I. Technical advantages of hysteroscopy?
Hysteroscopy is an emerging minimally invasive gynecological treatment technology for endoscopic examination and treatment in the uterine cavity. It can not only determine the location, size, appearance and scope of the lesion, but also make a detailed observation of the tissue structure on the surface of the lesion to understand the causative factors, and at the same time do surgical treatment for the abnormalities without opening the abdomen or even making a hole like laparoscopy, and can preserve the uterus, which is the most advanced examination and treatment method in the world.
The main functions of hysteroscopy for infertility patients
1.It can clearly observe the situation in the uterine cavity of infertile patients, understand whether there are factors in the uterine cavity that cause infertility, and do necessary surgical treatment for abnormal conditions, such as endometrial polyp removal, removal of submucosal fibroids, separation of uterine adhesions, etc. 2.It can do hysteroscopic tubal cannulation to check the patency of the fallopian tubes, and if the fallopian tubes are found to be incompetent or obstructed, it can do unblocking treatment at the same time. The result is very good.
Indications for hysteroscopy
Any form of intrauterine pathology or the need for diagnosis and treatment of intrauterine pathology are indications for intrauterine examination.
1, abnormal uterine bleeding, abnormal bleeding during fertility, perimenopause and postmenopause, excessive menstruation, excessive frequency, prolonged menstruation, irregular bleeding, and uterine bleeding before and after menopause are the main indications for hysteroscopy.
2, abnormal intrauterine cavity sonography, hysteroscopy can confirm and localize intrauterine cavity lesions, and can also locate biopsy for histocytological examination of suspicious areas. For infertility (infertility, habitual abortion), observe the anatomical morphology of the uterine cavity and the opening of the fallopian tubes, the presence of uterine malformations, uterine wall adhesions, mucosal myomas, etc. Observe the development of the endometrium and the presence of endometrial hyperplasia or endometrial polyps.
3. Physiological or specific changes caused by hormone therapy such as triamcinolone or HRT.
4.Subsequent to dysmenorrhea, submucosal fibroids, endometrial polyps, uterine adhesions and other intrauterine abnormalities, hysteroscopy should be the preferred examination method.
5.Staging of endometrial cancer and observation of adhesion surface with or without invasion of cervical canal.
6.Uterine fibroids, when choosing surgical method for multiple uterine fibroids, hysteroscopy should be performed to determine whether there are submucosal fibroids.
7.Check the intrauterine device and observe whether the position of the device is normal.
8.Abnormal vaginal fluid discharge.
III. Indications for hysteroscopic surgery
1.Endometrial resection – abnormal uterine bleeding that has not been treated for a long time, discharge of malignant disease 0 uterus 8-9 weeks gestation size, uterus 10-12CM
2.myomectomy – submucosal myoma 4-5cm, excessive menstrual flow or abnormal bleeding uterus limited to 10 weeks gestation size, uterine cavity limited to 12cm.
3.Symptomatic endometrial polyps, except for polyps with malignant changes.
4, symptomatic complete and incomplete longitudinal uterine septum.
5.Patients with symptomatic uterine adhesions.
6.Hysteroscopic intrauterine foreign body removal – including: IUD, embryonic material, fetal bone, retained sutures, etc.
7.Cervical electrosurgery – cervicitis, cervical polyps, etc.
Hysteroscopic examination and treatment has the following advantages
1.No need for open surgery, easy, safe and economic method with satisfactory results.
2.It can reduce the phenomenon of tubal pseudo-obstruction and can clearly check the tubal patency by side, especially for those with tubal patency (partial adhesions in the lumen) or proximal obstruction.
3.If examined under the surveillance of ultrasound or laparoscopy, it can observe whether the fallopian tubes are swollen, whether there is fluid flow from the umbilical end and the shape of the flow, so as to make a comprehensive assessment of the fallopian tubes.
V. Contraindications to hysteroscopic treatment
1. Excessively narrow uterine cavity or narrow cervix.
2. Those with a history of uterine perforation or uterine surgery within the last three months.
3, active uterine bleeding (with the exception of small amount of bleeding or special indications)
4.Acute or subacute reproductive tract infection.
5.Malignant tumor of the cervix.
6.Tuberculosis of the reproductive tract without appropriate anti-tuberculosis treatment.
7, serious heart, lung, liver, kidney and other disorders, metabolic acidosis and other intolerable people.
8, body temperature ≥ 37.5 degrees Celsius.