Diagnostic hysteroscopy is a method applied to diagnose pathologies such as polyps, fibroids, adhesions, and septum.
This method allows the inside of the uterus to be observed by examining the inner layer of the uterus after filling the uterus with an optical instrument with a cold light source, and allows intrauterine operations to be performed with the help of small instruments.
Hysteroscopy method is used in the detection and treatment of recurrent miscarriages, abnormal menstrual bleeding and all intrauterine pathologies.
There are two types of this method.
These two types are called Diagnostic (Diagnostic) Hysteroscopy and Operative (Surgical) Hysteroscopy.
At this stage, it is necessary to give the details of the methods by answering the question What is Diagnostic and Operative Hysteroscopy.
What is Diagnostic Hysteroscopy?
Diagnostic hysteroscopy, most commonly known as "Office Hysteroscopy", is performed with the aim of examining the inside of the uterus. Because it is applicable during the examination, it is more commonly called office hysteroscopy. Diagnostic hysteroscopy is performed through a lighted optical system called a telescope, as in the laparoscopy method. However, the diameter of this system is quite thin. The diameter of the systems used for diagnostic purposes is 5 mm on average. Intervention is performed without enlarging the cervix, that is, dilatation. This procedure is performed in the gynecological examination position.
What is Diagnostic and Operative Hysteroscopy?
In diagnostic hysteroscopy, some special fluids are given through the cervix. Thus, the uterine walls are separated from each other during the procedure. After the liquid filling, the structures in the enlarged uterus can be directly visualized by the hysteroscopy method. Thus, all intrauterine pathologies can be easily evaluated.
Diagnostic hysteroscopy is usually performed without the need for anesthesia. This method, which is performed without the need for local anesthesia and hospitalization, is performed in a certain period. It is usually performed a few days after the menstrual bleeding ends, so that the inside of the uterus can be evaluated more clearly and easily. During this period, the entire uterus is suitable for detailed examination, both structurally and functionally.
All intrauterine pathologies such as uterine fibroids, polyps and adhesions can be detected directly through diagnostic, that is, office hysteroscopy. After hysteroscopy, the diagnosis is made and appropriate methods and preparations for treatment are started if necessary.
What is Operative (Surgical) Hysteroscopy?
Many abnormalities diagnosed during diagnostic hysteroscopy can be treated with "Operative (Surgical) Hysteroscopy", that is, surgically as the name suggests. In particular, polyps in the uterus (growing parts), septum (the part that causes the uterus to divide), adhesion (adhesion) and intrauterine fibroids can be treated surgically by this method.
What is Diagnostic and Operative Hysteroscopy?
At this point, where the subject is explained in detail, we can say that the instruments to be used in the operation are allowed to pass through the uterus through the channels in the hysteroscope used in hysteroscopy. Surgical instruments to be used during the procedure can easily pass through these channels in the hysteroscope. After the technique designed in this system, surgical intervention is started.
Adhesions, fibroids and polyps that can be seen in the uterus are treated during surgery, that is, operative hysteroscopy. If there is a congenital abnormality or if there is a septum dividing the uterus completely or partially, it is corrected by hysteroscopy. After this intervention, a special anti-adhesion gel is applied to the uterus in order to prevent the uterine walls from sticking together. After the end of the entire intervention, some hormone drugs and antibiotics are used and the risk of infection is minimized. In addition, hormonal drugs can provide a faster healing of the intrauterine membrane.
What Are the Risks of Diagnostic and Operative Hysteroscopy?
The complication rate of diagnostic hysteroscopy is quite low. This rate is the same in operative hysteroscopy. However, perforation of the uterus is the most common complication in both of these methods. The resulting holes usually heal on their own without the need for a surgical intervention. Other complications are caused by the fluids used at the beginning of the procedure and injected into the uterus to expand the uterus. These fluids can cause allergic reactions in patients. Complications due to these drugs, which have side effects such as decreased body temperature, blood coagulation problems, respiratory difficulties and fluid accumulation in the lungs, are rarely encountered in diagnostic and operative hysteroscopy.
Except for perforation of the uterus during the operative hysteroscopy procedure,
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