In the modern world, women are increasingly faced with diseases of the genitourinary sphere. Some pathologies can easily be cured with the help of conservative methods. Others require careful examination and surgery. This article will discuss how to remove a polyp in the uterus. Feedback on the methods will be described below. It is also worth mentioning how the postoperative period proceeds.
Polyp in the uterus: removal
Reviews of physicians and experienced gynecologists say that it is possible not to treat the pathology until education has reached a large size. However, there are cases when even small growths cause discomfort and spoil the life of the representative of the weaker sex. What should be the symptoms of pathology, in order to need to remove a polyp in the uterus? Reviews of doctors and patients speak about the following signs:
- permanent intermenstrual spotting,
- pains and cramps in the lower abdomen,
- discomfort during intercourse,
- heavy menstrual bleeding,
- liquid whitish vaginal discharge in large quantities.
Most often, such a clinical picture gives a large education. If you have found several signs in yourself, then it is worth as soon as possible to visit the gynecologist and make the necessary examination.
How to diagnose a polyp?
When is the removal of a polyp in the uterus? Reviews of doctors say that you first need to make a certain diagnosis. At the reception, the doctor will record your complaints and conduct an external examination. Based on these data, a preliminary diagnosis can be made. It is worth noting that the polyp of the cervix is detected during colposcopy.
Additional studies are assigned to detect education in the genital organ: ultrasound, hysteroscopy, metrography, and so on. Be sure to test the blood for certain tumor markers. This analysis may show a predisposition for the transformation of a neoplasm into a malignant tumor. If the diagnosis is confirmed, then remove the polyp in the uterus. Reviews of doctors say that it can be done in several ways. Consider them in detail.
Scraping, or gynecological cleaning
Quite often, this method excised polyp in the uterus. Deleting reviews is highly controversial. Doctors say that at present there are more effective and effective methods. Patients prefer to choose this treatment regimen due to the fact that the operation is very fast and after a few hours you can go home.
Scraping is done immediately after the end of menstruation. The woman must be given an anesthetic. This may be general or local anesthesia. Then the doctor takes a special device (curette) and makes a cavity scraping. It is worth noting that in this case, the removal of the polyp is done "blindly." The doctor simply cleans the walls of the uterus from the remaining endometrium and various growths. The manipulation lasts no more than 10-15 minutes. Once a woman recovers from anesthesia, she can go home.
Hysteroscopic growth excision method
There is another way to remove a polyp in the uterus - hysteroscopy. This manipulation is also performed using anesthesia. Pain relief can be general or local.
During the procedure, special dilators are inserted into the woman's vagina, which open the cervical canal and allow the device to sneak into the cavity of the genital organ. After that, the doctor carefully examines the walls of the uterus and finds a polyp. With this method can be identified and additional education, which can not be seen during ultrasound and manual examination. After diagnosis, a polyp is removed in the uterus. Hysteroscopy of such a plan lasts no more than 30-40 minutes. After excision of the growth, its legs and base coagulate. This avoids the recurrence of pathology.
Removal of uterine polyp with laser reviews has only positive. This method allows you to shorten the rehabilitation period and not cause any discomfort to the woman during the procedure.
Removal of the polyp in the uterus with a laser is performed as follows. The doctor carefully examines the cavity of the genital organ with an ultrasound scan and notes the location of the growths. After this, the effect begins with laser beams. Be sure to control the depth of penetration.
The undoubted plus of this technique is that after it there is no bleeding. The patient can go home within a few minutes after the manipulation.
Reviews on how to remove a polyp
So, we found out how a polyp is excised in the uterus. Deleting reviews has different. Doctors say that if there is a possibility and the necessary equipment, then you need to choose a laser method of action. However, at present not all medical institutions can boast of such means. That is why the removal of a uterine polyp can be done by different methods.
Hysteroscopy reviews are also positive. This method is the second most popular. Doctors say that plus this method in the possibility of simultaneous diagnosis. On examination of the uterus, additional lesions may be detected, which can also be removed. It is worth noting that when using the hysteroscopic method, it is possible to conduct a histological study. In this case, the diagnosis will be made most accurately.
If it is not possible to use the above two methods, the usual cleaning is performed. However, doctors say that this method is not always effective. Some women in three months go to the doctor with the same complaints. As a result of diagnosis, a large polyp is found in the same place. This indicates a great possibility of relapse.
Removal of cervical polyp reviews has different. Doctors say that in this case laser therapy can also be used. Such treatment gives positive results and causes almost no complications. Another way is to remove a cervical polyp. Feedback from women suggests that the usual excision of education often leads to consequences. This way you should not choose young girls and those who are going to have children in the future.
If you have had a polyp removed in the uterus, the postoperative period begins from the moment the doctor finished the procedure. This time is divided into several stages. Practically all women after the procedure are prescribed treatment and a certain regimen. Only compliance with all the rules and recommendations will allow you to quickly recover and return to the usual way of life. Consider the main points of the postoperative period.
Removal of a polyp in the uterus can have consequences in the form of pain in the lower abdomen, the occurrence of adhesions, accumulation of fluid in the cavity of the genital organ. All this is due to improper treatment or possible infection. That is why it is so important to choose proven medical institutions for correction, and not to address dubious doctors.
