✓ Diagnostic hysteroscopy: what it is and why it is done

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Diagnostic hysteroscopy

The name may frighten those who come across it for the first time but do not worry, we are not facing a dangerous exam. On the contrary. L'diagnostic hysteroscopy it is the safest and most accurate investigation that the specialist can carry out to monitor the state of health of the uterus: in the fertile age and even after menopause it is the gynecologist who prescribes this in-depth study which is used to probe any uterine pathologies whose symptoms most abnormal bleeding is common. We talk about it with Alessandro , Head of Obstetrics and Gynecology of Humanitas San Pio X to our city.

Diagnostic hysteroscopy: what it is and why it is done

"Diagnostic hysteroscopy is an examination that is performed using a hysteroscope" - said the doctor - "and allows you to obtain accurate images of the uterine cavity on a monitor, allowing you to view both the morphology and the appearance of the endometrium of the uterus.

there two types of hysteroscopy:

the so-called "outpatient" they are mainly diagnostic or mini operative,
while a second type of hysteroscopy is defined "operational".

The former are performed in an outpatient clinic without hospitalization and local anesthesia can be performed at the cervical level: this type of hysteroscopy allows simple diagnostics or mini-operations in situations of endometrial biopsies, removal of small polyps or the correction of small uterine malformations such as uterine subsets or the removal of endometrial synechiae - or adhesions - ".

Diagnostic hysteroscopy: when to do this exam

Diagnostic hysteroscopy can be performed both in childbearing age and after menopause.

In the premenopausal period

"In the premenopausal period we proceed mainly for infertility or sterility of the woman, for suspicion of uterine malformation found in ultrasound, for suspicion of neoformations of the endometrial cavity such as polyps or fibroids "clarifies the doctor.

In menopause

"In menopause, on the other hand, the most frequent indications are endometrial thickening found in ultrasound, suspected endometrial polyp found in ultrasound or abnormal bleeding. Whenever there is bleeding in menopause, an endometrial or endocervix biopsy must be performed to rule out preneoplastic or neoplastic pathologies. In the endometrial biopsy that can be performed during diagnostic hysteroscopy, material is taken to carry out the appropriate histological investigations ".

Is diagnostic hysteroscopy painful?

"To carry out this examination a hysteroscope is used, that is an optic with a diameter of a few millimeters, e it can be done with or without local anesthesia - adds the gynecologist -. In menopausal women it is possible that hysteroscopy is more painful as well as, if not in menopause, in women who have never had pregnancies and births. In particularly fragile subjects or with other related pathologies, this examination is performed in a more protected environment, in operating room where a deep sedation is performed in cases of operative hysteroscopy, to solve different problems ".

How diagnostic hysteroscopy is performed

"On an outpatient basis, this examination takes about 10 minutes and lasts a few minutes longer in the mini-operation phase or endometrial biopsy. The images are collected by the hysteroscope, introduced into the vagina and conducted into the uterus thanks to liquid solutions that allow temporary flooding. If here the gynecologist notices that the necessary operation is greater, he can postpone the procedure to an operating room with sedation ".

Diagnostic hysteroscopy when there is a polyp

"The most common endometrial growth may be a octopus or fibroma. The finding of a endometrial polyp it is performed following an ultrasound scan and requires a close or more urgent hysteroscopic examination if there is associated abnormal bleeding: in the premenopausal period if the discharge is intermenstrual or if you have a bleeding period; In menopause, any polyp associated with bleeding needs shorter times because we are faced with a greater risk of having a polyp with neoplastic transformation. It is the gynecologist who prescribes this in-depth examination if necessary once he is aware of the patient's clinical history and after the ultrasound ".

Read also: Tests to prevent uterine cancer

Operative hysteroscopy

"In case you have to resort to one operative hysteroscopy, the surgery is performed in operating room with the anesthetist who performs sedation (general anesthesia) ", concludes the doctor." The patient sleeps, feels no pain, is ventilated but is not intubated. Recovery times are fast because the procedure lasts between 15 and 30 minutes and is performed in day surgery. Operative hysteroscopy is generally performed for endometrial polyps larger than 1,5 cm, submucosal uterine myomas, uterine malformations such as uterine septa. The latter are corrected in the premenopausal period because the purpose of the septal correction is to restore the uterine cavity to allow pregnancy ".

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