Hysteroscopy of the uterus

Hysteroscopy is a diagnostic and therapeutic procedure that allows the physician to examine the uterine cavity using a specialized instrument called a hysteroscope. The hysteroscope is inserted into the uterine cavity, enabling examination and, if necessary, therapeutic interventions without making any external incisions.

Hysteroscopy is used to diagnose various gynecological conditions and to perform minor surgical procedures within the uterine cavity, such as removal of polyps or fibroids, as well as to identify causes of infertility or abnormal uterine bleeding.

Types of hysteroscopy

Depending on the purpose of the procedure, hysteroscopy may be diagnostic or operative:

1. Diagnostic hysteroscopy. This type of procedure is performed to visually assess the inner surface of the uterus and diagnose conditions such as polyps, fibroids, endometrial hyperplasia, and intrauterine adhesions. It is often carried out on an outpatient basis under local anesthesia or mild sedation and usually does not require prolonged recovery.
2. Operative hysteroscopy. During operative hysteroscopy, the physician can remove intrauterine lesions, divide adhesions, or obtain tissue samples for biopsy. For this purpose, the hysteroscope is equipped with miniature surgical instruments. Operative hysteroscopy requires more thorough preparation and may be performed under general anesthesia.

Indications for hysteroscopy

• Endometrial polyps. Benign growths of the uterine lining that may cause abnormal bleeding and infertility.
• Uterine fibroids. Submucosal fibroids located within the uterine cavity may lead to heavy menstrual bleeding and pelvic pain.
• Abnormal uterine bleeding. Hysteroscopy helps determine the underlying cause and guide appropriate treatment.
• Infertility. The procedure can identify anatomical causes of infertility, such as intrauterine septa, adhesions, or other uterine cavity abnormalities.
• Intrauterine adhesions (Asherman’s syndrome). Adhesions within the uterine cavity may result in menstrual disorders and infertility.
• Retained products of conception. After miscarriage or incomplete abortion, hysteroscopy may be used to remove residual tissue.
• Endometrial hyperplasia. Excessive thickening of the uterine lining associated with hormonal imbalance that may require surgical management.

How is hysteroscopy performed in Belarus?

1. Preparation. Prior to hysteroscopy, the physician may order preliminary tests, including blood and urine tests and vaginal swabs for infection screening. Several days before the procedure, patients are advised to avoid sexual intercourse and the use of tampons. If general anesthesia is planned, fasting for several hours before the procedure is required.
2. Procedure. The patient is positioned on a gynecological chair. The hysteroscope is inserted through the vagina and cervix into the uterine cavity. The cavity is expanded using a special solution or gas to improve visualization. The physician examines the endometrium for abnormalities. If operative hysteroscopy is performed, surgical interventions such as removal of polyps, fibroids, adhesions, or tissue biopsy may be carried out.
3. Completion. After the procedure, the hysteroscope is removed, and the patient remains under medical observation for a short period.

Advantages of hysteroscopy

• Minimal invasiveness. The procedure does not require external incisions, reducing recovery time and the risk of complications.
• High diagnostic accuracy. Direct visualization of the uterine cavity allows precise identification of pathology.
• Simultaneous diagnosis and treatment. The physician can both diagnose and treat intrauterine conditions during the same procedure.
• Rapid recovery. Most patients can quickly return to their normal daily activities.

Hysteroscopy is a modern and effective method for the diagnosis and treatment of uterine disorders. Thanks to its minimally invasive nature, it allows for the safe and timely detection and management of intrauterine pathologies such as polyps, fibroids, and adhesions. Timely consultation with a gynecologist is essential to prevent complications and preserve reproductive health.