Hysteroscopy

What is hysteroscopy?

Hysteroscopy is a diagnostic and therapeutic procedure used to assess the shape of the uterine cavity, the condition of the endometrium and the cornual ostia. During the examination with a hysteroscope, the physician makes a detailed visualization of the interior of the uterus, so that even small pathological lesions in the mucous membrane, such as endometrial polyps, submucosal fibroids and intrauterine adhesions can be noticed.

How to prepare for a hysteroscopy?

Hysteroscopy is usually performed under general intravenous anaesthesia. For this reason, the patient should come to the procedure fasting. Hysteroscopic examination is performed in the first phase of the cycle (before ovulation). Slight spotting at the end of menstruation is not a contraindication to the procedure.

The following tests should be performed before hysteroscopy:

• VDRL
• Pap test
• blood typing,
• cervical swab culture (anaerobic and aerobic),
• Anti-HCV-Ab
• AntiHBC IgM,
• HBs Ag
• -Anti-HIV-1,2.

Sometimes it is necessary to perform additional examinations, for example ECG and X-ray of the chest in women over 40 years old. Preparation for hysteroscopy may also include the use of hormonal drugs that affect the thickness of the endometrium.

Patients who have had symptoms of allergy to any medications in the past should inform their physician before the qualification for surgery.

Contraindications for hysteroscopic examination:

Diagnostic hysteroscopy cannot be performed during pregnancy. The onset of menstrual bleeding is also not the right time to perform this examination. An important contraindication for the assessment of the uterine cavity is the ongoing inflammation.

Does hysteroscopy hurt?

Hysteroscopy is usually a painless examination for most patients, but for the comfort of the woman the examination is performed under general anaesthesia.

Necessary tests for the performance of anaesthesia:

• Blood count,
• APTT,
• Sodium,
• Potassium,
• Glucose.

When it is worth performing a hysteroscopy?

Hysteroscopic examination is recommended for women who:

• experience menstrual disorders (especially intermenstrual bleeding),
• have experienced miscarriages,
• have been unsuccessfully trying to conceive.

Hysteroscopy is also indicated in the following cases:

• pathological lesions in the uterine mucosa previously detected by ultrasound,
• anatomical defects of the uterus,
• suspected intrauterine adhesions.

Hysteroscopy and endometrial polyps

Endometrial polyps can cause difficulties in getting pregnant. They should be removed in patients trying to get pregnant. The removed lesions will then be subject to histolopathological examination (statistically 1% of such lesions are malignant). Information about uterine polyps can be found on many medical websites, but your physician will give you the most reliable information during your consultation.

Surgical hysteroscopy

Surgical hysteroscopy, also referred to as hysteroscopic procedure, helps in the diagnosis of excessive menstruation, uterine mucosal growth, anatomical defects of the uterus and the pathological lesions mentioned above (polyps, fibroids and intrauterine adhesions).

Surgical hysteroscopy is performed vaginally. There is no interruption of the abdominal wall. 

Price of hysteroscopy

At InviMed clinics, hysteroscopy is performed by experienced medical teams consisting of a gynaecologist, an anesthesiologist, midwives and nurses. The prices of hysteroscopy, depending on the clinic and type of examination, range from 700 PLN to 1500 PLN.

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Medical consultation of the article: M.D. Wojciech Rawski, gynaecologist-obstetrician, physician treating couples at InviMed clinic in Warsaw. He has extensive experience in endoscopic procedures. He performs surgical and diagnostic hysteroscopies.