Hysteroscopy is one of the most informative and innovative methods of diagnosis, it is also used as a treatment method for various diseases of female genital organs. The body's reaction to the conduct of this intervention is purely individual. Most often, patients are interested in when, after a hysteroscopic examination, they will have new menses. This article deals with the onset of critical days after hysteroscopy.
What is hysteroscopy
Hysteroscopy as a diagnostic method is often used in gynecology. Thanks to him, you can assess the condition of the uterine cavity, detect the presence of inflammation, tumors and various gynecological diseases. This is an invasive type of surgery, during which an experienced gynecologist introduces a special optical device hysteroscope through the external genitals into the uterus, which has a camera at the end. The picture from the camera enters the computer screen. To avoid postoperative complications, it is important that a physician with a certain skill conducts a surgical intervention.
Hysteroscopy is usually done on the 6-10 day of the menstrual cycle. Since during the operation a woman may feel a certain discomfort and pain, it is performed under general anesthesia. If the procedure is carried out for diagnostic and not therapeutic purposes, it is possible to conduct it with local anesthesia. The duration of the operation is 10-30 minutes depending on the skills of the doctor and the general condition of the patient. After a diagnostic intervention, the recovery period is about 3 days, and after a medical operation it is about 3 weeks.
There are several types of hysteroscopy:
- microhysteroscopy. The condition of the uterus is assessed at the cellular level, the organ is not injured,
- diagnostic procedure. According to the results of the intervention, it is possible to establish the presence of diseases, tumors and inflammations in the uterus. The body is not damaged,
- hysteroresectoscopy. During this operation, small tumors are eliminated, low-impact intervention under local anesthesia,
- diagnostic curettage. Used to eliminate polyps and myomas. Operational method requiring general anesthesia
- control hysteroscopy is carried out to verify the effectiveness of treatment and for the timely detection of possible complications.
Since the introduction of a foreign body, which is the hysteroscope, in the uterine cavity in any case is a traumatic procedure for the body, it is natural that after it is carried out there can be scanty red discharge from the vagina and weak pulling pain in the lower abdomen. In cases where there is a lot of blood loss after diagnostic hysteroscopy, you should immediately seek the help of a specialist. A large amount of bleeding going for a short time is permissible after curettage.
Is it possible to do hysteroscopy during menstruation?
Hysteroscopy is prescribed at the time when it is easiest to examine the uterine cavity using an optical device. Usually this period falls on the last day regul. But there are situations when intervention needs to be made urgently, then monthly are not a hindrance to the operation. With menstruation, it is better to spend it on their first day, when the discharge is not too intense, and the growth of the endometrium has just begun. The final decision on the date of the operation is made by the attending physician, who selects the best moment for himself when the structure of the patient’s uterine cavity is as accessible as possible for visualization.
If the procedure is prescribed to women suffering from various gynecological disorders during menopause, when their menstrual function is already complete, hysteroscopy can be performed on any day.
When the menstrual cycle is disturbed
Violation of the cycle is one of the possible consequences of any surgical intervention. Menstruation after hysteroscopy can also malfunction, since during the operation the integrity of the inner layer of the uterus can be broken. The menstruation cycle can be broken for other reasons:
- during the procedure, an infection has entered the reproductive system. This is a common situation with joint hysteroscopy and laparoscopy,
- if the endometrium has thinned during the procedure,
- the stress experienced by a woman can cause dysfunction, because any operation is an additional psycho-emotional load for a person,
- hormonal balance may be disturbed, time is simply necessary for its normalization, in especially severe cases hormone therapy may be required.
What may be failures
Most often, the days after a hysteroscopic intervention are critically critical and deviate insignificantly in parameters from the normal course. In cases where the nature of menstruation after hysteroscopy has changed significantly, you should definitely consult on this issue with a specialist. It may need additional diagnostics and treatment of the resulting complications.
Doctors before surgery warn that the onset of menstruation after hysteroscopy may be slightly delayed, but not more than a week. However, their nature and duration should not change.
