Today hysteroscopy is one of the most important places in the diagnostic research of gynecology. This endoscopic method has become mandatory in gynecological departments. Many are interested in the question: on what day of the cycle do hysteroscopy?
Hysteroscopy is a visual examination of the uterine cavity with a special optical system. With diagnostic hysteroscopy, an examination of the uterine cavity is performed. In surgery, small operations with endometrial disorders are available. To control surgical or conservative treatment, a control hysteroscopy is indicated. The appearance of new devices for hysteroscopy allows you to examine not only the uterine cavity, but also evaluate the condition of the vaginal epithelium, cervical canal, cervix, etc. Microhysteroscopes with magnification x60 and x150 allow studying the structure of cells, their nucleus, and cytoplasm.
On which day of the cycle it is better to do hysteroscopy, will be described below.
How is it done?
The most famous optical systems are Hamou I and Hamou II. The first carries 4 increases x1, x20, x60 and x150, the second x20 (for panoramic hysteroscopy) and x80 (for microhysteroscopy and surgical interventions with a 1-3 mm micro-tool).
For microhysteroscopy, touching the area under study with the distal end of the apparatus is sufficient.
With contact hysteroscopy, the endometrial area with a diameter of 6-8 mm enters the field of view, therefore, for a more complete picture, the hysteroscope is repeatedly moved to the uterine cavity.
An even clearer, vivid picture can be obtained using a flexible fibrohysteroscope, while the damage to the walls of the uterus is minimal.
Another novelty is the surgical hysteroresectoscope, this is Hopkins’s advanced rigid apparatus, it allows for electrosurgical procedures in the uterine cavity.
What is office hysteroscopy? What day of the cycle do? More on this later.
Office hysteroscopy in Russia is not common. It is mainly carried out in foreign clinics. This is an examination of the uterus using a thin tube-hysteroscope. It is carried out without special anesthesia in the doctor’s office. Requires expansion of the cervical canal.
It differs from the usual one in that it does not involve medical manipulations.
Hysteroscopy is divided, depending on the time, into preoperative or postoperative, emergency or planned. Sometimes, for greater effectiveness, this procedure is combined with laparoscopy.
When working with television systems, it is preferable to use sources of cold lighting. Currently, xenon lamps from 150 to 300 watts are common.
Electronic supply of CO 2 is carried out by hysteroinsulators. Gas insufflation allows metering and controlling the pressure and gas flow rate.
The introduction of liquid media is carried out using air pumps. The adjustment of the fluid flow is automatic, it can be intermittent and continuous.
Endoscopic rooms are equipped with modern television systems that satisfy the requirements of endoscopic surgery.
A light and small-sized camera transmits the image to the monitor, which allows you to archive the results of a hysteroscopic examination, and then compare the results. Use for demonstration and training of specialists.
With the advent of television hysteroscopy, the doctor’s work has reached a new level, the gynecologist’s face is removed from the woman’s sexual gap, the eye strain has been reduced by several times, which facilitates the implementation of intrauterine procedures. On what day of the menstruation cycle do hysteroscopy is of great importance.
Often the use of a laser during intrauterine operations. In this case, laser fibers are introduced into the cavity through the operating channel, in contact with the dissected surface, the septa are removed and the endometrium is destroyed.
For hysteroscopy, doctors stretch the uterine cavity, which allows you to better examine its walls. When stretched, gas or liquids may be used. Carbon dioxide, high molecular and low molecular weight media (saline, mannitol, sterile water), which are constantly used to stretch the uterine cavity. The most important thing is that the environment provides a good visual examination, sufficient intrauterine pressure to enlarge the uterus and not cause an infectious process. Therefore, it is important on which day of the cycle hysteroscopy is done.
Absolute indications for hysteroscopy
The absolute ones include: endometrial polyps, infertility, suspected cancer of the endometrium and cervix uteri, cystic-uterine fistula and suspicion of it, residues of fetal bone tissue, presence of a foreign body, perforation of the walls of the uterus, irregular menstrual cycle, internal endometriosis, clarification places where the intrauterine contraceptive is located, uterine fibroids, clarification of the nature of the development of uterine defect, suspected intrauterine synechia, contact bleeding, endometrial hyperplasia, metro and menorrhagia.
