One of the modern diagnostic and therapeutic procedures in gynecology is hysteroscopy. This operation allows you to examine the uterus, identify and, if necessary, promptly remove pathology, and in many cases determine the causes of infertility. The doctor decides whether to perform hysteroscopy, based on the indications and contraindications for this procedure, but the last word, of course, remains with the patient.

Briefly about hysteroscopy

Hysteroscopy is a therapeutic and diagnostic manipulation that allows you to visually evaluate the uterus from the inside, identify pathological formations or anomalies in its structure and, if necessary, remove them promptly, that is, without penetrating the abdominal cavity. This method is endoscopic and is performed using a special optical device - a hysteroscope - by a trained specialist.

Translated from Greek, hysteroscopy means “to examine the uterus.” Manipulation can be diagnostic or therapeutic. Diagnostic hysteroscopy is performed not only to examine the internal uterine surface, but also to collect material (endometrium) for histological examination (biopsy). During therapeutic hysteroscopy, surgical interventions are performed, for example, removal of tumors or foreign bodies.

Preparation for the procedure

Since hysteroscopy is an invasive procedure and is akin to surgery, before undergoing it the patient is prescribed an examination (excluding emergency cases):

The following instrumental methods are prescribed:

• Ultrasound of the pelvis;
• Ultrasound of the abdominal cavity (if indicated);
• fluorography;
• blood clotting test;
• ECG (if indicated).

If the patient has chronic extragenital diseases, a consultation with a doctor of the appropriate profile with corrective therapy is indicated. If colpitis is detected, vaginal sanitation is prescribed (up to 1–2 degrees of cleanliness).

The examination is carried out on an outpatient basis. After admission to the hospital, the patient is given a cleansing enema (bowel preparation) before the procedure, and immediately before hysteroscopy it is necessary to empty the bladder. Eating on the day of the procedure is prohibited due to intravenous anesthesia during hysteroscopy. Hysteroscopy is planned for days 5–7 of the cycle, that is, in the first (proliferative) phase, when the new functional layer of the endometrium has just begun to grow and the inner surface of the uterus is accessible for inspection.

It is also necessary to abstain from sexual intercourse 3 days before the procedure, and stop douching a week before. The use of spermicides and vaginal suppositories 7 days before hysteroscopy is also not recommended.

Types of hysteroscopy

Hysteroscopy, depending on the purpose, can be:

• diagnostic – when it is necessary to identify the causes of “problems” in the female line (to diagnose endometrial polyposis, submucosal myomatous node or other pathology);
• therapeutic - after examining the inner surface of the uterus, surgical intervention is performed (excision of polyps, resection of a myomatous node, dissection of adhesions or septum in the uterus);
• control - carried out after a certain time (usually six months) after intrauterine interventions using hysteroscopy.

For a successful operation, it is necessary to straighten the uterine walls, stretch and expand the uterus. For this purpose, media are introduced into the uterine cavity. Depending on the medium used, hysteroscopy is divided into:

• liquid (saline solution or 5% glucose is injected);
• gas (carbon dioxide is introduced).

Office hysteroscopy

Office endometrial hysteroscopy is one of the options for diagnostic hysteroscopy and is performed on an outpatient basis. This name for the procedure comes from Europe, where hysteroscopy for diagnostic purposes can be performed not only by a gynecologist, but by a general practitioner, and it is performed on an outpatient basis, in medical offices (by Western definition - in offices).

Office hysteroscopy is called simple hysteroscopy, mini-hysteroscopy, diagnostic video hysteroscopy. The latter term implies showing the patient a picture of the inner surface of the uterus during the manipulation. Advantages of minihysteroscopy:

• low traumatic procedure (a hysteroscope with the smallest diameter is used, without expanding the cervical canal);
• there is no need for general anesthesia, which reduces the cost of hysteroscopy and the risk of anesthetic complications;
• Possibility of outpatient implementation, does not require hospitalization and does not affect the ability to work;
• short period of the procedure (no more than half an hour);
• good tolerance to manipulation;
• It is possible to perform an endometrial biopsy.

The decision on the need for hysteroscopy is made by the doctor based on the following indications:

• various disruptions in the menstrual cycle in girls, women of childbearing and premenopausal age;
• bleeding and spotting in postmenopause;
• suspicion and for confirmation:
  • submucosal myomatous node;
  • adenomyosis;
  • endometrial cancer;
  • malformations of the uterus;
  • intrauterine synechiae;
  • perforation of the uterus;
  • remnants of the fertilized egg and membranes;
  • cervical cancer;
  • polyposis and endometrial hyperplasia;
  • foreign body in the uterine cavity;
• clarification of the localization of the intrauterine device or its parts;
• infertility;
• as a preparatory stage before IVF;
• miscarriage;
• evaluate the effect and monitor the result of hormonal treatment;
• complicated postpartum period.

As it becomes clear, hysteroscopy is the most effective and efficient method for diagnosing and treating gynecological pathology, so it is not advisable to refuse the procedure.

Contraindications

Like any other intrauterine procedure, hysteroscopy is not performed in the following situations:

• acute infectious diseases (colds, sore throat, thrombophlebitis or pyelonephritis and others);
• exacerbation of chronic diseases;
• acute inflammation of the genital organs (colpitis, endometritis, adnexitis);
• intrauterine pregnancy (desired);
• ectopic pregnancy or suspicion of it;
• advanced cervical cancer;
• extragenital diseases in the stage of decompensation (cardiovascular pathology, liver, kidney diseases);
• profuse bleeding from the uterus;
• atresia of the cervical canal.

Recovery period

The recovery period after the manipulation is conventionally divided into 2 stages. The first stage consists of the primary restoration and normalization of the structure and functioning of damaged uterine tissue (mucous membrane and muscle layer). At the first stage, microdamages and surgical incisions are completely healed, and the cervical canal is restored and regenerated. This stage lasts about 2–3 weeks and ends with complete regeneration of surgical damage and the formation of scar-free tissue.

The second stage of recovery is aimed at the formation of new, newly formed tissue, that is, a new endometrium after hysteroscopy. The new uterine mucosa must have a normal structure and all its inherent functional properties (proliferation and rejection of the endometrium according to the phases of the menstrual cycle). The second stage of recovery requires more time and lasts up to 6 months.

