Hysteroscopy – wikipedia

A hysteroscope is an endoscope that carries optical and light channels or fibers. Endometrial biopsy recovery It is introduced in a sheath that provides an inflow and outflow channel for insufflation of the uterine cavity. Endometrial biopsy video In addition, an operative channel may be present to introduce scissors, graspers or biopsy instruments.

Pain after endometrial biopsy [1] A hysteroscopic resectoscope is similar to a transurethral resectoscope and allows entry of an electric loop to shave off tissue, for instance to eliminate a fibroid. Cervical biopsy recovery [1] [2] A contact hysteroscope is a hysteroscope that does not use distention media. Endometrial biopsy complications Procedure [ edit ]

Hysteroscopy has been done in the hospital, surgical centers and the office. Hysteroscopy endometrial biopsy It is best done when the endometrium is relatively thin, that is after a menstruation. Breast biopsy recovery time Diagnostic can easily be done in an office or clinic setting on suitably selected patients. Endometrial biopsy ivf Local anesthesia can be used. Endometrial biopsy pain Simple operative hysteroscopy can also be done in an office or clinic setting. Breast biopsy recovery Analgesics are not always necessary. Endometrial biopsy results time frame [3] A paracervical block may be used using a Lidocaine injection in the upper part of the cervix. Endometrial biopsy results interpretation The patient is in a lithotomy position during the procedure. Endometrial biopsy results Hysteroscopic intervention can also be done under general anesthesia (endotracheal or laryngeal mask) or Monitored Anesthesia Care (MAC). Bleeding after endometrial biopsy Prophylactic antibiotics are not necessary. What is endometrial biopsy [3] Cervical dilation [ edit ]

The diameter of the hysteroscope is generally too large to conveniently pass the cervix directly, thereby necessitating cervical dilation to be performed prior to insertion. Endometrial biopsy results how long Cervical dilation can be performed by temporarily stretching the cervix with a series of dilators of increasing diameter. What is an endometrial biopsy [4] Misoprostol prior to hysteroscopy for cervical dilation appears to facilitate an easier and uncomplicated procedure only in premenopausal women. Biopsy endometrial [5] Insertion and inspection [ edit ]

The hysteroscope with its sheath is inserted transvaginally guided into the uterine cavity, the cavity insufflated, and an inspection is performed. Skin biopsy results time Insufflation media [ edit ]

The uterine cavity is a potential cavity and needs to be distended to allow for inspection. Pipelle endometrial biopsy Thus during hysteroscopy either fluids or CO 2 gas is introduced to expand the cavity. Endometrial biopsy procedure The choice is dependent on the procedure, the patient’s condition, and the physician’s preference. Endometrial biopsy side effects Fluids can be used for both diagnostic and operative procedures. Liver biopsy recovery time However, CO 2 gas does not allow the clearing of blood and endometrial debris during the procedure, which could make the imaging visualization difficult. Abnormal endometrial biopsy results Gas embolism may also arise as a complication. Endometrial biopsy recovery Since the success of the procedure is totally depending on the quality of the high-resolution video images in front of surgeon’s eyes, CO 2 gas is not commonly used as the distention medium.

Electrolytic solutions include normal saline and lactated Ringer’s solution. Endometrial biopsy video Current recommendation is to use the electrolytic fluids in diagnostic cases, and in operative cases in which mechanical, laser, or bipolar energy is used. Pain after endometrial biopsy Since they conduct electricity, these fluids should not be used with monopolar electrosurgical devices. Cervical biopsy recovery Non-electrolytic fluids eliminate problems with electrical conductivity, but can increase the risk of hyponatremia. Endometrial biopsy complications These solutions include glucose, glycine, dextran (Hyskon), mannitol, sorbitol and a mannitol/sorbital mixture (Purisol). Hysteroscopy endometrial biopsy Water was once used routinely, however, problems with water intoxication and hemolysis discontinued its use by 1990. Breast biopsy recovery time Each of these distention fluids is associated with unique physiological changes that should be considered when selecting a distention fluid. Endometrial biopsy ivf Glucose is contraindicated in patients with glucose intolerance. Endometrial biopsy pain Sorbitol metabolizes to fructose in the liver and is contraindicated if a patient has fructose malabsorption.