Delay of menstruation can cause hysteroscopy, combined with curettage. The delay period is usually equal to the period from the completion of the previous regulations to the day of the procedure.
Typically, critical days occur at the end of the month after hysteroscopy. If this does not happen, it is necessary to consult a gynecologist, because only he can establish the true reasons for the delay of menstruation.
There are no exact dates, how many periods should go after hysteroscopy, since this parameter is individual for each woman. The duration of critical days depends on the depth of the intervention, the general state of health of the patient, the number of births and abortions suffered before, as well as the presence of infections in the genitourinary system. If during the first menstrual periods after surgery, the nature of their course has changed, they become too long, abundant and painful, you should always consult with your doctor.
The most common reason that menstruation arrived prematurely is stress and anxiety. The operation itself is a stressful situation for a woman, therefore, against the background of emotional surges, one should not miss the pathological symptoms that may indicate that the early regulula began due to inflammation or illness. If it is not menstrual, but uterine bleeding, then there may additionally be pain in the lower abdomen.
Monthly after hysteroscopy are most often scarce, and this is a variant of the norm, since during the operation a part of the tissue is removed for the study. During the recovery period, this seized area will not have time to be updated. In this case, the selection will have a brownish tint.
Abundant periods can also occur after hysteroscopy, but if the gasket needs to be changed more often than once every 2-3 hours, and lethargy appears, weakness and hemoglobin decrease, you should immediately consult a doctor. The reason for visiting the gynecologist may also be the absence of menstruation after 3 months after the operation, because by this time the menstruation cycle should already be fully restored.
When menstruation comes after hysteroscopy
Most women who have to go through the procedure are concerned with the question of when the first menstrual periods begin after hysteroscopy. As a rule, a diagnostic type of intervention does not in any way affect the duration of the menstruation cycle, since it is carried out during the maximum thickness of the inner layer of the uterus. Critical days in this case may come with a slight delay, and it will be necessary to wait for their occurrence no more than 2-3 days, how much specifically depends on the characteristics of the female body.
If hysteroscopy was performed with full curettage of the uterine mucosa, in this case the menstrual periods begin with a delay, and they will go more abundantly, and their duration can last for 2-3 weeks, depending on the characteristics of the patient's body.
No matter how the menstruation changes immediately after hysteroscopy, the operation does not affect the hormonal background, which means that the situation should be normalized through the cycle.
Prevention of complications after hysteroscopy
To prevent possible complications after surgery, sexual tranquility should be observed for 3 days (with a diagnostic study) or 4 weeks (with surgical intervention). Doctors recommend to avoid heavy physical exertion, do not lift weights, do not overcool and do not overheat.
If the body temperature rises, there is pain in the lower abdomen and bloody discharge with an unpleasant odor from the vagina, it is possible that an infection occurred during or after the operation, which means that you should immediately consult a doctor and follow all of its instructions.
The recovery period of the uterus and the body as a whole after surgery depends largely on the patient herself and her desire to follow all the medical recommendations.
What it is
Hysteroscopy literally translates from Latin as "examination of the uterus." It is used for the diagnosis and treatment of gynecological diseases. Unlike ultrasound, it helps to detect the exact location of pathological tumors in the uterus and assess the condition of the endometrium. Thanks to the device with a fiber-optic system, the doctor can examine the organ cavity in great detail. The main advantage of hysteroscopy over laparoscopic and abdominal operations is the lack of need to make punctures or incisions in the peritoneum. The risk of infection in the uterus in this case is reduced. Accidentally damage its walls is almost impossible.
Types of Hysteroscopy
There are two types of procedures that differ in the purpose of: diagnostic and therapeutic. Anesthesia in each case will be different. After therapeutic action, control hysteroscopy is performed. It allows you to evaluate the effectiveness of treatment and avoid recurrence of the disease. Sometimes the procedure is carried out in preparation for IVF. It increases the likelihood of a favorable outcome of the operation. If you do not conduct hysteroscopy, an attempt to in vitro fertilization can be unsuccessful. It is necessary to determine in advance whether the endometrium is ready for embryo implantation.