Discharge after the procedure

Blood and moderate spotting will occur in the first 2 to 3 days after the procedure. This is explained by traumatic damage to the uterine mucosa by instruments. Subsequently, the discharge becomes bloody or yellow, which can last up to two weeks. The duration of ichor discharge is due to the expansion of the uterine cavity with liquid during hysteroscopy; the liquid penetrates into the vessels, damaging their walls, which leads to the release of “ichor”. But if heavy bleeding or blood clots appear, you should immediately consult a doctor.

Menstruation after hysteroscopy

When does your period come after hysteroscopy? It all depends on the purpose of the procedure. In the case of diagnostic, especially office hysteroscopy, menstruation occurs according to the usual cycle schedule, but slight delays are possible (2 - 3 days). This is explained by the fact that during the diagnostic procedure the endometrium is practically not injured, so a long time for its recovery is not required. But in the case of therapeutic hysteroscopy, especially after completion of the procedure by curettage of the uterine cavity, a longer delay in menstruation is possible. In this situation, the first day of the menstrual cycle should be considered the day of the operation and expect menstruation in about a month. It is important to monitor the nature of the first menstruation after the procedure. If there is a change in color or consistency, or an increase in the amount of bleeding, you should consult a gynecologist.

Pain after hysteroscopy is considered absolutely normal if it is minor or moderate, localized in the lower abdomen or lower back/sacrum and lasts a couple of days. Painful sensations are explained, firstly, by the stretching of the uterine cavity during the procedure with gas or liquid, and secondly, by traumatization of the tissues of the cervix and uterus with instruments. Women with a low pain threshold complain of severe pain; in such cases, the doctor may recommend taking NSAIDs with a good analgesic effect (ketorol, indomethacin, Nise). But if the stomach hurts unbearably, the nature of the pain is cramping, dagger-like or shooting, the temperature rises significantly and the symptoms of intoxication increase, the pain radiates to the perineum or leg, then you must immediately seek medical help to eliminate possible complications.

In the early recovery period, it is necessary to strictly follow all the recommendations of the gynecologist:

• abstain from sexual activity for about 3–4 weeks (ideally, before your first period);
• It is prohibited to take a bath, visit a bathhouse and sauna, or swim in a pool or open water for at least 3 weeks;
• maintain personal hygiene (shower daily, wash twice a day using detergents with a pH-neutral reaction (intimate gels, baby soap);
• as a rule, the doctor prescribes anti-inflammatory treatment after hysteroscopy (prophylactically) with antibiotics (ciprofloxacin) and metronidazole for a course of 5–7 days;
• daily monitoring of body temperature (in the morning and before bedtime);
• stop taking aspirin as a pain reliever (the drug thins the blood, which will increase spotting and can cause bleeding);
• postpone intense physical activity, heavy physical labor and lifting weights of more than 3 kg for 1 - 1.5 months (health-improving sports exercises are allowed after 2 - 3 weeks);
• refusal of tampons during the period of bleeding, it is better to use pads;
• a ban on intravaginal administration of tablets, suppositories, gels and creams, as well as douching;
• after hysteroscopy, you should not use spermicides for a month;
• adhere to a balanced diet so as not to provoke constipation (refusal of spicy, salty, pickled foods, fried and fatty foods).
• Empty your bladder promptly.

Pregnancy after hysteroscopy

Most women who undergo a hysteroscopy procedure are concerned about when pregnancy will occur after it. If the procedure was performed for diagnostic purposes, and no surgical interventions were performed in the uterine cavity, for example, excision of a polyp, then conception is possible already in the next cycle. This is due to the rapid restoration of the uterine mucosa and hormonal levels. But doctors warn the patient that there is no need to rush, and when you can get pregnant depends on many other factors:

• the nature of the menstrual cycle (regular or not);
• the presence of other gynecological diseases (inflammation of the appendages, background processes of the cervix, external endometriosis and others);
• the presence of extragenital pathology (it is necessary to correct the condition and undergo treatment);
• preparation for pregnancy (healthy lifestyle, taking folic acid, moderate physical activity for at least 3 months);
• examination for sexually transmitted infections and treatment of both partners if they are detected (chlamydia, cytomegalovirus, human papillomavirus and others).

Under favorable conditions, it is allowed to plan a pregnancy no earlier than 3 months after the procedure.

IVF after hysteroscopy

When a patient is preparing for IVF, she must undergo a fairly complex examination, the protocol of which includes hysteroscopy. But not all IVF clinics require this procedure. IVF after hysteroscopy may fail (miscarriage) in the case of undetected and untreated intrauterine pathology, which is why most reproductologists consider the procedure mandatory. What a doctor can identify and remove (if necessary) during hysteroscopy before IVF:

• excise polyps;
• remove hyperplastic endometrium;
• cut intrauterine adhesions;
• excise the intrauterine septum;
• remove foci of endometriosis;
• correct the shape of the uterus in case of its abnormal development;
• remove the submucosal myomatous node;
• check the patency of the pipes (inserting a catheter into the pipes).

After surgical hysteroscopy, planning a pregnancy is allowed no earlier than six months later. In case of successful fertilization and implantation of the egg, the woman is registered at the dispensary from the moment pregnancy is established and is carefully monitored. The course of pregnancy depends not only on the intrauterine surgery performed, but also on other factors:

• hormonal levels before pregnancy;
• age;
• number of births and abortions;
• cervical condition (UC);
• extragenital pathology.

Cost of hysteroscopy

The cost of hysteroscopy depends on the purpose for which it is performed. Diagnostic or office hysteroscopy, respectively, is cheaper since it does not include surgery. Prices for surgical hysteroscopy vary according to the level of complexity of the operation, the qualifications and experience of the doctor and the quality of the equipment. Increases the cost of the procedure and the need (in some cases) for hospital stay. But, of course, the price of the service depends on the region and the level of the clinic.

For example, in Moscow, diagnostic hysteroscopy will cost 15,000 - 35,000 rubles, and the price for an operating room reaches 60,000 - 65,000 rubles. In the provinces, the price of office hysteroscopy ranges from 2,500 to 9,000 rubles, and the procedure with surgical treatment of intrauterine pathology costs from 3,500 to 25,000 rubles. The average price for a hospital stay is 1,500 – 4,000 rubles.

Possible complications

Hysteroscopy, like any invasive procedure, is fraught with complications.

Early complications

Among the early postoperative complications, the following should be noted:

• inflammation of the uterus and peritoneum of the small pelvis (endometritis, pelvioperitonitis) – accounts for 90% of all complications;
• intravascular hemolysis caused by the duration of the operation and the use of distilled water or electrolyte-free media or increased intrauterine pressure;
• bleeding – no more than 5% of all complications (observed after resection of fibroids, resection or ablation of the endometrium).

