Removal of endometrial polyps, laser hysteroscopy uterus. Preparation for surgery, the procedure from the beginning to the end of the video, the recovery period

Removal of tumors is now considered the preferred method of treatment. Especially often held excision of a polypWhich is located in the uterus. The operation involves special training, as well as compliance with all the recommendations in the recovery period. When done properly, it rarely provokes complications.

What is a polyp endometrial cancer

A polyp is a benign tumor is localized on the inner layer of the uterus and consists of mucosal cell layer. Education can be single or multiple. In the second case we speak of the development of polyposis.

When the build-up on the inner layer of the endometrium in women observed violations of the reproductive system in the form of menstrual disorder, heavy bleeding and pain in the lower abdomen.

After intercourse, spotting appear brown, and there are difficulties with conception. In advanced cases develop infertility, and when attaching the fertilized ovum to the endometrium after a while there is a miscarriage.

What is a hysteroscopy

Polyp removal of the uterus performed by hysteroscopy. The method is minimally invasive intervention to remove the buildup on the inner layer of the uterus, carried out by using a hysteroscope or hysteroresectoscopy. When this tissue is practically not damaged, and the recovery period is reduced.

Experts identify two main types of hysteroscopy - diagnostic and surgical. The first is used when you want to get a small sample of tissue for histological examination. In this case, the manipulation may require only local anesthesia and is performed on an outpatient basis.

The second type is shown in the case of establishing the exact diagnosis and the need for an immediate removal of the neoplasm. Usually the first phase is carried out diagnostic hysteroscopy, whereupon growths removed using the same method.

The advantages of the procedure for the removal of a polyp

Manipulation has several advantages that make it the preferred one for the removal of polyps.

The main advantages:

• The minimal tissue damage that allows to shorten the period of healing.
• Short recovery period inner layer of the uterus.
• No need for repetition of the manipulation.
• The procedure can be used in the treatment of women of reproductive age, and patients after the onset of menopause.
• The possibility during the procedure to detect other irregularities on the part of the reproductive system.
• The rapid implementation of the removal.
• Before removing the material can be sent for a biopsy, which eliminates the possibility of deterioration after the procedure.
• The accuracy of the manipulation, excluding the negative impact on the surrounding tissue.

In addition, the operation is almost always eliminates the risk of recurrence and complications, which is considered to be beyond doubt, and one of the most important advantages.

The laser device for the removal of the polyp: the principle of action

Hysterectomy polyp using a laser has a high efficiency. The principle of operation is based on the adaptation point a laser beam at a polyp. When this happens its rejection from the inner layer of the uterus, followed by excretion of the body.

It should be noted that using such a device, you can remove multiple tumors in one procedure. The laser does not damage the healthy tissue of the uterus, as well as contributes to instantaneous stop bleeding, which eliminates the blood loss. Regardless of the device model, its operating principle is no different.

Absolute contraindications to hysteroscopy

Some diseases are considered to be absolute contraindications to manipulation because they can complicate the implementation of manipulation, and provoke unpleasant consequences:

• Inflammatory pelvic pathology occurring with severe symptoms of fever, weakness and menstrual irregularities.
• Disease, sexually transmitted diseases. In this contraindication may be the acute stage of the diseases, and similar violations in the history of the patient.
• Detection of deviations in the study of vaginal smear. Considered a contraindication 3 and 4 the purity when pathogens can penetrate into the uterus and provoke degradation.
• Acute colds and viral diseases that occur with severe symptoms.
• Uncontrolled hypertension when blood pressure figures is impossible to bring back to normal for a long period.
• The recovery period after surgery on the digestive system.
• Pathology of blood, characterized by coagulation disorders.
• Malignant tumors in the uterus.

When the operation is not carried out such disturbances as may induce complications.

Relative contraindications to hysteroscopy

In addition to absolute, relative contraindications exist in which to carry out manipulation is not recommended. These include the recovery period after myocardial infarction or stroke, the passage rate chemotherapy, as well as the cervical canal stenosis, in which it is impossible to artificially expand.

A further contraindication considered bleeding tendency, e.g., in the presence of diseases of the stomach, bowel perforation threatened organ wall. In some cases hysteroscopy refuse during treatment with hormonal agents, as well as an exacerbation of diseases of internal organs.

