Hysteroresectoscopy

Some diseases of the uterus can be eliminated only surgically. Modern gynecology makes it possible to perform such interventions through the natural genital tract, without incisions on the anterior abdominal wall. For this purpose, hysteroresectoscopy is used — an endoscopic operation during which the doctor removes pathological formations in the uterine cavity. This approach makes it possible to reduce the traumatic nature of the intervention and shorten the recovery period.

At the Oxford Medical medical center, hysteroresectoscopy is performed by experienced gynecological surgeons using modern endoscopic equipment. You can make an appointment for a consultation by calling the contact center or through the online appointment form on the website.

Hysteroresectoscopy — is an endoscopic operation that is performed through the cervix without incisions on the anterior abdominal wall. For this purpose, a hysteroresectoscope is used — a thin endoscopic instrument with a video camera that transmits an enlarged image of the uterine cavity to a monitor and allows the doctor to perform the operation precisely. 

Unlike office hysteroscopy, which is performed for diagnostic purposes to examine the uterine cavity, hysteroresectoscopy is a therapeutic intervention. During the operation, polyps and myomatous nodes can be removed, intrauterine adhesions can be dissected, or other necessary therapeutic manipulations can be performed in the uterine cavity.

For certain indications, hysteroresectoscopy can be combined with other gynecological operations. For example, if pathological changes are detected not only in the uterine cavity but also in other pelvic organs, the doctor can simultaneously perform laparoscopy, hysteroscopy, and other necessary surgical interventions.

Such changes can cause heavy or irregular menstruation, abnormal uterine bleeding, pain, difficulties with conception, or failure to carry a pregnancy to term. In such cases, hysteroresectoscopy makes it possible to eliminate the detected pathology without open surgery.

Before performing hysteroresectoscopy, it is important to make sure that there are no conditions that may interfere with the safe performance of the operation. That is why, before the intervention, the patient undergoes a mandatory examination.

The main contraindications include:

• pregnancy;

• acute inflammatory diseases of the pelvic organs;

• acute infections of the vagina or cervix;

• severe blood clotting disorders.

If an acute inflammatory process or infection is detected during the examination, treatment is carried out first. After recovery, the doctor reassesses the possibility of performing hysteroresectoscopy.

Preparation for hysteroresectoscopy begins with a consultation with a gynecologist and a preoperative examination. Its purpose is — to confirm the diagnosis, determine the optimal time for the operation, and make sure that there are no contraindications to the intervention.

Usually, before hysteroresectoscopy, the following are prescribed:

• gynecological examination;

• ultrasound examination of the pelvic organs;

• general and biochemical blood tests;

• general urine test;

• coagulogram;

• tests for HIV, syphilis, and viral hepatitis B and C;

• electrocardiogram;

• consultation with an anesthesiologist.

Hysteroresectoscopy is usually performed in the first phase of the menstrual cycle — after menstruation has ended, when the endometrium has minimal thickness and the doctor can better assess the uterine cavity and perform the necessary intervention.

Since operative hysteroscopy is performed under intravenous anesthesia or general anesthesia, before the procedure it is necessary not to eat for 6–8 hours, and clear liquids — for at least 2 hours before the intervention.

Doctors at «Oxford Medical» recommend: inform the doctor in advance about all medications that you take regularly, especially anticoagulants, antiplatelet agents, and medications for the treatment of diabetes mellitus. If necessary, the doctor will adjust the regimen for taking them before the operation.

Hysteroresectoscopy is usually performed under sedation — medication-induced sleep. This is a less deep type of anesthesia than general anesthesia, so it is usually tolerated more easily and is associated with a lower risk of complications characteristic of deep anesthesia. If a more complex or prolonged intervention is planned, the anesthesiologist may recommend short-term intravenous general anesthesia. 

The main stages of the operation:

1. Access to the uterine cavity. Through the vagina and cervix, the doctor inserts a hysteroresectoscope — a thin endoscopic instrument with a video camera that transmits an enlarged image to a monitor.

2. Examination of the uterine cavity. The doctor assesses the location, size, and features of the detected pathology in order to determine the optimal extent of the intervention.

3. Performance of the operation. Depending on the diagnosis, a polyp or submucosal myomatous node is removed, intrauterine adhesions or a septum are dissected, or other necessary therapeutic manipulations are performed. 

4. Completion of the intervention. After a control examination of the uterine cavity, the hysteroresectoscope is carefully removed. Since the operation is performed without incisions, sutures are not required.

After the operation, the patient remains under the supervision of medical personnel until full recovery from anesthesia. If her condition is satisfactory and there are no complications, in most cases discharge is possible on the same day as the hysteroresectoscopy.

Doctors at «Oxford Medical» explain: the main advantage of hysteroresectoscopy is the possibility of simultaneously detecting and eliminating intrauterine pathology without incisions on the anterior abdominal wall. This makes it possible to reduce the traumatic nature of treatment, shorten the hospital stay, and return to the usual way of life more quickly.

Recovery after hysteroresectoscopy usually proceeds quickly. As early as the next day, most women can return to their usual daily activities. However, for a certain period of time, it is important to follow the doctor's recommendations to ensure complete healing of the tissues.

In the first days after the operation, mild pulling pain in the lower abdomen and moderate bloody discharge are possible. This is a normal reaction of the body to the intervention, which gradually passes.

Usually, after hysteroresectoscopy, it is recommended to:

• abstain from sexual intercourse for 2–4 weeks;

• not use tampons or menstrual cups until complete healing;

• not take a bath, visit a swimming pool, sauna, or bathhouse for 2–4 weeks;

• avoid intense physical activity and lifting objects weighing more than 5 kg for 1–2 weeks;

• come for a follow-up examination within the period determined by the doctor.

Doctors at «Oxford Medical» recommend: even if your well-being has improved quickly, do not rush to resume intense physical activity or sexual life. Following the recommendations during the postoperative period promotes successful tissue healing and helps reduce the risk of complications.

Surgical hysteroscopy belongs to minimally invasive operations and in most cases is well tolerated by patients. At «Oxford Medical», special attention is paid to the safety of the intervention: before the operation, each patient undergoes the necessary examination, and the intervention itself is performed by experienced gynecological surgeons using modern endoscopic equipment. This approach helps ensure high precision of the operation even in complex clinical cases.

Possible complications include:

• uterine bleeding;

• infection of the uterine cavity;

• perforation of the uterine wall;

• formation of intrauterine adhesions.

Most complications occur rarely, and their risk largely depends on the nature of the disease, the extent of the operation, and adherence to the doctor's recommendations in the postoperative period.

Doctors at «Oxford Medical» recommend: do not postpone contacting a doctor if pain increases after the operation, body temperature rises above 38 °C, bloody discharge becomes heavy, or an unpleasant odor of the discharge appears. Timely consultation makes it possible to quickly identify possible complications and begin the necessary treatment.

You can find out what the hysteroresectoscopy price is here. The final cost of treatment may differ, as it depends on the extent of the intervention, the type of anesthesia, the need for histological examination, and the duration of the hospital stay. The doctor can provide you with more detailed information regarding the cost of medical services during the consultation. To make an appointment, use the online appointment form on the website or call the contact center.

The information is for informational purposes and does not replace a doctor's consultation.

Sources:

• American College of Obstetricians and Gynecologists
• US National Library of Medicine
• Royal College of Obstetricians and Gynaecologists