Late complications

Late complications include:

• formation of pyometra in postmenopausal patients (in case of rough manipulation);
• formation of hydrosalpinxes, especially with chronic adnexitis;
• deformation of the uterine cavity (after resection of the endometrium or removal of large myomatous nodes);
• exacerbation of chronic inflammatory processes;
• incomplete removal of intrauterine formations.

Question answer

Question: I was diagnosed with an endometrial polyp six months after hysteroscopy. What is the reason for this and how to treat it?

Answer: Recurrence of an endometrial polyp is most likely associated with incomplete removal of the formation during the previous procedure (a stalk remains). Treatment will consist of repeated hysteroscopy, with excision of the polyp and coagulation of its bed (with electric current or freezing) with the possible prescription of hormonal drugs.

Question: What should be the body temperature after hysteroscopy?

Answer: Ideally, body temperature in the morning and evening should not exceed 37 degrees. But while there is bloody or bloody discharge (7-10 days), the evening temperature may rise slightly (up to 37.2 degrees). In case of a higher temperature, as well as its increase in the morning, you should consult a doctor to exclude an inflammatory process of the internal genital organs.

Question: Is it possible to take hemostatic drugs after hysteroscopy and which ones?

Answer: As a rule, bleeding after the procedure is insignificant and short-lived and does not require the use of hemostatic agents. Vitamin C, calcium gluconate and Vicasol can be taken as hemostatic drugs. If you have anemia, your doctor will recommend taking iron supplements.

Question: Why are hormonal pills or injections prescribed after hysteroscopy?

Answer: Since the procedure in most cases is carried out to remove intrauterine tumors resulting from hormonal imbalance (polyps, fibroids, endometrial hyperplastic processes), the doctor recommends hormone therapy to normalize hormonal levels. As a rule, oral contraceptives are prescribed for a period of 3 to 6 months.

Question: Is it necessary to see a gynecologist after hysteroscopy?

Answer: Yes, definitely. The first visit to the doctor after the procedure should be 10 to 14 days. Control ultrasound is performed after 3 and then after 6 months. If the examination results are favorable and there are no complaints, the woman should subsequently visit a gynecologist every year.

Question: On what day are you discharged from the hospital after hysteroscopy?

Answer: If the procedure is planned as an inpatient procedure, then on average the patient is sent home the very next day. But in some cases it is possible to leave the hospital after a few hours (satisfactory condition, spotting). A woman may be left in the hospital for several days (2–3) after a significant surgical intervention (removal of a myomatous node or multiple endometrial polyps) or if complications arise.

Obstetrician-gynecologist Anna Sozinova

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Hysteroscopy and its consequences

Endoscopic research methods are one of the most developing areas of diagnostic medicine, allowing not only to visually assess the condition of the organ being examined, but also to perform various surgical procedures with minimal damage to the body.

Hysteroscopy, as one of the types of minimally invasive intervention, has significantly expanded the possibilities for diagnosing intrauterine pathologies, the detection of which using other diagnostic methods was quite difficult. Due to the fact that any endoscopic manipulation for the purpose of research or treatment is often accompanied by minor tissue damage, the consequences of hysteroscopy also depend on the purpose of the intervention and the volume of surgical procedures performed.

Hysteroscopy

Hysteroscopy is a method of visual examination of the uterine cavity, carried out through the natural genital tract using a hysteroscope. The hysteroscope is a multifunctional optical device, the design of which includes a channel for inserting surgical instruments, making it possible not only to identify existing pathologies, but also to perform various surgical procedures:

• curettage of the uterine cavity;
• removal of small benign neoplasms (endometrial polyps, submucous fibroids);
• separation of fibrous formations (synechia);
• restoration of patency of the fallopian tubes;
• removal of ingrown fragments of the intrauterine contraceptive device (spiral);
• cauterization of foci of endometriosis;
• performing a biopsy.

Diagnostic and operational hysteroscopes differ in the thickness of the working part

Carrying out

Depending on the purpose of the procedure, one of the stages of hysteroscopy is to increase the patency of the cervix through the gradual introduction of Hegar dilators into the cervical canal. In this case, purely diagnostic manipulations can be carried out without preliminary dilation of the cervix with a hysteroscope having a thickness of no more than 3 mm. The use of a hysteroscope, which has an operating canal in its structure for inserting surgical instruments, requires significant dilatation of the cervical canal (up to 9-10 mm).

Depending on the type of equipment used, surgery can be performed in the following ways:

• resection - in this case, the growth or neoplasm is cut off using so-called “scissors” or cutting instruments of a different shape;
• electroresection - provides a fairly large set of tools (loops, rollers, balls), the action of which is based on the electrical evaporation of tissue, which allows for the targeted removal of pathological formations;
• laser resection with coagulation - a significant advantage of such instruments is tissue coagulation after resection, which significantly reduces the risk of bleeding.

Carrying out diagnostic hysteroscopy

Consequences

Due to the fact that hysteroscopy, despite its relative safety, is a surgical intervention, after it is performed certain consequences may arise that can cause some discomfort to the patient. However, it is necessary to distinguish between consequences that are a normal reaction of the body to medical actions (artificial dilation of the cervix, curettage, etc.) and complications caused by incorrect actions of the doctor, characteristics of the body, or the patient’s failure to comply with postoperative recommendations.

Pain

Pain after the procedure is a completely natural reaction to surgical procedures. As a rule, the pain is spasmodic in nature and is a consequence of increased contractile activity of the muscular layer of the uterus and forced expansion of the cervical canal. Complaints of aching pain in the lumbar region are also common.

The intensity and duration of pain depends on the pain threshold of the individual patient and the goals of hysteroscopy. If hysteroscopy was performed solely for diagnostic purposes, then recovery takes no more than 4-6 hours, and even minor surgical procedures can cause longer-term pain, which can be successfully relieved with anesthetics.

Important! Regardless of the nature of the hysteroscopy performed, pain should not last more than 7 days (optimally 2-3 days).
Intramuscular injection of baralgin will help eliminate pain

Discharge

Slight spotting is normal even after diagnostic hysteroscopy. There should be no heavy discharge even after resection of polypous formations. The appearance of ichor after hysteroscopy, and then mucous discharge, may indicate minor damage to the mucous surface of the cervix or be a consequence of surgical actions to remove tumors or take a tissue sample for a biopsy.

If diagnostic curettage was performed for medical reasons, then the amount of blood after the procedure, as well as the duration of bleeding, should not differ significantly from menstruation and will end within the appropriate time frame, that is, after 4-7 days.

