Hysteroresectoscopy

Hysteroresectoscopy is a minimally invasive surgical procedure performed for the diagnosis and treatment of various conditions affecting the uterine cavity. During hysteroresectoscopy, the physician uses a specialized instrument called a hysteroresectoscope, which is inserted into the uterine cavity, allowing visual examination and surgical intervention without external incisions.

This procedure is commonly used to remove the abnormalities of the endometrium (the uterine lining), such as polyps, fibroids, adhesions, or endometrial hyperplasia, as well as to treat abnormal uterine bleeding.

Indications for hysteroresectoscopy

Hysteroresectoscopy may be recommended in the following cases:

1. Endometrial polyps. Benign growths of the uterine lining that may cause abnormal bleeding, pelvic pain, or infertility.
2. Uterine fibroids. Fibroids (leiomyomas) are benign tumors of the uterine muscle that may be located within the uterine cavity or beneath the endometrium (submucosal fibroids).
3. Endometrial hyperplasia. Excessive thickening of the endometrium, often associated with hormonal imbalance and can result in bleeding and increased risk of endometrial cancer.
4. Abnormal uterine bleeding of unknown origin. Hysteroresectoscopy helps identify the underlying cause of unexplained uterine bleeding.
5. Intrauterine adhesions (Asherman’s syndrome). Adhesions may lead to menstrual irregularities, pain, or infertility.
6. Congenital uterine anomalies. Hysteroresectoscopy can be used for the diagnosis and correction of congenital abnormalities, such as intrauterine septa.
7. Removal of retained products of conception after miscarriage or abortion. In cases of incomplete abortion, residual tissue may need to be removed from the uterine cavity.

How is hysteroresectoscopy performed in Belarus?

The procedure is performed under general or local anesthesia, depending on its complexity and the individual characteristics of the patient.

Main stages of the procedure:

1. Preparation. Prior to the procedure, blood tests, infection screening, and pelvic ultrasound may be required. Several hours before surgery, the patient is advised to refrain from eating and drinking if general anesthesia is planned.
2. Surgical procedure. The hysteroresectoscope is inserted into the uterine cavity. This instrument is equipped with an optical system, allowing the surgeon to visualize the uterine cavity on a monitor. A fluid or gas is introduced to expand the uterine cavity, improving visualization and facilitating surgical manipulation. If necessary, pathological lesions (polyps, fibroids, adhesions, etc.) are removed using specialized instruments. If the procedure is therapeutic, such as fibroid removal, electrosurgical coagulation may be used to prevent bleeding.
3. Completion of the procedure. After surgery, the instrument is removed, and the patient remains under medical supervision for several hours until full recovery from anesthesia.

Advantages of hysteroresectoscopy

Hysteroresectoscopy has several advantages over other diagnostic and therapeutic methods:

• Minimal invasiveness. The procedure is performed without external incisions, reducing recovery time and the risk of complications.
• High diagnostic accuracy. Direct visualization of the uterine cavity allows precise identification of abnormality.
• Simultaneous diagnosis and treatment. Hysteroresectoscopy enables both detection and immediate removal of pathology in a single procedure.
• Short recovery period. Most patients return quickly to their normal daily activities.

Hysteroresectoscopy is an effective and safe method for the diagnosis and treatment of various uterine conditions. Owing to its minimally invasive approach, it allows rapid and precise management of many intrauterine pathologies while preserving reproductive health and minimizing risks. With timely medical attention and appropriate procedural management, patients can return to normal life without significant complications.