Panoramic type of procedure is used to assess the entire uterine cavity. It is practiced to detect visible pathologies. Microhysteroscopy helps to examine certain parts of the endometrium at the cellular level. It is carried out by contact. The type of procedure is determined in advance, taking into account the disease and associated symptoms.
This kind of hysteroscopy is performed if the doctor doubts what diagnosis to make. It is carried out on an outpatient basis without the use of anesthesia. A woman may experience mild discomfort during a hysteroscope through a cervical canal. Sometimes this type of procedure is prescribed after curettage of the organ and cervical canal. This eliminates the likelihood of complications.
As part of the implementation of diagnostic hysteroscopy, the cavity of the fallopian tubes is examined for the presence of adhesions and polyps. They can be a barrier to pregnancy. After the detection of neoplasms, they are removed in the most appropriate way. In this case, the operation is considered therapeutic.
When this type of hysteroscopy is performed, pathological neoplasms (adhesions, fibroids, polyps, etc.) are removed from the uterus. The procedure is performed under general anesthesia. It lasts no more than half an hour. In order to expand the uterus, carbon dioxide or special solutions are used to improve visibility.
Hysteroscopy is carried out in order to treat and prevent gynecological diseases. Before sending a woman to the procedure, the doctor conducts a survey and visual inspection of the genitals. Atypical vaginal discharge, pain in the abdomen, disruption of the cycle regularity, etc., indicate the presence of pathology. The procedure should be carried out in the following cases:
- high probability of presence in the uterus fragments of the ovum after miscarriage,
- anomalies of the structure of the penis and fallopian tubes,
- bleeding of unknown origin,
- prolonged infertility
- suspected benign or malignant neoplasms in the uterus,
- fibroids or polyps,
- endometrial hyperplasia.
Sometimes diagnostic hysteroscopy is performed after hormonal therapy. It helps determine how successful the treatment was. Before in vitro fertilization, hysteroscopy identifies possible abnormalities that can prevent embryo attachment. IVF without prior screening may be useless. When unsuccessful attempts at artificial insemination hysteroscopy is sent again.
The procedure involves surgical intervention in the body, so before its implementation should be familiar with contraindications. The main one is pregnancy. Manipulations affecting the uterus and the canal of her cervix can cause miscarriage. Other obstacles to the procedure include:
- oncology in the cervix,
- infectious diseases,
- uterine bleeding,
- recurrence of chronic inflammation,
- heart and kidney ailments
- cervical stenosis,
- pathology of blood clotting.
Hysteroscopy may be performed if there are contraindications if there is a threat to the patient's life. In each case requires an individual approach. In cancer or cervical stenosis, surgery can be carried out as an exception, using a fibrogysteroscope, which does not require expansion of the cervical canal. In the presence of infectious diseases before the operation, it is necessary to strengthen antibacterial therapy.
Preparing for hysteroscopy of the uterus
Before the procedure, a woman is examined, revealing the presence of contraindications. It is necessary to discuss with your doctor the possibility of taking medicines. They can affect clotting, leading to blood loss during surgery. Preparation for the procedure includes the following:
- test for hepatitis, syphilis and HIV,
- Pelvic ultrasound,
- smear on flora,
- research on oncocytology,
- biochemical and general blood tests.
The procedure is allowed only in the absence of contraindications. Two days before the date of surgery, intimacy and the use of any funds intended for vaginal administration are excluded. Sometimes, 5-6 days before hysteroscopy, antimicrobials are prescribed. Eating on the day of the procedure is prohibited. You should first carry out the depilation of the inguinal and pubic zones. Before visiting the operating room, the woman should empty her bladder and remove the jewelry. Upon admission to the hospital, the patient should always bring replacement linen, slippers, bathrobe and sanitary napkins.
When is held
Most often, hysteroscopy is prescribed after the end of menstruation. The optimal period is considered 5-7 day cycle. At this time, the endometrium is in the proliferation phase. In the secretory mucosa is thickened, so surgery can cause bleeding. Sometimes for diagnostic purposes, research is prescribed immediately before the onset of menstruation.