Temperature

The temperature after hysteroscopy should not exceed the threshold of 37º-37.2º. As a rule, a similar reaction of the body to intervention occurs in a fairly large percentage of women and differs from the temperature associated with complications in that it occurs on the same day and repeats in the evening for 2-3 days. Temperature caused by inflammatory processes or other complications is characterized by exceeding a threshold of 37.2º, is not related to the time of day and usually occurs 2-3 days after hysteroscopy.

Complications

Despite the relative safety of the procedure, the possibility of complications cannot be excluded, the conditional classification of which divides them into two types:

• surgical;
• physiological.

Laparoscopy or hysteroscopy - which is better?

Surgical complications include all complications associated with incorrect performance of the procedure due to the unprofessionalism of the doctor or the characteristics of the patient’s body. The list of pathologies resulting from hysteroscopy includes:

• perforation of the wall of the uterus or cervical canal. As a rule, such a complication occurs in cases of resection of the uterine wall using an electroresectoscope or laser, for example, to remove deep-lying fibroids. Treatment after hysteroscopy involves repairing the damage using simultaneous laparoscopy and hysteroscopy;
• intestinal damage as a result of perforation of the muscular layer of the uterus;
• bleeding. Occurs as a result of damage during surgery to a large blood vessel;
• air embolism caused by the penetration of gas bubbles into the bloodstream. As a rule, air enters the uterine cavity through tubes that supply lavage fluid during surgery;
• anesthetic complications. They are a consequence of an allergic reaction to anesthesia.

Important! The use of electro- or laser resection with coagulation minimizes the risk of bleeding due to the ability to “seal” the vascular bed immediately after tissue excision.
All complications of a surgical nature are prevented by careful compliance with all norms and rules for performing the operation.

Postoperative complications of a physiological nature are divided into the following types. Early - inflammatory processes (endometritis, parametritis, adnexitis). Late - deformation of the uterine wall due to the removal of large fibroids, recurrent growth of previously removed tumors and endometriosis. The removed endometrium after surgery can enter the abdominal cavity due to perforation of the uterine wall or through the fallopian tubes.

If the polyp grows again after removal, this may indicate either incomplete removal during surgery or hormonal disorders in the woman’s body. In this case, hormonal drugs are prescribed as treatment. A characteristic feature of the endometrium is its ability to take root on nearby organs, forming endometriosis cysts in the process of growth.

Recovery

The recovery period depends entirely on the severity of the intervention and ends during the period of growth of the new endometrium, indicating the beginning of a new menstrual cycle. The most common question asked after hysteroscopy is “How many days until menstruation?” If the procedure was diagnostic in nature, regeneration of damaged tissue does not take much time, so the start of the next cycle should occur at the right time.

If the purpose of hysteroscopy was to restore the functional abilities of the uterus and the treatment procedure was performed within the generally accepted time frame (5-11 days from the start of the cycle), then a delay in menstruation may occur. If during hysteroscopy the uterine cavity was curetted, then the first day of the cycle should be considered the day following the day of the operation.

An integral part of treatment after hysteroscopy is taking antibiotics and broad-spectrum antibacterial drugs

Compliance with the recommendations in the postoperative period after hysteroscopy is of great importance for the speedy recovery of the body. The list of recommendations includes what you can and cannot do after the procedure:

• to prevent infection, you should abstain from sexual activity for a month;
• You should not swim, completely immerse yourself in the bath, or steam in a bathhouse or sauna, as overheating can cause bleeding or inflammation;
• carefully observe the rules of personal hygiene, using detergents with neutral pH;
• Avoid taking medications that affect blood clotting (aspirin, painkillers containing aspirin);
• After hysteroscopy, you should not engage in sports that include intense strength training or heavy lifting. Aerobic exercise is allowed 2-3 weeks after surgery;
• carefully monitor the functioning of the intestines, preventing possible constipation by adjusting the diet, since straining during bowel movements can disrupt the process of repairing damage to the uterus;
• it is necessary to urinate as often as possible (do not tolerate it), since a full bladder prevents the contraction of the walls of the uterus and impairs its blood supply;
• you cannot swim in the pool, as there is a risk of infection;
• You should sunbathe, strictly dosing your time in the sun to prevent overheating.

Important! Restrictions are also placed on the use of intravaginal tampons, which not only prevent the normal outflow of blood and mucus, but also do not allow assessing the quality of the discharge (appearance, smell), which may cause untimely consultation with a doctor in case of complications.
It is advisable to use Terzhinan antibacterial suppositories 1-2 days before the procedure in order to reduce the risk of infection

Planning a pregnancy

How long after hysteroscopy can you plan a pregnancy? If the procedure was carried out for diagnostic purposes, then it is highly likely that you can become pregnant as early as next month. However, if even minor surgical procedures have been performed, the body requires much more time to recover.

When planning a pregnancy, you should consider the following facts:

• regularity of the menstrual cycle;
• absence of inflammatory diseases;
• absence of recurrent development of pathological formations removed during surgery.

If the results are positive, pregnancy may occur within 3 months. However, the optimal period for completely restoring the reproductive functions of the body after hysteroscopy is considered to be 6 months.

Eco

The need for hysteroscopy before IVF is controversial. Due to the fact that the IVF procedure is quite complex in terms of collecting material and preparing the patient, the risk of miscarriage due to possible injuries from the previous diagnostic procedure is quite high. However, given the fact that women who have unsuccessfully tried to get pregnant for quite a long time resort to IVF, undergoing hysteroscopy will identify and eliminate any structural deformations of the uterus (adhesions, septa) that prevent the implantation of the fertilized egg into the endometrium and its subsequent development.

According to statistics, a much larger percentage of women who have not undergone hysteroscopy (12%) have experienced unsuccessful IVF, while women who underwent surgical treatment of intrauterine pathologies using hysteroscopy and underwent IVF have only 5% of failures.

Carrying out hysteroscopy before IVF will help create ideal conditions for the birth of a future life

In all cases, after a certain period of time, it is necessary to do an ultrasound and undergo a full examination to minimize the risk of premature termination of pregnancy.

It is impossible to guarantee a positive outcome of the IVF procedure with 100% certainty, but if after hysteroscopy a woman’s chances of giving birth to her own child increase significantly, this chance has a right to exist.

