To date, hysteroscopy takes onefrom 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 examinationthe uterine cavity with 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 epithelium of the vagina, the cervical canal, the 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.
The most well-known optical systems are Hamou I andHamou 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 endometrium area with a diameter of 6-8 mm falls into the field of vision, therefore, for a more complete picture, the hysteroscope is repeatedly moved into the uterine cavity.
An even clearer, vivid picture can be obtained by applying a flexible fibrogysteroscope, with damage to the walls of the uterus minimal.
Another novelty is the operational hysteroresectoscope, this 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 is an examination of the uterus with 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. At present, xenon lamps from 150 to 300 W are common.
Electronic feed of CO2 is carried out by hysterossors. Insufflation of gas 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 takes place in an automatic mode, it can be intermittent and continuous.
Endoscopic cabinets are equipped with modern television systems that meet the requirements of endoscopic surgery.
Easy and compact camera transmitsimage on the monitor, which allows you to archive the results of a hysteroscopic study, and then compare the results. Use for demonstration and training of specialists.
With the advent of television hysteroscopy workthe doctor has reached a new level, the face of the gynecologist is removed from the woman's sexual slit, the load on the eyes is 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 laserintrauterine operations. In this case, laser light guides are introduced into the cavity through the operating channel, in contact with the dissected surface, the partitions are removed and endometrium is destroyed.
For hysteroscopy, doctors stretchthe cavity of the uterus, 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.
The absolute are:polyps of the endometrium, infertility, suspicion of endometrial and cervical cancer, vesicoureteral fistula and suspicion of it, on the remains of bone tissue, on the presence of a foreign body, on the perforation of the uterine walls, broken menstrual cycle, internal endometriosis, contraceptive intrauterine, uterine fibroids, clarification of the development of uterine malformation, suspected intrauterine synechia, contact bleeding, endometrial hyperplasia, metro- and menorrhagia.
From these indications directly depends on what day of the cycle do hysteroscopy of the uterus.
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 readings, the time is selectedresearch. If a woman is suspected of adenomyosis or submucous myoma, the study is conducted 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.
5% iodine solution, alcohol or "Iodonate"the internal surface of the thighs and the external genital organs are treated. 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 expanders of Geiger cervical canal is expanded to provide 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 state and accessibility of the uterine tubes. The area 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 often wonder what day of the menstrual cycle they make hysteroscopy. About this - below.
В расширении цервикального канала нет the need for fibrogysteroscopy, since the working part of the fibrogysteroscope diagnostic diameter is 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.
Surgical operations in the uterine cavity are desirable to be carried out in the first phase of the cycle, when enough of the endometrium is thin, which does not prevent examination.
Operations available for hysteroscopy:
Patients who have undergone diagnostichysteroscopy, do not need special supervision. Uterotonics and painkillers are prescribed extremely rarely. If the patient is at risk for the occurrence of purulent-septic complications, antibiotics are prescribed. On what day of the cycle, you can do hysteroscopy, we analyze at the end of the article.
Antibiotic therapy with prophylacticthe target is prescribed after surgical hysteroscopy (Gentamicin intramuscularly in doses of 80 mg twice a day). Antibacterial therapy is combined with metronidazole preparations (“Trichopol” on table 1, 3 times a day).
On the first day after hysteroscopy are observed fromgenital tract bleeding, they further cease. To accelerate uterine contractions prescribed "Oxytocin" 1 ml / m twice a day and hemostatic "Vikasol" or "Ditsinon" 1 tab. 3 times a day.
Non-narcotic analgesics are prescribed for anesthesia after surgery: Analgin, Baralgin, Maksigan.
1. With this method of examination it becomes possible to establish the nature of intrauterine pathology.
2. This is the only method that enables inspection of the cervical canal, uterine cavity and the isthmic department.
3. Replaces laparotomic access to the uterus with hysteroscopic.
4. Allows you to visually monitor the operations.
5. This is a simple, low-impact and highly informative method.
6. Easily tolerated by patients.
7. Hospital stay is shortened.
It depends on what kind of hysteroscopyplanned If planned, then everything will depend on the physiological characteristics of the woman. Most often, the follicular phase of the menstrual cycle is more informative, when the endometrium has just begun to recover after rejection. It is thin during this period, so the uterine cavity is clearly visible. So hysteroscopy is most often carried out on the 7-9th day from the start of menstruation.
In case of emergency hysteroscopy, the day of the cycle does not matter. But with monthly informational content significantly reduced, so it is better to refrain from research in this period.
