On what day of the cycle do hysteroscopy of the uterus?

To date, hysteroscopy occupies one of the most important places in diagnostic studies of gynecology. This endoscopic method became mandatory in gynecological departments. Many people are interested in the question: on what day of the cycle is hysteroscopy done?

Hysteroscopy is a visual inspection of the uterine cavity by a special optical system. With diagnostic hysteroscopy, the uterine cavity is inspected. When surgical, small operations are possible with an endometrial disorder. To control the surgical or conservative treatment, control hysteroscopy is indicated. The appearance of new devices for hysteroscopy allows us to examine not only the uterine cavity, but also to assess the condition of the vaginal epithelium, cervical canal, cervix, etc. Microhysteroscopes with an increase in x60 and x150 allow us to study the structure of cells, their nuclei and cytoplasm.

On which day of the cycle it is better to do hysteroscopy, will be described below.

How is it performed?

The best known systems are Hamou I and Hamou II. The first performs 4 x1, x20, x60 and x150 magnifications, the second x20 (for panoramic hysteroscopy) and x80 (for microhysteroscopy and surgical interventions with a 1-3 mm microtool).

For microhysteroscopy, it is sufficient to touch the distal end of the device to the area under study.

With contact hysteroscopy, the endometrial region with a diameter of 6-8 mm falls into the field of view, therefore, for a more complete picture, the hysteroscope is repeatedly moved into the uterine cavity.

An even clearer, more vivid picture can be obtained using a flexible fibrogysteroscope, with damage to the walls of the uterus minimal.

Another novelty is the operational hysteroresectoscope, it is an advanced rigid Hopkins apparatus, it allows performing electrosurgical procedures in the uterine cavity.

What is office hysteroscopy? On what day of the cycle do? About this - further.

Office hysteroscopy in Russia is not common. Mostly it is carried out in foreign clinics. This examination of the uterus using a thin tube-hysteroscope. It is conducted without special anesthesia in the doctor's office. Requires an extension of the cervical canal.

It differs from the usual one in that it does not involve therapeutic manipulation.

Hysteroscopy is divided, depending on the time of the conduct, on preoperative or postoperative, emergency or planned. Sometimes for greater efficiency this procedure is combined with laparoscopy.

When working with television systems, it is preferable to use cold light sources. Currently, xenon lamps from 150 to 300 W are common.

The electronic supply of CO _{2 is} carried out by hysterosusufulyatorami. Gas insufflation allows you to dose and control the pressure and speed of gas supply.

The introduction of liquid media is carried out using air pumps. The adjustment of the supply of liquids occurs in an automatic mode, it can be intermittent and continuous.

Endoscopy rooms are equipped with modern television systems that meet the requirements of endoscopic surgery.

An easy and compact camera transmits the image to the monitor, which allows you to archive the results of the hysteroscopic examination, and then compare the results. Use for demonstration and training of specialists.

With the advent of television hysteroscopy, the doctor's work has reached a new level, the face of the gynecologist has been removed from the woman's sexual slit, the load on the eyes has been reduced many times, which facilitates the implementation of intra-uterine manipulation. On what day of the menstrual cycle make hysteroscopy, is of great importance.

Often the use of a laser during intrauterine operations. In this case, laser fibers are inserted into the cavity through the operating channel, in contact with the dissected surface, the partitions are removed and endometrium is destroyed.

For hysteroscopy, doctors stretch the uterine cavity, which allows you to better examine its walls. When stretching, gas or liquids can be used. Carbon dioxide, high-molecular and low-molecular media (saline, manitol, sterile water), which are constantly used to stretch the uterine cavity. Most importantly, the environment provides a good visual inspection, sufficient intrauterine pressure to increase the uterus and does not cause an infectious process. Therefore it is important, on what day of the cycle do hysteroscopy.

Absolute indications for hysteroscopy

The absolute include: polyps of the endometrium, infertility, suspicion of endometrial and cervical cancer, vesicoureteral fistula and suspicion of it, the remains of bone tissue, the presence of a foreign body, the perforation of the walls of the uterus, the broken menstrual cycle, internal endometriosis, clarification Places where the intrauterine contraceptive is located, uterine fibroids, clarification of the development of uterine malformation, suspected intrauterine synechia, contact bleeding, endometrial hyperplasia, metro- and menorrhagia.

From these indications, it directly depends on what cycle day hysteroscopy of the uterus is made.