High-viscous Dextran also has potential complications which can be physiological and mechanical. Breast biopsy recovery It may crystallize on instruments and obstruct the valves and channels. Endometrial biopsy results time frame Coagulation abnormalities and adult respiratory distress syndrome (ARDS) have been reported. Endometrial biopsy results interpretation Glycine metabolizes into ammonia and can cross the blood brain barrier, causing agitation, vomiting and coma. Endometrial biopsy results Mannitol 5% should be used instead of glycine or sorbitol when using monopolar electrosurgical devices. Bleeding after endometrial biopsy Mannitol 5% has a diuretic effect and can also cause hypotension and circulatory collapse. What is endometrial biopsy The mannitol/sorbitol mixture (Purisol) should be avoided in patients with fructose malabsorption.

When fluids are used to distend the cavity, care should be taken to record its use (inflow and outflow) to prevent fluid overload and intoxication of the patient. Endometrial biopsy results how long [6] Interventional procedures [ edit ]

If abnormalities are found, an operative hysteroscope with a channel to allow specialized instruments to enter the cavity is used to perform the surgery. What is an endometrial biopsy Typical procedures include endometrial ablation, submucosal fibroid resection, and endometrial polypectomy. Biopsy endometrial Hysteroscopy has also been used to apply the Nd:YAG laser treatment to the inside of the uterus. Skin biopsy results time [7] Methods of tissue removal now include electrocautery bipolar loop resection, and morcellation. Pipelle endometrial biopsy [8] Indications [ edit ]

• Asherman’s syndrome (i.e. Endometrial biopsy procedure intrauterine adhesions). Endometrial biopsy side effects Hysteroscopic adhesiolysis is the technique of lysing adhesions in the uterus using either microscissors (recommended) or thermal energy modalities. Liver biopsy recovery time Hysteroscopy can be used in conjunction with laparascopy or other methods to reduce the risk of perforation during the procedure. Abnormal endometrial biopsy results [9]

Hysteroscopy has the benefit of allowing direct visualization of the uterus, thereby avoiding or reducing iatrogenic trauma to delicate reproductive tissue which may result in Asherman’s syndrome.

Hysteroscopy allows access to the utero-tubal junction for entry into the Fallopian tube; this is useful for tubal occlusion procedures for sterilization and for falloposcopy. Endometrial biopsy recovery Complications [ edit ]

A possible problem is uterine perforation when either the hysteroscope itself or one of its operative instruments breaches the wall of the uterus. Endometrial biopsy video This can lead to bleeding and damage to other organs. Pain after endometrial biopsy If other organs such as bowel are injured during a perforation, the resulting peritonitis can be fatal. Cervical biopsy recovery Furthermore, cervical laceration, intrauterine infection (especially in prolonged procedures), electrical and laser injuries, and complications caused by the distention media can be encountered.

The use of insufflation (also called distending) media can lead to serious and even fatal complications due to embolism or fluid overload with electrolyte imbalances. Endometrial biopsy complications [1] [6] Particularly the electrolyte-free insufflation media increase the risk of fluid overload with electrolyte imbalances, particularly hyponatremia, heart failure as well as pulmonary and cerebral edema. Hysteroscopy endometrial biopsy The main factors contributing to fluid overload in hysteroscopy are: [13]

The overall complication rate for diagnostic and operative hysteroscopy was 2% with serious complications occurring in less than 1% of cases using older methods. Breast biopsy recovery time [1] Morcellation has fewer complications than electrocautery, less than 0.1%. Endometrial biopsy ivf [14] [15]

The English Member of Parliament, Lyn Brown (West Ham, Labour), has spoken twice in the House of Commons on behalf of constituents who have been coerced into completing unbearably painful outpatient hysteroscopies without anaesthesia. Endometrial biopsy pain Lyn Brown cites numerous instances of women throughout England being held down by nurses in order to complete an ambulatory hysteroscopy and thus avoid the expense of safely monitored sedation or general anaesthetic. Breast biopsy recovery [16] See also [ edit ]