Hysteroscopy is a modern method of diagnosis and treatment in which an optical system (hysteroscope) is guided through the cervix into the uterine cavity, which allows to visualize the walls of the cervical canal and uterine cavity, detect and eliminate intrauterine pathology, remove foreign bodies, perform tissue biopsy remove endometrial polyps.

Indications for diagnostic hysteroscopy:

Menstrual irregularities at different periods of a woman's life.

Bloody discharge after menopause.

Suspicion of the following diseases:

submucosal uterine fibroids;

adenomyosis;

endometrial cancer;

abnormalities of uterine development;

intrauterine synechiae;

remnants of the fertilized egg in the uterine cavity;

a foreign body in the uterine cavity;

perforation of the uterine wall.

Clarification of the location of the intrauterine contraceptive or its fragments.

Infertility.

Miscarriage.

Control study of the uterine cavity after operations on the uterus, vesical drift, chorionepithelioma.

Evaluation of the effectiveness and control of the endometrium during hormone therapy.

Complicated course of the postpartum period.

Contraindications to diagnostic hysteroscopy are the same as to any intrauterine intervention:

Infectious diseases (influenza, sore throat, pneumonia, pyelonephritis and others).

Acute inflammatory diseases of the genitals.

3-4 degree of purity of the vagina.

Severe condition in diseases of the cardiovascular system and parenchymal organs (liver, kidneys).

Pregnancy.

Cervical stenosis.

Common cervical cancer.

Uterine bleeding.

Anesthesia.

The best option for analgesia, taking into account the contraindications to it - intravenous anesthesia.

Method:

For hysteroscopy it is necessary to create a working space by expanding the uterine cavity. To do this, use fluid to expand the uterine cavity. The patient is in a gynecological chair in a standard position. The external genitalia and vagina are treated with an antiseptic solution. Before hysteroscopy, a bimanual examination should be performed to determine the position of the uterus and its size. The cervix is ​​fixed with ball forceps to the front lip, which allows it to be tightened, to align the cervical canal and to determine the length of the uterine cavity. It is also necessary to expand the cervical canal with Gegar dilators.

The expansion of the cervical canal is performed depending on the hysteroscope and fixed with a closing lock. A flexible light guide with a light source, a conductor connecting the device to the uterine dilatation medium, and a video camera are connected to the hysteroscope. Prior to the introduction of the hysteroscope into the uterine cavity, the fluid intended for the expansion of the uterine cavity is supplied, the light source is turned on and the camera is fixed. The hysteroscope is inserted into the cervical canal and under visual control is gradually advanced to the middle, examining all the walls of the uterine cavity, the area of ​​the cervix.