TH

Office Hysteroscopy

Center : Women Health Center

Article by : Dr. Ong-Arj Bovornsakulvong

Office Hysteroscopy

Although the vaginal ultrasound is a highly effective method for diagnosing uterine abnormalities. But in case of suspicion of abnormality present in the uterine cavity, the endoscopic examination of the uterus using Hysteroscopy is the choice. It is a method that provides information on anomalies and general characteristics and is the best way to view the inside of the uterus. Which is considered modern technology that makes the diagnosis of uterine abnormalities more convenient, accurate, less painful, and safer.


What is a microscopic examination of the uterine cavity (Office Hysteroscopy)?

Is a method for examination using a small camera inserted through the cervix, which can show abnormalities in the uterus, through the display screen, in cases where the diagnosis cannot be made from the regular physical examination, history or Ultrasound and X-ray, like an abnormal menstrual period, presence of small polyps or tumors in the uterus, fibrosis, abnormalities of the shape of the uterus, vaginal bleeding during menopause and diagnosed with infertility, etc.


Advantages of uterine cavity examination with a small instrument (Office Hysteroscopy)

Examinations of the uterus can be done together with other methods, such as curettage or the use of a small tube to gather cells for examination, Wherein these methods cannot directly see the pathology of the uterine cavity. Make it more accurate than endoscopic examinations, Which doctors can visualize the abnormality This allows the biopsy to be precisely aligned with the pathology. Also, the examination with this method is convenient and less likely to have complications than normal hysteroscopy (Hysteroscopy) because patients do not need anesthesia or to fast before the endoscopy.


Preparing for a uterine endoscopy

In the endoscopic examination of the uterine cavity to diagnose disease Patients do not need special preparation. In some cases, the doctor may give a sublingual medication to dilate the cervix approximately 2 hours before the exam. But should choose a period of examination that the menstrual period has closed for 5 to 7 days and make sure that it is not in the period of pregnancy. In case the pathology is large The doctor may need to make an appointment for surgery for uterine pathology in the operating room. The patient must refrain from water. No food at least 6 hours before the treatment and have a tampon prepared.


What are the steps in the diagnosis?

The examination is similar to the internal examination. In which the doctor will put the patient to sleep on the legs like an internal examination Insert a device to expose the cervix After that, the doctor will gradually A small endoscopy through the cervix into the uterine cavity To see abnormalities within the uterine cavity The examination takes about 10-15 minutes in some cases where abnormalities are found. The doctor may have a biopsy to be tested for pathology. And continue to plan for treatment May take a longer period of examination.

This diagnostic method is suitable for patients with abnormalities in the uterine cavity, such as suspected polyps or tumors. Unusual bleeding with no known cause Diagnose and find the cause of infertility for people with IVF. The doctor may examine the uterine cavity before the embryo is implanted. This ensures that the uterine cavity does not contain any abnormalities that hinder the possibility of embryo implantation.

Usually, complications or side effects from a uterine endoscopy are rare but can occur, such as inflammation, infection. This can happen if the patient has a pelvic infection. Or the fallopian tube already Including lower abdominal pain Which can take pain medication After an endoscopic examination of the uterus The patient can perform normal activities after the examination. But recommended abstaining from sex for 3-5 days.


Those who should undergo an office hysteroscopy

  • Women of childbearing age with irregular menstrual bleeding
  • Women undergoing uterine ultrasound suspected fibroids or polyps in the uterus.
  • Postmenopausal women with uterine bleeding
  • Women with abnormal uterus such as Septate uterus.
  • Women who have had 2 or more recurrent miscarriages
  • Infertile women
  • Women with very little or no history of menstruation.
  • Women who have been wearing an IUD for a long time and are unable to pull out the loop normally.
  • Women with heavy menstruation Without finding any pathology from outside the uterus
  • Women who were not pregnant after a miscarriage and underwent a curettage.
  • Women with severe menstrual cramps with suspected uterine pathology
  • Non-pregnant women from IVF And two or more good quality embryos have been transferred

Who is not suitable for this method?

  • Endoscopic examination of the uterus with this small instrument. Not suitable for patients with the following conditions
  • People who are currently having menstruation
  • Those who are pregnant
  • People with inflammation in the pelvis or fallopian tubes.

If there is more abdominal pain than usual or found that there is more or longer vaginal bleeding than normal Purulent discharge with a foul odor and high fever, etc. Do not ignore or tolerate the pain until it gets worse, causing problems in the uterine cavity and when in doubt seek medical attention. To receive a diagnosis of the cause to lead to timely treatment.


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