Sex after curettage: sexual abstinence. Doctors' recommendations after hysteroscopy Hysteroscopy sexual rest
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Oksana asks:
How to restore the body after a hysteroscopy procedure?
To restore the body after hysteroscopy, you do not need to take any special actions that will help you do this as quickly and efficiently as possible. Hysteroscopy is a minimally invasive surgical procedure, the recovery from which is relatively quick and easy. To maximize the speed of recovery processes, you need to adhere to the rules of a healthy lifestyle, that is, eat right, get proper rest and keep your emotions under control.
During the recovery period, you can take complex vitamin-mineral complexes that will provide the body with all the necessary microelements. In addition, it is recommended to eat lean meats and fish, plenty of vegetables and fruits, as well as cereals. Products are best steamed, boiled, baked or stewed, but under no circumstances fry, especially with the formation of a hard, crispy crust. In order not to irritate the smooth muscle elements of the colon, bladder and uterus, it is necessary to avoid the use of hot, bitter and generally any strong seasonings.
In addition to proper dietary nutrition, to ensure maximum recovery of the body after hysteroscopy, it is recommended to walk in the fresh air, walking at a leisurely pace and avoiding heavy physical activity. If possible, you should alternate walks with simply being in the fresh air, for example, sitting on a chair in a park or forest. You should not engage in sports during the recovery period after hysteroscopy, as this can cause complications.
In addition, proper rest and good sleep play a huge role in the recovery of the body after hysteroscopy. You should relax in a homely, comfortable environment, devoting yourself to your favorite activities or any kind of activity that brings a feeling of satisfaction and pleasure. It is recommended to go to bed before midnight so that a night's sleep gives the body the opportunity to rest well.
For complete and maximum recovery of the body after hysteroscopy, you should eat properly, walk and fully rest for at least 3 weeks. It is optimal to adhere to this regime for 2 – 3 months.
If during recovery after hysteroscopy any housework seems difficult to a woman, she should ask her family for help. Don't be afraid to rest often while doing any work. For example, it is completely normal if, after a hysteroscopy, a woman interrupts several times while vacuuming the carpets to sit and rest for a few minutes.
For 2 to 3 weeks after hysteroscopy, you should not take any medications without consulting your doctor, as some medications may increase or provoke bleeding. In addition, during these 2 - 3 weeks you cannot do thermal procedures (bath, sauna, solarium, etc.), swim in open bodies of water (river, pond, lake, etc.) and take a bath. You only need to wash in the shower.
Since there may be watery or bloody discharge from the genital tract for 2 to 4 weeks after hysteroscopy, you should carefully clean the external genitalia every day and use pads. During this period, you should not use tampons, suppositories, creams, douches, or any other items or procedures that involve the introduction of any substance into the vagina. Accordingly, to restore the body after hysteroscopy, it is necessary to abstain from sexual intercourse until the vaginal discharge completely stops.
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Many women who are in the process of treating polypous formation, or recovering from it, are interested - after removal of a polyp in the uterus, when can you sleep with your husband? This question is not as straightforward as it might seem, since it cannot be answered only on the basis of general indicators of the dynamics of the patient’s recovery after surgery. Much depends on the individual characteristics of the woman’s body, the presence of concomitant pathologies and other factors. Let us consider the process of treatment and rehabilitation after removal of polyps in more detail.
Nature and dynamics of the disease
Polyps are benign formations that develop on the basis of hormonal imbalances in the female body.
Due to the influence of progesterone deficiency, pathological changes begin in the female body - dysfunctional endometrium is not removed from the uterine cavity, but accumulates there, forming specific growths.
Over time, a characteristic structure forms inside such growths, blood vessels develop, and connective tissue appears. This is how a polyp is formed.
Visually, it resembles a rounded tumor-like growth of a reddish color. If the polyp is located on the outside of the uterus, it is often subject to irritating external influences - for example, during sexual intercourse, or the use of intrauterine contraception.
When conducting a gynecological examination, it is impossible not to notice the irritation of the polypous form - it acquires a bluish or burgundy tint and begins to quickly increase in size.
A patient who had an active sexual life before the disease will face the inevitable consequences of increased trauma to polypous formation:
- pain localized in the lower abdomen;
- spasmodic contractions, indicating the development of inflammatory processes;
- bleeding outside the menstrual cycle;
- disturbances in the intensity and regularity of menstruation;
- sudden changes in body temperature.
All this indicates that, due to regular damage, pathological transformations began inside the polyp. With polyps of this type, an infectious lesion may develop against the background of inflammation - then the patient experiences a characteristic discharge of a viscous consistency with a brownish tint. In such cases, sex with a polyp is contraindicated.
If the neoplasm is located inside the uterine cavity, the risk of injury is minimal, however, diagnosing polyps in the uterus is more difficult.
They can only be identified using ultrasound diagnostics, when the clinical symptoms of the tumor become quite clear.