Hystroscopy today is the most informative method for identifying intrauterine pathologies, the average cost of which ranges from 3,000 to 60,000 rubles, depending on the equipment used, the purpose of the procedure and the prestige of the clinic. Following the recommendations after hysteroscopy will help to avoid the development of complications, minimize the consequences and restore health in a short time.

Recommendations after hysteroscopy help you recover faster and return to your normal lifestyle. Recovery after a diagnostic procedure is conventionally divided into two stages. First, there is a primary restoration of tissues that have been damaged, in addition to this, the tissues of the uterus, mucous membranes, and the entire muscle layer are restored. At the first stage, healing of microdamages and incisions occurs. Treatment after hysteroscopy is prescribed by the doctor.

After the procedure, the cervical canal is restored. The first stage of recovery lasts about 20 days. As a result, the damage becomes less noticeable; Scarless tissue begins to form. The second stage of recovery after hysteroscopy of the uterus lasts longer: a renewed endometrium is formed (the mucous membrane of the uterus must have its own structure and its own biological functions). The second recovery stage lasts up to 5 months.

Causes of discharge after the procedure

After this type of diagnosis, discharge in the form of blood may appear: they are usually observed on the 3rd day. The discharge occurs due to the fact that the mucous membrane of the uterus is damaged as a result of medical manipulations and the uterine solution is used for hysteroscopy. At first, the discharge is bloody, then it becomes yellow in color; their approximate duration is two weeks. The discharge is due to the fact that during the procedure the uterine cavity expands. The liquid used during manipulation is able to penetrate into the vessels, thus their walls are damaged and the woman observes discharge.

Determination of the menstrual cycle: are delays possible?

If you notice excessive blood clots, be sure to seek help! As for the menstrual cycle, it all depends on the purposes of hysteroscopy. If it was carried out for diagnostic purposes, menstruation will occur without delay. There may be delays of several days: this is normal. If hysteroscopy is performed for diagnostic purposes, the endometrium is not damaged, so it does not require much recovery time. In the case of therapeutic hysteroscopy, everything is different. If curettage of the uterine cavity has occurred, menstruation will most likely be delayed. In this case, the menstrual cycle will begin the day after the operation: this means that menstruation should be expected in a month.

You should pay attention to the nature of the first menstruation after therapeutic hysteroscopy. Pay attention to the color and consistency of your periods. If you notice that your bleeding is increasing, be sure to consult your gynecologist. After hysteroscopy, pain often occurs. This is normal, but if it is intense, you should consult a gynecologist. In normal condition, a woman has pain in the lower abdomen along with the lower back. The duration of such pain is 3 days. They are explained by the fact that during manipulation the uterine cavity is stretched (it is affected by liquid or gas).

The pain is caused not only by this reason: the fact is that the tissue of the cervix is ​​injured by medical instruments. If a woman has a low pain threshold, she will complain of severe pain. In this case, the doctor recommends a medicine with a powerful analgesic effect. If a woman feels unbearable cramping pain, her temperature may rise, and symptoms of intoxication may appear. If a woman feels that the pain is radiating to the perineum or legs, she needs to urgently call an ambulance, otherwise complications will arise. Be sure to follow your doctor's recommendations.

1. You should be away from sexual activity for 3 months.
2. It is forbidden to go to the bathhouse or sauna.
3. You cannot visit swimming pools, swim in rivers or ponds.
4. Compliance with hygiene rules is mandatory: take a shower, wash yourself 2 times a day (it is advisable to use a special gel with neutral PH).

For the purpose of prevention, the doctor may prescribe anti-inflammatory drugs, including antibiotics. The course of treatment will be 7-8 days. Antibiotics are prescribed taking into account the patient's health condition. Body temperature must be monitored. Do not take aspirin: it is a painkiller. The medicine can thin the blood and increase blood discharge. It is important to know that ordinary aspirin can cause bleeding. During the rehabilitation period, you should not overload, both mentally and physically. Try to rest on time and don’t get nervous. If we talk about health-improving sports exercises, they can be done after 3 weeks.

What should you not do after hysteroscopy? You should stop using tampons and replace them with pads. It is prohibited to administer tablets intravaginally. All kinds of suppositories and douching creams are contraindicated. You need to eat rationally, not drink strong drinks, and especially alcohol. It is worth emptying your intestines on time, giving up all harmful foods: these include salty, spicy, pickled, fried, and too fatty foods. You need to take medications with the permission of a gynecologist: uncontrolled use is fraught with consequences.

About pregnancy

Women are interested in: when pregnancy occurs after a diagnostic procedure. If a diagnostic hysteroscopy was performed and the doctor did not perform surgical intervention, for example, removal of polyps, you can begin conceiving in the next cycle. Some doctors are confident that there is no need to rush into pregnancy. It is necessary to pay attention to the features of the menstrual cycle, as well as to the frequency and regularity. Other gynecological diseases should also be taken into account. For a successful pregnancy, you need to lead a healthy lifestyle.

It is recommended to do moderate exercise for three months. It is necessary to be examined for the presence of sexually transmitted infections. Treatment is mandatory if chlamydia, papillomavirus and other unpleasant infections are detected. Pregnancy can be planned no earlier than 4 months after the medical procedure. If a woman is going to do IVF, she needs to undergo a long and very complex examination. It is important to know that IVF after hysteroscopy can end badly: a woman may have a miscarriage.

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Hysteroscopy. Postoperative period and possible complications

Any woman undergoes hysteroscopy. However, not everyone undergoes resectoscopy. What is the difference between these concepts?

1. In definition. Hysteroscopy is an examination of the uterine cavity to identify tumors. And resectoscopy is a surgical intervention performed in connection with the detection of these same formations.
2. In the method of implementation. The first option uses only a gyroscope, and the second uses additional tools: a scalpel, forceps and much more.

Thus, these two procedures have their similarities and differences. However, the reasons for carrying them out are approximately the same:

1. Sterility.
2. Presence of polyps.
3. Pain during the menstrual cycle.
4. Failure to comply with basic hygiene standards.

One way or another, after diagnostic hysteroscopy it is often necessary to perform resectoscopy.

Postoperative period. What is possible and what is not? Complications

After the operation, which lasts 6 hours, the patient is discharged home in normal condition. In case of violations, they are left under medical supervision.

Upon discharge, each woman is warned about what she can and cannot do. So, after hysteroscopy you cannot:

1. Have sex. This may cause excessive bleeding or complications during healing. Sex is not allowed for 7-21 days.
2. Use douching or tampons. They can cause erosions or other problems in the uterus.
3. Lift weights. This may cause the seams to come apart.