How is hysteroscopy performed
The procedure is performed in the gynecological department or perinatal center on an outpatient basis. In the operating room there is a chair and a special apparatus equipped with medical instruments. In some cases, a laser or electrodes are required to coagulate the tissue. The operation is carried out in strictly sterile conditions. A woman is given anesthesia, taking into account her weight and the likelihood of an allergic reaction.
Further, the vaginal cavity and the cervix are treated with antiseptic solutions. A probe is inserted into the cervical canal with which the organ is filled with gas or liquid. The latter type of manipulation is resorted to more often. It allows to evaluate the relief, structure and presence of tumors in the body.
Normally, the uterus should have a rounded shape and a vascular pattern. The thickness of the endometrium depends on which day of the cycle the operation is performed. In the follicular phase, it varies from 5 to 8 mm. In luteal, the endometrium is significantly thickened and loosened. Любые отклонения в его строении фиксируются и по возможности устраняются.
Одновременно проверяется проходимость фаллопиевых труб. This is especially important if a woman suffers from infertility. When pathological neoplasms are detected, uterus is scraped. In the presence of partitions or adhesions cut through them.
What diseases can be detected
Diagnostic hysteroscopy helps to detect pathology of the endometrium, fallopian tubes or uterus.
If on the eve of a woman pregnancy was interrupted, fragments of fetal tissue can be found in the uterus. In some cases, adhesions and partitions are diagnosed in the uterus. But the following pathologies can also be detected:
- areas of hemorrhage,
- varicose veins of the pelvis,
- the presence of necrotic tissue,
- abnormalities of the structure of the uterus,
- endometrial vessels ruptures.
Treatment of diseases with hysteroscopy
When pathological neoplasms are detected as part of the procedure, the resection is performed. It is the targeted removal of suspicious areas. After this, the functional layer of the uterus is scraped. Part of the material is sent for histological examination. Depending on the result obtained, further measures are taken.
Laser cauterization of the endometrium is necessary in the presence of hyperplasia or uterine bleeding of unknown origin. In this case, the patient is shown hormone therapy before surgery. They will reduce the growth rate of the endometrium, which will avoid overloading the vascular bed. Laser moxibustion is contactless, contact and mixed.
The process of removing myoma nodes is called myomectomy. If the fibroid is small, no special preparation is required. A large neoplasm is removed in two stages, which prevents the development of adhesions in the uterine cavity. Methods of performing hysteroscopy aimed at removing fibroids are as follows:
- The impact of the laser contact or contactless.
- Electrosurgical type of operation involves the use of resectoscopes and electrodes for cauterization of vessels.
- Mechanical myomectomy is practiced in the presence of neoplasms up to 5 mm.
Recovery after hysteroscopy
The procedure is considered a low-impact operation due to the absence of abdominal incisions. Its duration is 15-20 minutes. Usually a woman is allowed to go home 12-24 hours after the operation. If there is a risk, the patient may be detained in the hospital for several days to carry out antibiotic therapy.
On the first day, there is bloody discharge and pain in the lower abdomen. During this period, it is not recommended to carry out douching and use gynecological tampons. Sex acts during the recovery of the body is strictly prohibited. Bathing and hot bath are not recommended. If the uterine cavity is dilated with gas, pain in the chest area can be noted on the first day after the procedure. They pass by themselves. To make you feel better, a woman is recommended to move more.
With a weak contraction of the uterine muscles, oxytocin is prescribed. In the case of a pronounced pain syndrome, analgesic drugs are indicated: Ketorol or Baralgin. When intensive blood loss is prescribed Etamzilat or Dicynon. If during the operation polyps were removed, in order to avoid relapses, oral contraceptives are prescribed. Usually a course of hormone treatment is 3-6 months.
Complications after hysteroscopy
With the observance of the technique of implementation and preparation for the procedure, the probability of the development of negative manifestations is low. To provoke undesirable consequences damage of large vessels, as a result of which the bleeding opens, can. In this case, the clots accumulate in the uterus, which leads to painful sensations. The entry of pathogenic microorganisms during the operation contributes to the development of the inflammatory process.