Relative readings

• Postoperative condition.
• After a bubble drift.
• When miscarriage occurs.
• After hormonal treatment for the purpose of control.

Contraindications

Hysteroscopy is contraindicated in patients with acute and subacute inflammation of the genitalia, with abundant uterine bleeding, pregnant women, women with stenosis of the cervix, cervical cancer.

On what day of the cycle do hysteroscopy for various diseases?

Depending on the indications, the time of the study is selected. If a woman is suspected of adenomyosis or submucous myoma, the study is performed on the sixth-ninth day of the menstrual cycle. To determine the functionality of the endometrium, for example, with hyperplasia or infertility, hysteroscopy is carried out in the second phase of the cycle.

Technique of research

5% iodine solution, alcohol or "Iodonate" treat the inner thighs and the inner organs of the external organs. The cervix is exposed with vaginal mirrors and treated with alcohol. They lower the front lip of the cervix, probe the uterine cavity and mark its length along the probe. Sequentially expanded Geiger expand the cervical canal to ensure free outflow from the uterine cavity. Rapid removal of blood is achieved by constant rinsing. The hysteroscope is connected to a sterile fluid delivery system and a light source, and then through the cervical canal it is inserted into the uterine cavity. To begin with, a general overview is given, attention is drawn to the shape and size of the uterine cavity, the state of the endometrium (vascular pattern, color, thickness, folding), the relief of its walls, the condition and accessibility of the uterine tubes. The region of the uterine fundus, the cervical canal, the isthmic department and the side walls are inspected, moving further the hysteroscope. The inspection is performed clockwise.

Women are often interested in what day of the menstrual cycle they make hysteroscopy. About this - below.

In the expansion of the cervical canal is not necessary for fibrogysteroscopy, since the working part of the fibrogysteroscope has a diagnostic diameter of 3.6 millimeters. Movement in the uterine cavity of the working part of the apparatus is carried out by rotating the distal section of the hysteroscope.

About transactions

Surgical operations in the uterine cavity are desirable to be carried out in the first phase of the cycle, when enough thinning of the endometrium, which will not prevent examination.

Operations available for hysteroscopy:

• Ablation of the endometrium hysteroscopic;
• Polypectomy;
• cryosurgery;
• Sterilization hysteroscopic;
• Myomectomy;
• Intrauterine septum resection;
• Removal of foreign bodies and IUD;
• Intrauterine synechiasis dissection;
• Removal of remains of bone fragments;
• Tubing catheterization.

Patients who underwent diagnostic hysteroscopy do not need special observation. Uterotonics and painkillers are rarely prescribed. In the case of finding a patient at risk for the occurrence of purulent-septic complications, antibiotics are prescribed. On what day of the cycle it is possible to do hysteroscopy, we will analyze at the end of the article.

Recommendations after surgical hysteroscopy

Antibacterial therapy for preventive purposes is prescribed after surgical hysteroscopy ("Gentamicin" intramuscularly at 80 mg twice a day). Antibiotic therapy is combined with preparations of metronidazole ("Trichopolum" 1 tablet 3 times a day).

In the first day after hysteroscopy, bloody discharge is observed from the genital tract, in the future they cease. To accelerate uterine contractions, designate "Oxytocin" 1 ml IM twice a day and hemostatic "Vikasol" or "Dicinon" according to 1 table. 3 times a day.

For analgesia after surgery, non-narcotic analgesics are prescribed: Analgin, Baralgin, Maxigan.

Advantages of hysteroscopy

1. With this method of examination, it becomes possible to establish the nature of intrauterine pathology.

2. This is the only method that makes it possible to examine the cervical canal, the uterine cavity and the isthmic department.

3. Replaces laparotomic access to the uterus with hysteroscopic.

4. Allows you to visually monitor ongoing operations.

5. This is a simple, low-traumatic and highly informative method.

6. Easily tolerated by patients.

7. Stay in the hospital is reduced.

On what day of the cycle are hysteroscopy planned?

It depends on what kind of hysteroscopy is planned. If planned, then everything will depend on the physiological characteristics of women. Most often, the follicular phase of the menstrual cycle is more informative, when the endometrium has only begun to recover after rejection. It is thin in this period, so the uterine cavity is clearly visible. So hysteroscopy is most often performed on the 7-9th day from the beginning of menstruation.

On which day of the cycle should I do emergency hysteroscopy?

With an emergency hysteroscopy, the day of the cycle does not matter. But with monthly informative content is significantly reduced, so it's better to refrain from research during this period.