For relative contraindications include PIS and severe heart failure. When running renal and liver failure hysteroscopy is performed only if strict indications and there is no possibility to postpone the procedure.

Preparation for surgery

Removal of tumors is performed after a preliminary survey of the patient. The doctor listens to complaints and identify the presumed causes of the formation of a polyp on the inner layer of the uterus. After that the standard examination, suggesting examination chair for gynecological, taking the stroke to determine the degree of purity of the vagina.

To prepare and use other methods:

• Total and biochemical blood tests to assess the patient's condition.
• General urine analysis.
• ECG. The method is applicable not always, but it is recommended for patients older than 40 years.
• Radiography or fluoroscopy.
• Blood tests for the detection of venereal diseases, hepatitis and HIV.
• Colposcopy - vaginal examination using a colposcope special device that allows to explore the mucous membranes.
• Ultrasound examination of the uterus and appendages.

Sometimes for an overall picture of the patient's condition requires consultation of the endocrinologist, internist and cardiologist. After receiving the results of the survey the doctor sets the date of the procedure. It is usually performed in the morning.

The patient should not eat anything on the day of the operation, only allowed to drink water, but no later than 2 hours before removal.

Before the operation the patient should shave the hair in the genital area. If it did not, manipulation carries nurse immediately before the intervention. In addition, it is recommended to do a cleansing enema for intestinal release.

Immediately prior to hysteroscopy offer patient to empty the bladder. Without the permission of a doctor should not use sedatives, painkillers or antispasmodic drugs. If the patient is taking any funds on an ongoing basis, it must inform the doctor in advance.

The procedure from the beginning to the end

On the day of re-manipulation specialist tells the patient about the procedure, its effectiveness and possible risks. After that, the patient signs an agreement on the removal of tumors. It is worth remembering that it is best to carry out the operation on 7-9 days of the menstrual cycle.

Anesthesia for removal of uterine polyps

The procedure is most often performed under general anesthesia, as accompanied by pain. Only when a diagnostic form of manipulation of anesthetic is not always applied.

It is worth noting that the doctor used no form of endotracheal anesthesia, a short-term, involving intravenous administration of special drugs, plunging the patient to sleep for 15-20 minutes. These medicines are usually better tolerated, rarely provoke complications of the heart and brain.

Removal under anesthesia

Polyp removal of the uterus is carried out in several stages, which are carried out in sequence:

1. The woman was escorted to the preoperative room, where she is released from the clothes and put on sterile disposable gown, hat.
2. Nurse accompanies her to the operating room where the patient is placed on a gynecological chair.
3. At the foot of the patient wear disposable shoe covers.
4. A doctor holds dual processing genitals and inner thighs antiseptic solution.

   

5. After that is introduced into the vagina speculum, which raises the wall and allow access to the cervix.
6. The next stage - the artificial expansion of the cervical canal and the introduction into the lumen of the hysteroscope uterus.
7. Next, the doctor removes polyps. If they have a small size, an electrode, which cauterizes neoplasm. If the size of a large build-up, use special tongs.
8. After removal of the re-processing is carried out of the surgical field to prevent infection. When this iodine solution was applied, or rubbing alcohol.

After all the manipulations of the patient on a gurney brought to the ward where she is under observation.

The use of laser

Today is becoming more popular with the use of laser removal. It does not require the use of electrodes and forceps for cutting polyps. The procedure is performed on the same principle, the standard preparation. After the expansion of the cervix uterus is studied using a hysteroscope, and then the doctor inserts the laser.

The adaptation of acupressure on the polyp, burned it, and the vessels, which prevents the development of bleeding. Manipulation using laser takes less time and is considered to be less dangerous. However, with general anesthesia is required, as in the standard procedure.

The duration of hysteroscopy

The duration depends on the amount of manipulation tumors in the uterus, as well as internal organ layer state. The average duration of hysteroscopy is about 20-45 minutes. If complications arise operation may last up to 60 minutes.

The postoperative period

After the removal of the patient for at least 5 days under the supervision of specialists in the hospital. If necessary spend symptomatic therapy to normalize blood pressure, relieve pain in the lower abdomen.