With this type of polyposis, you can have sex without experiencing pain. However, often after sexual intercourse, patients who have been diagnosed with a polypous neoplasm feel discomfort and note the appearance of bloody discharge in small quantities. This may mean that the polyp is dynamically progressing and increasing in volume, causing pathological changes in endometrial tissue. This situation requires urgent medical intervention.
Specifics of treatment
- Successful treatment of a polyp is achieved when it is removed. To achieve this, modern gynecology uses several methods:
- surgical curettage (hysteroscopy);
- cryotherapy (freezing the polyp with nitrogen or low temperature);
- radio wave method;
laser removal.
What all these methods have in common is that after excision of the tumor, the area of its attachment to the endometrial tissue is carefully treated with special means that prevent the development of recurrent manifestations. However, in some cases, if pathological tissue is not eliminated thoroughly enough, or as a result of the influence of other factors, relapses still occur.
In order to protect the patient as much as possible from the recurrence of the disease, she is prescribed a course of restorative antibiotic therapy, in some cases hormones, and is also ordered to take preventive measures against the disease.
Postoperative treatment will take from three months to six months. Whether it is possible to engage in sex or intense sports depends on the pace and dynamics of the recovery process, the patient’s individual feelings and the doctor’s prescriptions.
Recovery after surgery
After removal of a polypous neoplasm, the female body needs some period of calm and rest in order to reanimate damaged tissues and restore resources.
Curettage is a serious surgical operation that requires absolute sterility in the operating room and certain surgeon skills. Indications for this operation may vary. This is a therapeutic (medicinal) need or diagnosis of diseases. It may be necessary to cleanse to remove a frozen pregnancy from the uterine cavity. Sometimes curettage is performed to clean the uterine cavity from fetal remains after a spontaneous miscarriage.
Regardless of the reason for curettage, women are often afraid of postoperative reproductive dysfunction. How long after curettage can you have sex? How soon can you get pregnant? Will a woman be able to bear a child? Patients often ask these questions before surgery.
Precautionary methods when curettage of the uterine cavity
To avoid undesirable consequences during surgery, the patient must be examined initially. They take blood for clotting and do a general analysis. A vaginal smear helps identify infectious diseases of the patient’s genital organs. In the operating room, the anesthesiologist talks with the woman and identifies possible allergic reactions to pain medications. If during the preliminary examination no contraindications for the operation were found, the woman is given anesthesia and the surgeon begins his work. It is very important to maintain sterile conditions throughout the entire operation. After a successful curettage, a period of rehabilitation begins. During this period, the woman herself should worry about her safety. After the operation, it is prohibited to use cotton swabs and hygienic chemicals for the genitals. And an important precaution is sexual relations.
Sex after scraping
The period of sexual abstinence after surgery is determined only by the attending physician and only after examining the patient. The period of recovery of the genital organs depends on the reason for curettage, the health of the patient and the quality of the surgical intervention. On average, after curettage you can have sex, you can have sex only after 2 weeks. This period is due to the need to restore the mucous membrane of the uterus and its cervix. If the mucosa is not restored, then there is a huge risk of unnecessary post-operative infection. Even if you are confident in your sexual partner, you still need to take care and refrain from having sex. There are many diseases of the genital organs that occur in a latent form and do not pose a danger to a healthy body. In the case of a weakened uterine cavity after surgery, the consequences of the above-mentioned infections can be dangerous, and in some cases can even become irreversible. In addition to infection, sex can lead to microtrauma of the vagina. Microtraumas are dangerous because severe bleeding can occur.
After restoring sexual relations, a woman may experience pain, burning, dryness or other types of discomfort. As a rule, these symptoms are considered acceptable and go away very quickly. If you cannot get rid of the unpleasant sensations, then you need to visit your gynecologist. After examination on the chair and based on the results of ultrasound diagnostics, the doctor will give you further recommendations.
To summarize all of the above, I would like to once again remind you of the enormous role of the surgeon in the curettage procedure. The more experienced the surgeon, the less likely there are undesirable consequences after surgery. The body's lack of ability to become pregnant and carry a baby does not in any way threaten a woman's life. But reproductive function is a very important indicator for the happiness of her family. If problems of such a delicate nature arise, then the doors of our clinic are always open for you. The many years of experience and professional development of our medical staff are supported by all the technical base necessary for the diagnosis and treatment of diseases. Our laboratories are constantly replenished with all the reagents necessary for analysis.
The postoperative period begins from the moment the operation is completed and lasts for several months, until complete recovery – six months. And throughout this period, you must adhere to these recommendations by your doctor and lead an appropriate lifestyle. Certain restrictions also apply to the sexual sphere.
How to prepare for hysteroscopy
In order to prepare for surgery, a number of laboratory and clinical examinations are required, as well as consultations with other specialists in case of problems with the health of other organs and systems. And also, some changes in lifestyle a few days before the operation. Often, women are interested in information about whether it is possible to have sex before hysteroscopy. Here you need to take into account the time period for which sexual intercourse is planned before the operation. If a week in advance, then you can have sex before hysteroscopy. But three days before the upcoming operation you should abstain from sexual intercourse. Since this can provoke the development of infectious complications.