Sometimes, immediately after surgery, a woman may experience the following complications:

1. Bleeding after hysteroscopy. In this case, the patient remains under the supervision of doctors to identify and treat the causes.

Hysteroscopy is a minimally invasive method of surgical intervention in the organs of the reproductive system. It is used for diagnostic purposes and in the treatment of gynecological pathologies. Sometimes complications occur after hysteroscopy. To prevent such consequences from appearing, you must follow all medical recommendations.

Depending on the purpose for which hysteroscopy is performed, it is divided into the following types:

• diagnostic. During the study, it is possible to determine the degree of enlargement of the uterus, study the condition of the endometrium and identify various pathologies;
• surgical During the examination of the organ, the affected tissue is excised. Such manipulations can be carried out when identifying polyps, endometriosis, fibroids and other diseases of the uterus;
• control. Prescribed after a certain period after the start of therapy. In this way, it is possible to determine the degree of effectiveness of treatment and, if necessary, make adjustments;
• office.

Regardless of the purpose of the study, after it is carried out the body needs time to recover.

Diagnostic

The study is carried out to identify myomatous nodes, polyps and other pathologies of the genitourinary system. In this case, a hysteroscope of minimal diameter is inserted into the vagina.

Among the advantages of this method it is worth highlighting the following:

• mucous membranes are practically not damaged;
• general anesthesia is not required, thereby reducing the risk of complications caused by the use of anesthesia;
• hospitalization is not necessary;
• the duration of the procedure does not exceed half an hour;
• The operation was tolerated quite well.

Surgical

The procedure is indicated for endometriosis. With the development of this disease, the endometrium grows abnormally. It is possible to stop the pathological process by removing the uterine layer. The operation is also used for fibroids, adhesions and septa in the uterus.

Often during the rehabilitation period, women have stomach pain, but gradually the pain syndrome subsides. Bloody discharge also appears, which completely disappears after a week and a half.

Test

A hysteroscope is used during the examination. With its help, it is possible to determine what changes have occurred in the cervical canal and uterus after surgery and therapy. Thanks to monitoring the condition of the organ, it is possible to promptly identify complications after hysteroscopy and eliminate them.

Office hysteroscopy

It is considered the simplest. It is carried out on an outpatient basis. An endometrial biopsy is often performed.

The risk of complications is minimized. Only minor pain and bleeding appear after hysteroscopy, gradually decreasing in volume.

Indications for use

There are a number of indications for hysteroscopy. Among them the following stand out:

• failure of the menstrual cycle;
• the appearance of spotting after menopause;
• adenomyosis;
• myoma;
• endometrial cancer;
• synechiae inside the uterus;
• abnormalities of organ development;
• miscarriage;
• infertility;
• complications in the postpartum period;
• preparation for in vitro fertilization;
• assessment of the effectiveness of drug therapy;
• remnants of the fertilized egg in the organ after abortion.

Contraindications

There are certain contraindications in the presence of which the operation is not performed:

• infectious diseases occurring in acute form;
• inflammatory process in the genital organs;
• desired intrauterine pregnancy;
• cervical cancer;
• cardiovascular diseases;
• kidney and liver pathologies;
• atresia of the cervical canal;
• ectopic pregnancy;
• profuse bleeding in the reproductive organ.

If such problems exist, the study is not carried out. This is due to the fact that if manipulations are performed, the risk of complications increases significantly.

Postoperative period

Rehabilitation after hysteroscopy is conventionally divided into two stages. At the first stage, the integrity of the mucous membranes is restored and their functioning is normalized. During this time, the uterine mucosa completely heals, and the tissue of the cervical canal regenerates. Often, at the initial stage of recovery, a woman experiences pain in the abdominal area. They are most pronounced in the first few hours after the operation.

After 2–3 weeks, the damaged tissues are completely restored, and the second stage of rehabilitation begins. Now a new endometrium is beginning to form, with a normal structure and characteristic functional features.

Painful sensations

Minor, nagging pain is not considered a deviation from the norm. As a rule, the pain syndrome is localized in the lower abdomen and lower back. After a couple of days, the discomfort disappears. Their appearance is caused by tissue damage as a result of removal of a myomatous node, polyp, or other manipulations.

If a woman’s pain threshold is low, then the discomfort becomes more pronounced. In this case, they resort to the use of painkillers.

A cause for concern is unbearable pain and fever after hysteroscopy. The appearance of signs of intoxication should also alert you. In this case, in order to eliminate possible complications, you should immediately seek help from a medical institution.

Vaginal discharge

Bloody discharge is observed for several days after the operation. They appear due to damage to the mucous membranes of the organ with instruments. After 2–3 days, the discharge is insignificant and bloody. They disappear completely after a week and a half. The presence of ichor for such a long time is explained by the expansion of the organ cavity during the study and the penetration of fluid into the vessels. Severe bleeding should not be observed. Their appearance is a reason for urgent contact with a gynecologist.

Menstrual cycle

The timing of the arrival of the regula after hysteroscopy largely depends on the purpose of the study. If a diagnostic procedure was carried out, then the appearance of menstrual blood should be expected on the usual days. The cycle failure in this case is minor. Your period may be late by just a few days. The explanation for this is quite simple. The uterine cavity is practically not damaged, and recovery is much faster.

Therapeutic hysteroscopy with curettage has a more serious effect on the body. A missed period may last longer. In this case, the first day of the cycle should be considered the date of the operation. Accordingly, the arrival of the regulator is expected after 30 days.

It is extremely important to monitor the nature of the first menstrual flow. If their consistency, volume or color has changed, you should definitely tell your doctor about it.

Antibacterial drugs

Antibiotics after hysteroscopy are prescribed to prevent complications. During this period, the mucous membranes are damaged and not protected from infection, and as a result of the proliferation of pathogenic microorganisms, an inflammatory process begins.

Sometimes additional antibiotic therapy is used before the procedure. Often a three-day course of treatment is prescribed after hysteroscopy has been performed. Then they begin to restore hormonal levels. For this purpose, the drug Duphaston is prescribed.

Possible complications

As a result of the study, complications are sometimes observed. Among the early consequences after surgery are the following:

• inflammation of the uterus and peritoneum. Pelvioperitonitis and endometritis are considered the most common complications;
• hemolysis inside blood vessels;
• bleeding. Its appearance is due to the fact that during the operation the tissues of the uterus are injured, and large blood vessels may be damaged.

