Hysteroscopy is a modern endoscopic procedure that enables diagnosis and therapy of changes in the uterine cavity.
We perform advanced office hysteroscopy, in which we enter the uterine cavity without anesthesia (or only with local anesthesia) with a thin optical instrument through the vagina and cervix. We open the uterus with a saline solution and look at its interior.
In most cases, office hysteroscopy is decided upon when changes in the uterine cavity are found by ultrasound examination.
These can be congenital, such as a septate uterus (lat. septum uteri).
Mostly, these are acquired changes, such as submucosal fibroids (lat. myoma submucosum), polyps and thickened mucous membrane, and remnants of pregnancy (lat. residua) after childbirth or abortion. All these changes can also be surgically removed by hysteroscopy and sent for pathohistological examination.
We also decide on office hysteroscopy in cases of unexplained bleeding (where no abnormality was found by ultrasound examination), both during the childbearing period and postmenopause. In all these cases, tissue is also removed for pathohistological examination.
We also remove residual uterine implants or their parts with office hysteroscopy.
A special part of office hysteroscopy is cervicoscopy, in which, due to a pathological PAP smear, we look at the cervical canal and take samples for pathohistological examination. This examination is mainly used when no changes are found during colposcopy of the cervix that would explain a pathological PAP smear, especially when glandular cells are identified as pathological.
The preparation of the patient is not demanding. First, we need a gynecological examination and a vaginal ultrasound examination. At that time, the date of office hysteroscopy is set, for patients of childbearing age immediately after menstruation, when the uterine mucosa does not obstruct the procedure, and for postmenopausal patients at any time. Patients are advised to take a painkiller an hour before the scheduled procedure. These are usually non-steroidal antirheumatic drugs such as Nalgesin or Ketonal, but they must not take Aspirin under any circumstances.
Diagnostic office hysteroscopy takes 5 to a maximum of 10 minutes, and operative office hysteroscopy takes a maximum of 20 minutes.
In case of diagnostic hysteroscopies, the patient’s stay will not be necessary, but in the case of operative hysteroscopy, a day or two will be required.
Patients should come in loose pants or a skirt, as the saline solution will continue to pour out of the uterus or vagina for some time and the patient will therefore need a thicker pad.