Hysteroscopy is the application of a dilating medium to dilate the uterine cavity and direct visualization of physiological and pathological changes in the cervical canal, endocervix, endometrium and fallopian tube opening through a light-guided glass fiber speculum inserted into the uterine cavity to allow visual and accurate sampling of diseased tissues and sending them for pathological examination; it can also be performed directly under the hysteroscope for surgical treatment.
Indications for hysteroscopy
1, abnormal uterine bleeding.
2, suspected uterine adhesions and malformations.
3, abnormal uterine echogenicity and occupying lesions on ultrasonography.
4.Localization of birth control device.
5, unexplained infertility.
6, abnormal hysterosalpingogram.
7, recurrent miscarriage.
Indications for hysteroscopic treatment
1, endometrial polyps.
2, submucosal fibroids of the uterus and intermyometrial fibroids that partially protrude into the uterine cavity.
3, separation of uterine cavity adhesions.
4, endometrial resection.
5.Septal resection of the uterus.
6, removal of foreign bodies in the uterine cavity, such as embedded birth control devices and abortion residues.
7.Hysteroscopy-guided tubal intubation, drug injection and sterilization.
Contraindications to hysteroscopy
Absolute contraindications.
1, acute and subacute reproductive tract infections.
2, acute stages of heart, liver and kidney failure and others who cannot tolerate the procedure.
3, recent history (within 3 months) of uterine perforation or history of uterine surgery.
Relative contraindications.
1, cervical scarring, who cannot be adequately dilated
2, cervical laceration or relaxation, with large leakage of irrigation fluid.
Pre-operative preparation and anesthesia
1.Examination time One week after menstruation is appropriate, when the endometrium is in the early stage of hyperplasia, thin and not easy to bleed, with little mucus secretion and easy to see lesions in the uterine cavity.
2, physical examination and vaginal preparation Careful history taking, general examination, gynecological examination, cervical exfoliation cytology and vaginal secretion examination.
3.Fasting before surgery Fasting for 6-8 hours before surgery.
4.No anesthesia is needed for hysteroscopy or local anesthesia for the cervix; epidural anesthesia or intravenous anesthesia is mostly used for hysteroscopy.
Complications
Mainly include uterine perforation, urinary tract and intestinal tract injury, bleeding, hyperhydrosis syndrome, pelvic infection, cardio-cerebral syndrome and postoperative uterine adhesions.