From these indications directly depends on which day of the cycle hysteroscopy of the uterus is done.
Relative indications
- Postoperative condition.
- After cystic drift.
- With miscarriage.
- After hormonal treatment to control.
Contraindications
Hysteroscopy is contraindicated in patients with acute and subacute inflammation of the genital organs, with profuse uterine bleeding, pregnant women, women with cervical stenosis, cervical cancer.
On what day of the cycle do hysteroscopy for various diseases?
Depending on the indications, the time of the study is also selected. If a woman suspects adenomyosis or submucous myoma, the study is carried out on the sixth to ninth day of the menstrual cycle. To determine the functionality of the endometrium, for example, with hyperplasia or infertility, hysteroscopy is performed in the second phase of the cycle.
Research Technique
A 5% solution of iodine, alcohol or "Iodonate" treats the surface of the thighs internally and the genitals are external. The cervix is exposed using vaginal mirrors and treated with alcohol. The anterior lip of the cervix is produced, the uterine cavity is probed and its length along the probe is noted. Successively with Heger's dilators, the cervical canal is dilated to provide free outflow of fluid from the uterine cavity. Rapid removal of blood is achieved by constant washing. The hysteroscope is connected to a sterile fluid supply system and a light source, and then through the cervical canal it is inserted into the uterine cavity. To begin with, a general review is carried out, 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 condition and accessibility of the mouths of the fallopian tubes. The area of the uterine fundus, cervical canal, isthmic section and side walls are examined, moving the hysteroscope further. Inspection is carried out clockwise.
Women are often interested on what day of the menstrual cycle do hysteroscopy. About this - below.
In the expansion of the cervical canal there is no need for fibrohysteroscopy, since the diameter of the working part of the fibrohysteroscope is 3.6 mm. The movement in the uterine cavity of the working part of the apparatus is carried out by rotating the distal hysteroscope.
About operations
Surgical operations in the uterine cavity are preferably performed in the first phase of the cycle, when the endometrium is thin enough, which will not interfere with the examination.
Operations available with hysteroscopy:
- hysteroscopic endometrial ablation;
- polypectomy;
- cryosurgery;
- hysteroscopic sterilization;
- myomectomy;
- intrauterine septum resection;
- removal of foreign bodies and IUD;
- intrauterine synechia dissection;
- removal of bone fragments residues;
- tube catheterization.
Patients who have undergone diagnostic hysteroscopy 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 which day of the cycle you can do hysteroscopy, we will analyze at the end of the article.
Recommendations after surgical hysteroscopy
Antibacterial therapy for prophylactic purposes is prescribed after surgical hysteroscopy ("Gentamicin" intramuscularly at 80 mg twice a day). Antibacterial therapy is combined with metronidazole preparations (Trichopolum, 1 tablet 3 times a day).
On the first day after hysteroscopy, bleeding is observed from the genital tract, and then they stop. To accelerate uterine contractions, “Oxytocin” is prescribed 1 ml IM twice a day and hemostatic “Vikasol” or “Dicinon”, 1 tablet each. 3 times a day.
For anesthesia after surgery, non-narcotic analgesics are prescribed: "Analgin", "Baralgin", "Maxigan".
The benefits of hysteroscopy
1. With this examination method, it becomes possible to establish the nature of the intrauterine pathology.
2. This is the only method that makes it possible to examine the cervical canal, uterine cavity and isthmic section.
3. Replaces laparotomic access to the uterus with hysteroscopic ones.
4. Allows you to visually monitor ongoing operations.
5. This is a simple, less traumatic and highly informative method.
6. Easily tolerated by patients.
7. Hospital stay is declining.
On what day of the cycle do hysteroscopy be planned?
It depends on what kind of hysteroscopy is planned. 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 only began to recover after rejection. It is thin during this period, so the uterine cavity is clearly visible. So hysteroscopy is most often performed on the 7th-9th day from the onset of menstruation.
On which day of the cycle do I need to do emergency hysteroscopy?
In an emergency version of hysteroscopy, the day of the cycle does not matter. But with menstruation, information content is significantly reduced, so it’s better to still refrain from research during this period.