroscopy
In the appointment of hysteroscopic surgery the doctor should fully inform the patient about the rules of training and the required tests. How remove tumors, the duration of hysteroscopy polyp and the postoperative period (rehabilitation) after it, and what recommendations after the hysteroscopy must be performed to avoid complications.
In order for the operation had been performed, it is necessary to prepare for it as follows:
Collect the tests:
- swab of vagina, confirming the absence of Ureaplasma, Mycoplasma, chlamydia shelf life studies 10-14 days;
- common DAB «U, V, C»;
- results for AIDS, herpes, papillomavirus, hepatitis b virus and With a shelf life of 3 months before the day of the hysteroscopy;
- ultrasonography (us) of the uterus: the length of time prescribed by a doctor;
- the results of the diagnostic hysteroscopic examination;
- General blood and urine tests, blood clotting and glucose level in the time specified by the doctor;
- documents confirming the blood group and RH factor;
- cardiogram done a month before the day of the hysteroscopy and «year» need fluoroscopy for the anesthesiologist.
Prepare yourself for the surgery:
- 3-4 days to completely stop the use of alcohol and to reduce the number of cigarettes smoked;
- to purchase compression stockings that must be worn in the morning, immediately after waking up, the day of the operation;
- 2-3 days to shave the pubes and in the groin;
- the last meal should be a day earlier, in the afternoon, are advised not to eat, only to drink;
- in the evening to put high cleansing enema and to drink 2-3 sleeping pills;
- don’t forget to bring your passport and originals of tests.
On the day of surgery, prior to it is prohibited to drink, eat and chew bubble gum. As an exception, immediately after waking, you can drink not more than 100 ml of drinking water without gas, but this will have to warn the anesthesiologist.
The operation and its possible variations
Hysteroscopy takes place in the gynecological chair. The type of anesthesia that will be applied during a hysteroscopy based on the estimated duration of operative intervention. When you remove a single polyp of small size, perhaps a local anesthesia, and if a large single tumor, or a large number of small polyps will be performed General anesthesia.
The choice of the variety of technology surgical hysteroscopy that will be used to remove the polyp(s) depends on the equipment of clinics and is in the competence of the gynecologist performing surgery. It can be:
- polypectomy a polyp (up to 3 cm) gets out of conchotomy, and his bed prizhivaetsya;
- coagulation laser leg polyps of any size prizhivaetsya laser, with coagulation of blood vessels minimizes excessive bleeding;
- cryosurgery – the freezing of numerous small polyps with the help of liquid nitrogen allows you to leave scars on the endometrium;
- Vit scarring of the endometrium;
- deuteroacetone– moxibustion polyposes legs electric current;
- coagulation by radio – frequency heating of the feet of a polyp, by which it is destroyed.
After the removal of polyp is performed curettage of the endometrium and cervical canal, but if you cut a single small polyp, it is a complete cleansing of the mucous membranes, as a rule, do not. After a polyp of the cervix or endometrium are removed, and the mucosal scrapings sent for histological examination and results will be ready within 10 days.
Pregnancy after hysteroscopy polyp of the endometrium is possible in 3-6 months after surgery, but only in cases where there were no complications and no other causes of infertility. To plan the pregnancy only after the permission of the gynecologist.
In most cases, the discharge takes place within 4-6 hours after the hysteroscopy. In the first week, in order to avoid negative consequences of hysteroscopy, it will be necessary to take antibiotics, pain reliever and anti-inflammatory drugs which impose a ban on alcohol. In General, however, rehabilitation takes 25-30 days.
In order to avoid the negative consequences of the removal of endometrial polyp by hysteroscopy during the rehabilitation period you should observe the following rules:
- Do not raise weights, and physical activity to build gradually.
- To avoid taking baths, swimming pool, sauna, Solarium.
- If you experience bleeding that is normal within 7-10 days after hysteroscopy, not to use hygiene gynecological tampons, only pads.
- To start sexual life only after permission of the attending physician.
You should immediately contact the physician if there is:
- excessive bleeding from the vagina;
- rose or more days, a fever;
- acute pain in abdomen;
- during urination there are cramps and/or blood in the urine;
- pursues vomiting and nausea.
You need to remember that no matter how good were the modern methods of removal of nasal polyps, 10% of women these benign tumors grow back. Thus they should be also removed, as to prevent their subsequent appearance, the doctor will apply a different tactic and scheme of postoperative hormonal treatment.
In any case, if you have the hysteroscopy of the uterus or treatment of an endometrial polyp – removal of polyp or uterine polyp of the cervical canal with the help of this procedure, do not be afraid. Despite the relatively high price, removal of a polyp in the uterus hysteroscopy for part of the patients is the only effective way of infertility treatment. And it is this procedure done many desperate women happy moms.