Later consequences include:

• hematometer. This is a pathological condition in which blood accumulates in the reproductive organ due to spasm of the cervical canal;
• deformation of the organ cavity;
• exacerbation of chronic inflammation;
• re-growth of removed tumors.

Damage to the vagina and uterine lining increases the risk of developing a bacterial infection. In this case, pain occurs in the lower abdomen and uncharacteristic discharge appears.

Pregnancy after hysteroscopy

There are certain recommendations that, if followed, will make the recovery process much faster. During the first month, a woman needs sexual rest. This is primarily due to the fact that the organ at this moment is not protected from negative influences from the outside. A sexually transmitted infection can penetrate the uterine cavity, and the condition will significantly worsen.

In addition, during the first week and a half, spotting from the vagina is observed. It also makes intimacy impossible. The woman’s well-being during this period is deteriorating.

Pregnancy after eliminating the pathology in the uterine cavity is possible. Doctors recommend thinking about conceiving no earlier than three months after surgery.

Normally, the recovery period lasts about a month. After curettage and hysteroscopy, you must strictly adhere to the following recommendations during this time:

• don't have sex. In addition to the fact that this will cause pain, there is also a risk of pathogenic microorganisms entering the organ cavity;
• do not swim in open water, pools, or even take a bath. Only showers are allowed;
• refuse to visit saunas and baths;
• do not neglect the rules of intimate hygiene and wash yourself at least twice a day;
• take antibiotics, strictly adhering to the regimen chosen by the doctor;
• measure body temperature twice during the day;
• avoid excessive physical activity and heavy lifting;
• do not use tampons. Preference should be given to pads and changed every 3-4 hours. Blood is a favorable environment for the development and reproduction of bacteria;
• organize your diet correctly. It is extremely important that the menu contains a sufficient amount of vegetables, dairy products and fruits;
• systematically undergo examination by a gynecologist;
• ensure timely emptying of the bladder.

Despite the fact that hysteroscopy is considered a minimally invasive operation, the risk of complications still exists. A woman must properly prepare for this procedure and strictly follow all medical recommendations after it. Due to this, the occurrence of undesirable consequences is observed much less frequently.

Temperature after hysteroscopy, is this normal? Not all women can boast of the absence of consequences after the procedure. Everything has its downsides. Although this method allows you to avoid the development of a large number of difficult-to-diagnose problems. An examination of the uterine cavity from the inside allows you to track the effectiveness of treatment and select the most effective method to eliminate the disease. The consequences are not pleasant.

Types of complications

Complications after hysteroscopy depend on many factors: the patient’s age, the state of the immune system, the presence of diseases and the purpose of the examination. The first two days after the examination, the woman may experience pain. And this is normal if the inconvenience lasts no more than two days. But if the pain syndrome becomes acute and the temperature begins to rise, urgently contact a specialist to eliminate possible consequences.

Even a slight temperature of 37.1 may indicate incipient inflammation. This is the body’s protective reaction to infection, and given the complexity of the manipulations performed, it needs help. Consult your gynecologist and he will prescribe suitable antibiotics or anti-inflammatory drugs. As a rule, an increase in temperature occurs after hysteroscopy with curettage. This happens due to microtraumas caused, the body tries to cope with them on its own.

List of the most common complications after surgery:

1. Infection of the internal genital organs;
2. Entry of air or gas into the vessels of the uterine cavity;
3. Perforation of walls;
4. Bleeding;
5. Allergic reactions to anesthesia;

Candidiasis after surgery

Thrush after hysteroscopy may occur due to infection. This problem occupies fourth place in statistical studies of complications. However, it is not only poor-quality sterilization of instruments that can cause this. If you carry out manipulations against the background of sexually transmitted diseases or HIV, the likelihood of infection with candida fungus doubles. In addition, severe stress suffered by a woman during the procedure can contribute to weakened immunity and illness.

Please note: you should not blame doctors for all your problems. After all, the most common cause of infection with candida fungus remains irresponsibility to personal hygiene and health. Long-term use of contraceptives or antibiotics, douching, use of other people's personal hygiene products - all this can provoke the disease.

Hysteroscopy with curettage

Particular attention should be paid to the condition of a woman after complex operations. A temperature of 37.1 after hysteroscopy with curettage on the first day is absolutely normal. Even if it rises above 37.5, there is no reason to panic. But if the situation does not change for several days, it’s worth thinking about it. The consequences of hysteroscopy of the uterus must be noticed as early as possible, then the situation will be easier to correct. Also pay attention to the sensations. The stomach may hurt and “ache”, but no more than three days. The consequences of uterine hysteroscopy can be very serious without timely intervention. There are several types of complications:

• Tear of cervical tissue. This is due to the forceps nipples. If the damage is minor, the body will soon cope with this problem on its own. If the gap is large, you will have to put stitches;
• Breakthrough of the uterine walls with instruments is eliminated by suturing. This usually happens when collecting samples using curettage;
• After the procedure, cervical spasm may occur. It does not allow blood to flow freely, and it begins to accumulate, increasing the risk of infection;
• Infection. There can be two reasons for the occurrence: unscrupulous compliance with sanitary standards or untimely use of antibiotics. Therefore, it is important to notice changes in temperature conditions in time. A temperature of 37.1 after hysteroscopy is normal. But if it lasts for several days or is getting worse, go to the doctor;
• Damage to the growth layer of the endometrium is one of the most serious disorders. If the disruption is too severe, he may never recover;
• The pathology was not completely removed. In this case, the operation will have to be repeated;

Recurrence of pathologies

Polyps are formations in the uterine cavity. They come in different diameters: from a few mm to several cm. To eliminate them, if there are no contraindications, surgical treatment is most often used. However, there are situations when the polyp makes itself felt again. What does this come from?

Often one of the reasons may be a complication after curettage. The pathology was not completely removed, and it reappeared. The second reason is hormonal imbalance. To avoid recurrence of the endometrial polyp after hysteroscopy, the patient is prescribed hormone therapy.

Chest hurts

A woman’s condition after hysteroscopy is very painful, and this happens very often, but if breast tenderness is mixed with the aching pain in the abdomen, this is an alarming symptom. Hormonal imbalances affect the entire body as a whole. The patient feels depressed and overwhelmed. But in addition to psychological problems, physiological ones are of great importance.

Important information: if your breasts hurt, most likely the level of progesterone in the blood exceeds the norm; it is very important to immediately consult a gynecologist for detailed advice. He will prescribe appropriate medications to normalize the patient’s condition as soon as possible.

Hysteroscopy is a micro-operation, and the recovery period after it is not much different from classical ones. It is necessary to follow a number of recommendations to promote a speedy recovery and carefully monitor your condition.