Also, it is necessary to take into account the diet on the eve of surgery. You should exclude “heavy” foods and include easily digestible foods in your dinner, which should be consumed no later than six o’clock in the evening if hysteroscopy is planned in the morning. Also, in the morning, on the day of surgery, food consumption should be completely eliminated. And significantly limit fluid intake.
Hysteroscopy operation
Hysteroscopy is performed on the fifth to ninth day of the menstrual cycle in order to prevent bleeding, due to the presence of a thin uterine mucosa and the lack of increased blood supply. Next, the woman is placed on a regular gynecological chair, anesthetized, and the operation itself begins. Using special instruments, after treating the vagina and cervix with a disinfectant solution, the cervical canal is expanded and a hysteroscope is inserted through it into the uterine cavity. After that, for better visualization and expansion of the uterine cavity, a gas or liquid medium is used and diagnostics is started, and then, when pathological foci are identified, their removal is started. During the entire operation, the pressure of the injected gas, or the amount of liquid, as well as the patient’s vital parameters, are carefully monitored.
During the examination, the clinical picture of what is happening is displayed in the form of an image on the screen, which the operating doctor is guided by. At the end of the operation, separate diagnostic curettage of the mucous membrane of the uterine cavity and the cervical canal is performed, with further histological examination of the resulting material.
When can you be sexually active after hysteroscopy?
Taking into account the above-described aspects of the operation, after the examination the woman is given appropriate recommendations for restoring the body. After hysteroscopy, antibacterial therapy is prescribed to exclude infectious complications and the development of endometritis. For the same purpose, sexual abstinence after hysteroscopy is recommended. Thus, a sexual partner can be a carrier of even the most banal pathogens that normally “live” in a woman’s vagina. But, since the local immunity of the vagina is provoked by the operation, sex after hysteroresectoscopy can lead to the development of undesirable consequences - from the banal “thrush” to pelvioperitonitis (an infectious process of an ascending type).
So, how many days after hysteroscopy can you have sex? Following generally accepted recommendations, calculations are not carried out in days. Only after three to four weeks, in the absence of complications and additional complaints from the patient, is sexual activity allowed after hysteroscopy. When you can start having sex, you should remember about contraceptive methods, since the body is not yet ready for pregnancy, this takes time. And now, when you can engage in intimate life after hysteroscopy, you should also especially not forget about the banal rules of personal hygiene.
Are other types of sex possible?
Often, women who have undergone hysteroscopy undergo long courses of treatment before and after it for any disease, or in the fight against infertility. And against this background, recommendations can be given for a long time to abstain from sexual activity. This is where the social question of the precariousness of family life comes into play. It happens that the spouses of patients are unable to abstain from intimacy for a long period, as a result of which the family idyll begins to shake. Based on considerations of preserving the unit of society, women ask the question: Is not quite traditional sex possible? Hysteroscopy of the uterus is a vaginal operation and does not affect other organs and systems. Therefore, oral sex after hysteroscopy is not prohibited at all. Reviews from patients who have gone through this claim that attempts at anal sex are also possible. This statement is incorrect. In the first four weeks, any stress on the pelvic organs should be excluded, since an increase in intra-abdominal pressure can be a provoking factor in the development of complications.
conclusions
Let's summarize. Hysteroscopy is performed by inserting a hysteroscope through the vagina. After which, it is necessary to exclude any stress on the abdominal area, as well as contact with a potential carrier of pathogenic or conditionally pathogenic microflora, as a result of which all rules of personal hygiene, the use of tampons and sexual intercourse must be observed for one month.
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 the 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 in a timely manner.
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 can end unsuccessfully (miscarriage) in the case of undetected and untreated intrauterine pathology, so most reproductologists consider it mandatory to undergo the procedure. 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 an 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 significant surgery (removal of a myomatous node or multiple endometrial polyps) or if complications arise.
Obstetrician-gynecologist Anna Sozinova
zdravotvet.ru
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.
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.
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.
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, septums) 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 the vessels, thus damaging their walls 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 a normal state, 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.
- You should be away from sexual activity for 3 months.
- It is forbidden to go to the bathhouse or sauna.
- You cannot visit swimming pools, swim in rivers or ponds.
- Compliance with hygiene rules is mandatory: take a shower, wash your face 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 pain reliever. 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 it is recommended to 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?
- 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.
- 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:
- Sterility.
- Presence of polyps.
- Pain during the menstrual cycle.
- 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:
- Have sex. This may cause excessive bleeding or complications during healing. Sex is not allowed for 7-21 days.
- Use douching or tampons. They can cause erosions or other problems in the uterus.
- Lift weights. This may cause the seams to come apart.
Sometimes, immediately after surgery, a woman may experience the following complications:
- Bleeding after hysteroscopy. In this case, the patient remains under the supervision of doctors to identify and treat the causes.