Hysteroscopy (HSK) refers to the endoscopic examination of the uterine cavity.
Hysteroscopy is used diagnostically, for example, to clarify any pathological findings in the case of bleeding disorders (cycle disorders), conspicuous ultrasound findings and suspected malformations. Therapeutically, polyps, myomas (benign muscular growths) or other changes can be biopsied (sampling of tissue for further examination) or removed.
Indications (areas of application)
- Investigation of causes of infertility suspected in the uterus, such as synechiae (adhesions), polyps, or anomalies – malformations such as a chambered uterus; this leads to an increased risk of abortions (miscarriages)
- Myomas (myoma uteri) – benign growths that form on or in the uterine wall and can cause disruption of nidation (implantation of the egg)
- Removal of an IUD (intrauterine device; coil), which was no longer detectable from the outside.
- For tumor diagnosis in suspected otherwise undetectable endometrial carcinoma (carcinoma of the endometrium).
- For clarification of vaginal bleeding
- Chorionic villus sampling (synonyms: chorionic biopsy; villus skin test; placenta puncture or also placentapuncture) – procedure of prenatal diagnostics (prenatal diagnostics); removal and examination of cells of the villus skin (throphoblast cells) for karyotyping/chromosome analysis.
- Transcervical tubal sterilization – method of sterilizing a woman by closing both fallopian tubes (tubes) i.e. the connection between the uterus (womb) and ovary (ovary); this method uses the vagina as an access route
Contraindications
- Inflammation of the internal genitals
- Pregnancy
- Heavy uterine bleeding (from the uterus).
The surgical procedure
During hysteroscopy, an endoscope equipped with a light source (called a hysteroscope) is inserted into the cavum uteri (uterine cavity) through the vagina (vagina). To obtain a better view, the cavum uteri, which is not unfolded in its normal state, is “inflated” or expanded and unfolded with carbon dioxide or, more frequently, with a special irrigation fluid. This examination is usually performed under general anesthesia or, less commonly, under local anesthesia (local anesthetic).
Possible complications
- Perforation (piercing) of the uterus (uterine wall) to the abdominal cavity or into the parametria (pelvic connective tissue) is very rare; injury to the bowel and bladder is also very rare.
- Severe bleeding or postpartum hemorrhage is rare.
- Carryover of inflammatory processes (infections) is possible but rare. This may cause permanent damage or adhesions to the cervix, cervical canal, uterine cavity or fallopian tubes.
- Possibility of carryover of tumor cells is discussed.
- Urinary tract infections after hysteroscopy are rare.
- Hypersensitivity or allergies (e.g., anesthetics/anesthetics, dyes, medications, etc.) may temporarily cause the following symptoms: Swelling, rash, itching, sneezing, watery eyes, dizziness or vomiting.
- The occurrence of a thrombus (blood clot) in the large veins, which can be carried away and block a blood vessel (embolism) is possible, but rare.
- Infections resulting in severe life-threatening complications in the area of vital functions (e.g., heart, circulation, respiration), permanent damage (e.g., paralysis), and life-threatening complications (e.g., sepsis/blood poisoning) are very rare.