If the patient suffers from chronic pathologies associated with inflammatory forms assigned antibiotic therapy and other means. In some cases, the length of stay increased to 7-10 days.

The possible negative consequences

Hysteroscopy can provoke negative effects. They develop in violation of the doctor's recommendations in the postoperative period, but can also occur in compliance with all the rules, as well as improperly performed all actions.

The most frequent complications are:

• Exacerbation of chronic nature of diseases affecting the organs of the reproductive system.
• Perforation of the uterus wall resulting tamperproof tools.
• Damage to healthy tissues of the uterus with an imprecise direction of the laser beam.
• Postoperative bleeding.
• Severe pain in the lower abdomen that is not relieved by analgesics.
• Allergic reaction to the means used for pain relief.
• Uterine infection by penetration of pathogens from the vagina.

The most difficult and dangerous complication is considered to be anaphylactic shock, as well as damage to the uterine wall during handling.

recovery period

The recovery period at correct the operation lasts no more than 4 weeks. During this time, the inner layer of the uterus is restored. However, it should comply with all rules to prevent complications.

Absolutely contraindicated drink alcoholic beverages, as well as potent drugs. It is necessary to consult an expert before taking any means. Do not immediately expose the body severe emotional and physical stress.

It is recommended to exclude the sports for the entire period of rehabilitation, and avoid bathing in ponds, the use of tampons.

Permission is granted to make walking in the fresh air. It is important to adjust the diet, eat more vegetables, fruits, dairy products. It is recommended to drink fresh juices and eat dried fruits and nuts.

When the discomfort or pain in the lower abdomen should see a doctor, but not to self-medicate. After full recovery appointed re-examination on the chair, the general analysis of blood and urine. Often the ultrasound diagnosis is required.

Allocation after the procedure

Removal of the uterus polyp often causes secretions. Over the 3 days after surgery there are insignificant allocation of dark crimson color, which is considered the norm. If the blood scarlet, copious and there are more than 3 days, you should enroll to the gynecologist. Allocation may be absent altogether if the laser has been used for removal.

Sex life after surgery

Over the 2 weeks after removal of polyps is strictly prohibited sex. After that, the patient should visit a gynecologist, who will examine. Usually sexual life can be resumed 4 weeks after removal. In some cases the abstinence period is extended up to 6-8 weeks if there are any complications.

Treatment after hysteroscopic uterine polyp

After the operation, in most cases appointed replacement therapy. The patient receives antibacterial, antiinflammatory and hormonal medicaments, accelerate healing and prevent complications.

preparations	Features of the application
Azitral	Antibiotic, which is prescribed to prevent infection and inflammation inner layer of the uterus. Means of helping to destroy microorganisms that can trigger disease. The course usually lasts no more than 5-7 days
ibuprofen	Nonsteroidal anti-inflammatory drug which is prescribed for the purpose of analgesia and reduce the body temperature. Not only helps to eliminate the acute symptoms, but also to prevent the development of inflammation by blocking substances that provoke it. The day the patient is prescribed 2 tablets, course duration is typically less than 5 days
Nospanum	Antispasmodic medicament for attenuating the tone of the uterus, and warning pain that can occur after surgery. Accept means necessary to 1 tablet 2 times per day. Course duration is 7-10 days
Klayra	With oral contraceptive containing dienogest. It has a positive effect on the organism and the endometrium. Take the necessary means by the standard procedure, ie 1 tablet in one and the same time for 6 months. If necessary, extend the course

In each case, the list of drugs may vary. Especially when the patient suffers from any concomitant diseases.

Pregnancy after the removal of a polyp

After a successful manipulation of the complete restoration of the inner layer of the uterus takes about 3 months. Only after such a period is allowed to resume the attempt to conceive a child. However, it is provided that the sterility was linked precisely to the presence of a polyp in the uterus.

Usually pregnancy in women uncomplicated. With the development of complications of prolonged recovery period that lays the time of conception for an indefinite period.

Removal of tumors of the endometrium is a fairly common manipulation. Very often it is used in the localization of the polyp in the uterine cavity. Subject to any rules, the operation is successful and does not cause complications.

Video of uterine polyps

Diagnosis and treatment of uterine polyps: