What are the risks?

Endometriosis is a low-risk procedure. However, like any medical procedure, the examination can bring about possible complications. Patients often experience abdominal pain for several days after the endoscopy, which is similar in intensity to menstrual pain.

Spotting is particularly common in therapeutic uterine endoscopies and usually lasts for a few days. There is also a risk of infection of the uterus, fallopian tubes and ovaries due to germs carried over during the procedure. For this reason, the doctor should be consulted after a uterine endoscopy if the pain or fever is unclear.

In addition, perforation, i.e. breaking through and injury to the uterus by the instruments used, with subsequent bleeding into the abdominal cavity, can occur. Depending on the extent of the bleeding, it may be necessary to stop the bleeding surgically. In mild cases, a close monitoring of the patient’s vital parameters is sufficient.

An extremely rare complication of the procedure is the emergency removal of the uterus if it has been severely injured and is bleeding uncontrollably. In rare cases the use of blood preserves is necessary. Another rare scenario is the accumulation of water in the lungs after endoscopy, which is caused by the excessive use of irrigation fluids in the uterus.

Is uterine endoscopy possible during pregnancy?

Endometriosis is relatively contraindicated during an intact pregnancy, i.e. it should not be performed. However, in urgent, exceptional cases, endoscopy is possible. It is not recommended because of the danger to the fetus from the medical instruments introduced. If the pregnancy is no longer intact and the fetus has not come off on its own, or if parts of the fetus or placenta (placenta) have remained in the uterus, a miscarriage curettage is performed, i.e. a scraping of the remaining fetus. This procedure can be viewed hysteroscopically or checked for completeness by ultrasound.

Should a uterus endoscopy be performed before artificial insemination?

In patients who are suspected of having possible limitations in the ability of the uterus to implant the implantation device, it is recommended that a diagnostic uterine endoscopy be performed before a planned artificial insemination (in vitro fertilization (IVF)). This allows possible obstacles to embryonic implantation, such as fibroids, polyps, etc., to be detected and then treated. In this way, the implantation conditions can be optimized and the success rate of IVF can be increased. Furthermore, the individual condition of the uterine cavity and thus the best area for the later embryo transfer can be determined by means of endoscopy.