HYSTEROSCOPY is a minimally invasive gynaecological procedure used to examine the inside of the cervix and the uterus.
It is painless when done by a skilful operator, using the smallest optical devices and cameras. During the hysteroscopy fluid is introduced into the uterine cavity for easier location of pathological changes and their painless removal.
In our clinic we use the most innovative 2 mm-diameter CAMPO TROPHYSCOPE® telescopes from STORZ. This special device facilitates atraumatic access to the uterine cavity to minimize the risk of endometrial injuries.
Diagnostic hysteroscopy can also be used to examine fallopian tubes for potential blockage and the flow of fluid medium to the smaller pelvis through the fallopian tubes (tubal patency).
Indications for hysteroscopy
- infertility
- miscarriages
- history of curettage of the uterus
- abnormal size and shape of the uterus
- suspected pathologies inside the uterus such as adhesions, septum, polyps, foreign bodies, fibroids
- infertility for unexplained reason
- disorders of menstrual cycle or bleeding of unclear aetiology
- hyperplasia of the endometrium and the cervical canal
How to prepare for diagnostic hysteroscopy
The patient has to do the following tests before hysteroscopy:
- Microbiological analysis of a smear from the cervical canal for Chlamydia t., Ureaplasma, Mycoplasma, and bacteriological and mycological culture of a smear from the genital tract
- Blood type
- Test for hepatitis B (HBs and a-HCV) and HIV
- Additional tests necessary before surgical procedures: whole blood count, sodium, potassium, INR, APTT, albumin, creatinine
How is hysteroscopy performed?
You will be asked to come to the clinic on the day of the surgery 30 minutes before the planned procedure (you have to be fasting for at least 6 hours); during this time you will have a medical interview, and a small cannula will be inserted into a vein. The doctor will explain to you how the procedure will be done. Then you will be asked to remove your private clothes and put on a special gown, and will be taken to the operating room.
The procedure is usually painless and does not require anaesthesia. If you feel pain, you will be given local anaesthesia. In exceptional situations, if the pain persists, the patient is qualified for general anaesthesia.
The doctor performing the procedure prepares the operating area with special liquids and then painlessly inserts a hysteroscope inside the uterine cavity. The procedure usually takes about 5 minutes.
When the procedure is completed, the doctor performing hysteroscopy will discuss the findings with you and will suggest further treatment.
After hysteroscopy you can return to normal daily activities; you may experience some abdominal pain and minor spotting from the vagina, similar to menstruation, but this is a normal reaction of the body.
LAPAROSCOPY and treatment of infertility
Laparoscopy is a type of surgery during which the doctor can inspect the anatomy of the reproductive organs, in particular the uterus, the shape of the fallopian tubes, and the location of the ovaries. Laparoscopy is also the most objective method of evaluating the patency of the fallopian tubes. If abnormalities that often lead to reduced fertility, such as endometriosis, adhesions, ovarian cysts, fibroids are found, they can be immediately removed.
Indications for laparoscopy in patients with infertility
- Idiopathic infertility
- Tubal factor infertility (fallopian tube obstruction)
- Suspected endometriosis
- Ovarian cysts
- Uterine fibroids
- Severe PCOS (non-responsive to ovulation stimulation)
- Genital malformation
- Ectopic pregnancy
How to prepare for laparoscopic surgery
The patient has to do the following tests before laparoscopy:
- Microbiological analysis of a smear from the cervical canal for Chlamydia t., Ureaplasma, Mycoplasma, and bacteriological and mycological culture of a smear from the genital tract
- Blood type
- Test for hepatitis B (HBs and a-HCV) and HIV
- Whole blood count, sodium, potassium, glucose, INR, APTT
- ECG
How is laparoscopy performed?
All surgical procedures in our clinic are performed in line with the ERAS protocol (Enhanced Recovery After Surgery), which means the patient is prepared for the surgery in such a way as to ensure fast return to normal activity. Most procedures following this protocol are done as same-day surgeries. Coordinators from our clinic will discuss your preoperative diet with you.
You will be asked to come to the clinic on the day of the surgery 60 minutes before the planned procedure (you have to be fasting for at least 6 hours); during this time you will have a medical interview, and a small cannula will be inserted into a vein. The doctor will explain to you how the procedure will be done. Then you will be asked to remove your clothes and put on a special gown, and will be taken to the operating room.
Surgery is done under general anaesthesia and usually lasts from 30 minutes to 3 hours. After surgery you will be taken to the postoperative care department and you will stay there for at least 6 hours. If the doctor decides you are ready to leave the clinic, you will be discharged. It may happen that you will have to stay with us for the night – in this case, we provide 24-hour medical care.