In the presence of extensive foci of endometriosis, there is a possibility of the formation of intrauterine synechiae in the postoperative period. The complications associated with anesthesia include an allergic reaction to drugs. In this case, angioedema may develop. In case of violation of the technology of gas or fluid in the uterus, there is a risk of embolism, hypoglycemia and vascular overload.
The presence of possible complications during the recovery of the body is indicated by the following signs:
- painful abdominal cramps
- the presence of impurities of pus in the vaginal discharge,
- unpleasant smell from the genitals
- drop in blood pressure.
If you see anxiety symptoms, you should consult a doctor. In this case, you will need a detailed examination, including ultrasound of the organs and testing. When conducting repeated diagnostic procedures, hematomas in the uterus, which are caused by a bleeding disorder, can be detected. To remove clots requires repeated cleaning of the organ. To prevent postoperative complications, the following principles should be observed:
- carrying out the procedure taking into account the correct technique of execution,
- use of prophylactic antibiotic therapy,
- observance of the optimal rate of supply of fluid or gas to the uterus
- full examination of the body on the eve of the procedure.
Monthly after hysteroscopy with scraping
After the operation has been completed for several days, the woman has spotting. They are accompanied by moderate abdominal pain. In the absence of complications, the following menstruation will begin in 21-28 days. If the integrity of the endometrium has been significantly impaired, long delays are possible. In this case, it may take several months to restore the menstrual cycle.
The nature of menstruation depends on the degree of intensity of scraping. Damage to the functional layer leads to a decrease in the amount of blood secreted during critical days. Pathology during the recovery period is considered as scanty and abundant menstruation. Normally, menstrual blood has a scarlet color and a liquid structure. Its optimal volume is 60 ml per day. If the discharge becomes brown and has an unpleasant odor, then it is an inflammatory process. The presence of blood clots is an alarming sign requiring a visit to a doctor.
Pregnancy after hysteroscopy
Surgery has no effect on reproductive health. Sometimes it is carried out in preparation for pregnancy. The procedure helps to identify and eliminate pathologies that prevent conception. Doctors recommend planning replenishment in the family three months after surgery, because the body needs time to recover. If conception happened earlier, special attention is paid to the woman by the medical staff, because then the probability of abortion increases.
In complicated cases, additional manipulations are carried out, activating the function of the appendages and the growth of the endometrium. These include maintenance therapy with hormones and stimulation of ovulation with the help of drugs. To normalize the cycle, prescribe Duphaston orally or Utrozhestan vaginally. To stimulate ovulation most often use drugs based on clomiphene. For the growth of the endometrium is prescribed Proginova or Divigel.
If the woman complied with the recommendations prescribed by the doctor, the hysteroscopy will not affect the child's birth. Exceptions are cases of severe injury to the mucous membrane of the uterus. For successful implantation and childbearing, its thickness should be 10-13 mm. Thin endometrium is one of the causes of early pregnancy termination.
Impressions of the patients about the operation vary greatly. Most of them do not regret that they decided on the procedure. Hysteroscopy helps to diagnose and eliminate serious gynecological diseases and bring the patient closer to the desired pregnancy. According to statistics, it occurs within six months after the procedure. When conducting hysteroscopy use short-term anesthesia or local anesthesia. This moment is discussed in advance with the anesthesiologist. Most women quickly come to their senses. Side effects in the form of nausea or dizziness occur if the patient eats on the day of surgery. Signs such as discomfort, abdominal pain and spotting disappear the next day without medical intervention. Repeated surgery is required in rare cases.
Hysteroscopy is an effective method to eliminate and diagnose diseases of the genital organs. Refusing to conduct it in the presence of evidence is unwise. The operation is less traumatic and safe for the reproductive system. The very next day, women forget about surgery. Many of them immediately return to everyday matters.
It is necessary to avoid infectious diseases and take prescribed medications.