In addition, during surgery, not all of the polyp can be removed. In this case, the woman may experience severe abdominal pain and heavy bleeding. If such circumstances arise, you should immediately contact the doctors for help. Most likely, you will need re-scraping and cleansing the uterus.
Since a polyp is an exclusively hormonal disease, the postoperative period should include the use of hormonal drugs. Most often, a course of three or six months is prescribed. In most cases, the use of agents that normalize the hormonal background: "Janine", "Diane", "Logest", etc.
If a woman plans a pregnancy in the near future, then the following means are assigned to her: Duphaston, Norkolut, Utrogestan. These drugs contribute to the proper production of progesterone and reduce the concentration of estrogen.
If the representative of the weaker sex does not plan to have children in the near future, then she may be asked to establish a hormonal coil, for example, such as Mirena. In this case, do not have to drink daily capsules.
The postpartum period necessarily includes antimicrobial correction. The most commonly used drugs are "Vilprafen", "Naxojin", "Metronidazole", etc. You must start taking these drugs immediately after the manipulation. The duration of the course is chosen individually by the doctor.
In some cases, a woman may need several antimicrobials. Before manipulation, a test for sexually transmitted infections is required. If some of them are found, then the treatment is prescribed to both partners. Otherwise, at the very first sexual contact without protection, re-infection will occur.
The postoperative period involves careful monitoring of health. A woman needs to regularly visit a gynecologist and undergo examinations. Quite often, doctors prescribe ultrasound diagnostics, which is carried out every three months. During the examination, the condition of the organ and the presence or absence of relapses are noted.
In addition, a woman needs to take a blood test. Be sure to take into account the result of histology. If a malignant tumor is detected, then a course of chemotherapy and radiation therapy should be taken.
Summing up and conclusion
So, you now know how to remove a polyp of the uterus. Hysteroscopy reviews are positive, as is laser correction. Remember that with the appearance of education that causes discomfort, it is necessary to be regularly examined. In some cases, the polyp grows very quickly and in a few months reaches large sizes.
If education does not bring discomfort, it is possible to somewhat delay its treatment. In this case, the doctor often prescribes a course of hormonal and antimicrobial drugs, which can lead to a reverse transformation of the growth.
Examined by a gynecologist should be at least twice a year. Such diagnostics will allow timely detection of the pathological process and early treatment. Have regular checkups and always be healthy!
How long is the postoperative period and after how much is allowed to go home
As a rule, the postoperative period when using the method of hysteroscopy is shorter than during abdominal surgery on the uterus, including laparoscopic. The period during which a woman will need to observe a strict postoperative regimen and stay in the hospital depends on the objectives of the procedure:
- If a diagnostic procedure was performed in the form of an examination of the uterus, a woman can leave the walls of the hospital within a few hours. The full recovery period after such an operation lasts no more than 3 days.
- If diagnostic hysteroscopy of a small uterus polyp was performed, which did not require extensive intervention and trauma to the endometrium, the patient may stay in the hospital for a day, sometimes up to three days. The same period of hospital stay requires a hysteroscopy procedure with endometrial scraping. In this case, the need to monitor the patient's condition after the removal of polyps in the uterus is required for early detection and elimination of bleeding and other probable problems.
- Postoperative follow-up after hysteroscopy to remove uterine fibroids is the longest. After her, the patient is in the hospital for at least a week after surgery. The full recovery period can last up to one and a half months.
In general, the recovery period lasts much longer than the duration of stay in the walls of a polyclinic. After a woman is discharged from the hospital, her state of health will be restored gradually. Long-term treatment may be required after hysteroscopy with the use of medications and physiotherapeutic methods, gymnastics, diet and other therapeutic and rehabilitation measures.
The end of the recovery period will come when the atypical discharge from the uterus stops, when its condition returns to normal, and this is confirmed by the diagnosis. The terms of full recovery, as well as the period of hospitalization, are variable: if you have done hysteroresectoscopy, the postoperative period and recovery will take at least three weeks, while diagnostic manipulations do not require long rehabilitation.
Important! If hysteroscopy was used as a method of treating infertility, pregnancy is planned after completing a full course of rehabilitation, but not earlier than 3 months after surgery.
Recovery after hysteroresectoscopy
The complexity and duration of the postoperative period after hysteroresectoscopy, that is, the procedure during which surgical manipulations were performed, are caused by trauma to the lining uterus of the mucous and sometimes the submucosal and muscular layer of the organ. As a rule, the operation is performed to remove a polyp in the uterus or fibroids. These tumors are removed either by electrocoagulation or by direct excision with surgical instruments followed by coagulation of the wound surface.
Since the risk of bleeding after resection of fibroids or a polyp remains high enough, a woman should be under the supervision of a doctor for at least 3 days. If after surgery in the uterus are not observed heavy bleeding and signs of inflammation, the woman is discharged home, where she will undergo further treatment (medication).
