Definition
Cervical endoscopy, medical hysteroscopy, is a diagnostic procedure in which the cervix, uterus and fallopian tubes are viewed and evaluated. For this purpose, an optical instrument is inserted through the vagina via the cervix into the cervix and further into the uterine cavity, delivering images to a monitor, which the examiner evaluates. On the other hand, uterine endoscopy also represents a therapeutic procedure, whereby surgical interventions on the uterus can be performed if necessary. For this purpose, in addition to the optics, further instruments are inserted into the uterus after dilation of the cervix.
When is a hysteroscopy performed?
For uterine endoscopy (hysteroscopy) there can be diagnostic as well as therapeutic indications. Diagnostic objectives are pursued, for example, when abnormal ultrasound findings are present and these need to be clarified more precisely by hysteroscopy. Other reasons for this examination may be: If malignant changes are suspected, the principle of fractional abrasion can be applied, i.e. the separate scraping of the uterine cavity and cervix in order to be able to process the samples separately for histological examinations.
Hysteroscopy often allows an assessment of underlying symptoms and enables a better diagnosis to be made. Among the therapeutic indications are In addition, after a miscarriage, the uterine cavity is scraped out during hysteroscopy in order to dissolve any residual fruit and prevent infection. In general, we try not to perform uterine endoscopy during menstruation, but in urgent cases, for example, the uterus can be scraped out during menstruation.
- An unfulfilled desire to have children
- Bleeding disorders or irregularities
- Polyps
- Myomas of the uterine cavity
- The ablation of myomas or polyps
- The loosening of adhesions or adhesions of the uterine mucosa (synechia)
- The removal of the mucosa (endometrial resection/ablation) in case of heavy bleeding
Can this be done without anesthesia?
In diagnostic uterine endoscopies, general anesthesia is not necessary. Although the examination can be unpleasant, the pain is usually mild and limited. If desired, local anesthesia is performed.
If the patient wishes, she can even follow the diagnostic uterine endoscopy on a monitor at some doctors. In contrast, therapeutic operative uterine endoscopies require anesthesia in any case. The pain would in any case be too great if the patient were conscious and the procedure would not be feasible due to physical defensive tension. In rare cases, epidural (PDA) or spinal anaesthesia are also options for pain reduction during uterine endoscopy.
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