During the postoperative period, it is forbidden to lift heavy things, loads and physically strain - this can cause bleeding. Its intensity can be so great that the patient begins to lose consciousness. You shouldn't joke about this. It’s better to gain strength, and after a week, with new strength, you can get back to work.

Until the injured area has completely healed, it is forbidden to use tampons. Only gaskets. It is also worth waiting at least a week before starting sexual activity again. The consequences of such negligence can be unpredictable.

Conclusion

Hysteroscopy is a complex surgical operation. Talk to your doctor before agreeing to surgery. Ask him all your questions. Ask if it is necessary to comply with hospital conditions in your case. All these little things greatly affect a woman’s psychological state. And a lot depends on it in the postoperative period. Monitor your condition, measure your temperature every morning and evening, do not overexert yourself, take antibiotics, follow all doctor’s recommendations.

If you notice at least one alarming sign, contact a specialist for help as soon as possible. Complications after hysteroscopy may be minor, but it is better to protect yourself. Don't joke with your health.

You can get more detailed information on the topic from the video:

I’ll say right away that it’s hardly appropriate to evaluate this operation, much less recommend it to other readers. This operation requires medical indications. If it is indicated for someone, then it is probably worth doing it to get rid of the disease. Assessing the operation right away is also difficult, because I don’t yet know what the results and long-term consequences of this intervention will be. Well, first things first:

I was referred for hysteroscopy after an ultrasound. For 2 years I was tormented by severe bleeding both during menstruation and in the middle of the cycle, and also: my lower abdomen ached almost every day, regardless of the day of the cycle. At the first ultrasound, they diagnosed “uterine pathology and multiple polyposis”, and at the second, they said that there was one large polyp, and it was sitting tightly, they say that Duphaston could not cure it - you just need to cut off the leg and cauterize it. Of course, I didn’t want to have surgery, especially since I had to go to the hospital for 3 days and before that I had to pass 10 tests, consult with a therapist, do an ECG, fluorography and ultrasound. I was shaking for a long time, sat on forums, read reviews, and looked for recipes for traditional medicine, but I really couldn’t find anything... and decided to have an operation.

On August 31, 2016, I had surgery under general anesthesia. I fell asleep quickly, the operation itself lasted no more than 20 minutes, of course I didn’t feel anything (in short: the operation is not scary). When I woke up, I felt that my vagina hurt, as if an elephant had raped me. Then, when the anesthesia completely wore off, my lower abdomen began to hurt. The pain was as if I had a bruise inside, i.e. It was painful to move and turn from side to side. The doctor said that this is normal, my stomach may hurt, especially since I have not given birth. On the third day, the pain in the lower abdomen changed to aching. My general health was good, there was no fever, and I was discharged. After being discharged, I realized that I felt “good” only because in the hospital we lay in bed for 3 days and did nothing. As soon as I got out and got home, I began to feel severe weakness in my arms and legs and lethargy. I felt like I was drunk and my legs were staggering. She stayed at home for a couple more days. After the operation, the hospital didn’t do anything else with us, they just took our temperature 2 times a day (they didn’t even look at us in the chair). The gynecologist did not see the polyp; he said that there was a hyperplastic process (thickening of the walls inside the uterus). They scraped out my entire uterine cavity and sent it all for histology. Based on the results of histology, they will conclude whether there was a polyp in the thickness of these walls or not... Meanwhile, it’s already 7 days after the operation, and my stomach hurts every day: it aches, then cuts (.

Hysteroscopy is a modern procedure that is used for therapeutic and diagnostic purposes in gynecological practice. This endoscopic manipulation is carried out with a special optical device - a hysteroscope. It is performed using sedation in combination with local anesthesia or general anesthesia.

For diagnostic purposes, it is used to examine the inside of the uterus and to collect biological material for research. It can also be used to remove tumors and foreign bodies. This procedure can be performed if there is a suspicion of an oncological process, a perforation of the uterine wall after surgery, or to clarify the position of the spiral inside the uterus.

Despite the fact that hysteroscopy is considered a simple procedure and is well tolerated by patients, certain complications may occur after it is performed. Patients often complain of pain after hysteroscopy.

Causes and nature of pain

Pain after the procedure can be explained as follows:

• During the manipulation, the uterine cavity was stretched with gas or liquid.
• Minor damage that can be caused by instruments in direct contact with the uterine mucosa.
• The patient has a low pain threshold.

If for several days after hysteroscopy the lower abdomen or lower back/sacrum hurts and these sensations are insignificant or moderate, then this phenomenon is quite normal.

For 3 days after the procedure, patients may be recommended painkillers - Nurofen, Ketanov, Dexalgin, Nimid. But they should not be abused, so as not to miss some more serious complications.

There are emergency conditions in which you should definitely seek medical help:

• the lower back hurts very much;
• cramping, stabbing or shooting pains in the lower abdomen that radiate to the perineum;
• body temperature rises sharply;
• symptoms of general intoxication are observed.

If the patient does not experience serious complications, then sick leave is usually not provided. In most cases, 3-4 hours after the procedure or the next day, the woman is allowed to go home. However, each case is individual and health workers usually accommodate patients who are unable to go to work after the manipulation.

If the patient feels well and has no complaints after hysteroscopy, a cycle duration of 50 days can be considered normal

Features of menstruation after hysteroscopy

The diagnostic procedure, as a rule, does not disrupt the patient’s cycle. In this case, the endometrium is practically not injured and does not require a long period of time for its recovery. Menstruation occurs on time or with a slight delay of 2-3 days.

With therapeutic hysteroscopy with curettage of the uterine cavity, everything is different. In this case, the menstrual cycle begins to count from the day of the operation and menstruation should be expected in about a month. But sometimes after this endoscopic manipulation a more serious delay can occur.

After hysteroscopy, the selections deserve special attention, of which there will be quite a lot. You should pay attention to their color, smell and quantity. If some characteristic confuses you, then you should not delay your visit to the gynecologist.

After the procedure, pain in the sacrum and lower abdomen is definitely expected, which will resemble the sensations before the arrival of menstruation. If they go away on their own after some time, then this is considered normal. If, after hysteroscopy, periods become too painful, then this is a serious reason for a visit to the gynecologist, especially if this occurs along with specific discharge.

There is no reason to expect that there will be no pain at all after such an endoscopic procedure. However, as a rule, they are quite tolerable or easily relieved with analgesics, and also go away on their own after a few days.