Within two weeks after a hysteroresectoscopy of an endometrial polyp or uterine fibroid, a woman will have to:
- eliminate physical exertion, jumping, running, bending and squats, cycling,
- give up intimacy
- refuse to visit the pool, baths and saunas,
- observe thorough intimate hygiene,
- Use sanitary pads, not tampons.
In addition, it will be necessary to periodically be monitored by a gynecologist, as well as undergo an ultrasound diagnosis after 1, 3 and 6 months after the intervention.
Recovery after diagnostic surgery
After diagnostic hysteroscopy, the postoperative period usually lasts no more than a day. After the end of this period, the woman is allowed to go home, where she will stay for another 3-5 days. At this time, the patient may experience scanty bleeding from the vagina, which is considered normal, as well as pain in the lower abdomen of medium and low intensity.
To eliminate them, the doctor may prescribe antispasmodics or other drugs.
In most cases, special rehabilitation after diagnostic hysteroscopy is not required. The only thing worth paying attention to the patient is careful hygiene and temporary rejection of sex. If an additional medical procedure was performed (coagulation of tumors, curettage), physical activity and heavy loads should be reduced by at least a week.
When the pains go away
Unpleasant sensations in the lower part of the abdominal cavity, lower back, and sometimes in the perineum are observed in almost all women who have undergone hysteroscopy. Their appearance is due to the violation of the integrity of the mucous membranes and endometrium of the uterus. Since they have many nerve receptors, there is a spasm and pain that sometimes persists until the tissues heal, that is, for about a week or a little longer.
Important! If the pain is regular and unbearable, the doctor may use an injection of analgesics and antispasmodics. More often, however, he recommends that patients take pills.
Does endometrium grow rapidly after hysteroscopy?
Full recovery after surgery on the uterus is fixed when the endometrium becomes holistic, uniform and able to perform its functions. In this regard, after hysteroscopy, there are some features of the postoperative period. For example, the healing of the endometrial layer of an organ always occurs by natural regeneration. The tissue recovers itself within a few days or weeks depending on the scale of the surgical intervention and the area of the wound surface.
Forced to restore the original state of the endometrium is very difficult, since the ability of this type of tissue of the uterus to divide and regenerate is influenced by several factors:
- intake of basic nutrients and biologically active substances.
У большинства женщин со стандартными показателями здоровья восстановление эндометриального слоя происходит через 1-2 менструальных цикла.
Как восстановить эндометрий
Experts say that endometrial repair after hysteroscopy is a purely intimate and unique affair for each patient. They prefer to interfere in the process if within a month after the intervention the ultrasound scan reveals insufficiently fast tissue regeneration. Most often this occurs during treatment after hysteroscopy of an endometrial polyp, which has a large size and wide base. In this case, the wound surface is extensive and requires the use of additional measures:
- taking drugs to equalize hormonal levels,
- receiving funds to stimulate the immune system and the regenerative abilities of the body,
- taking antibiotics or anti-inflammatory drugs to prevent infection of postoperative wounds,
- carrying out physiotherapy, massage and so on.
A good stimulating effect is provided by the observance of the norms of proper nutrition and moderate physical activity. As a rule, efforts pay off quickly enough - in 2-3 weeks the endometrium begins to recover more intensively.
Note! It is impossible to use stimulating preparations without consulting a doctor, since there is a possibility that instead of normal endometrial tissues, connective or scar tissue will grow in place of the postoperative wound.
Nutrition after hysteroscopy
Recommendations on nutrition after hysteroscopy with endometriosis, myoma or uterine polyp are standard: on the first day it is necessary to gently load the digestive tract with liquid food, and then gradually load the intestine to restore peristalsis.
The list of things you can eat on the first day after uterine hysteroscopy includes:
- clear broths,
- liquid porridges on water or milk,
- sour milk drinks,
- grated cottage cheese with cream,
- soft vegetable purees.
On the second and third day after hysteroscopy, you can add soups in vegetable or lean chicken broth, steam cutlets from dietary meats, steamed fish, cereals (millet, buckwheat, oatmeal) into the diet. You can also eat steamed and boiled vegetables, omelets, casseroles with meat and vegetables. It is advisable to drink lightly brewed black or green teas, compotes, fruit drinks, natural juices and mineral water without gas.
Important! To reduce the risk of constipation, it is recommended to drink at least 2 liters of water per day.
It is strictly forbidden to consume alcohol, coffee, dishes with an abundance of spices, as well as fried vegetables and meat, sauces and mayonnaise. Products with high fat content is desirable to exclude from the menu until full recovery.
When can you play sports
After hysteroscopy, it is allowed to play sports no earlier than a week after the procedure. Particular attention should be paid to the choice of physical activity, because not all sports can be useful. What you should pay attention to:
- training should not bother or provoke the occurrence of discomfort,
- physical exercises should not contain jumps, run, weight lifting and other loads that are prohibited during the recovery period,
- full loads should not start earlier than allowed by the doctor.
Despite the fact that hypodynamia after hysteroscopy is contraindicated, almost all sports can be potentially dangerous. The only exceptions are yoga, breathing exercises and walking.
General recommendations on how to behave after hysteroscopy
In general, the lifestyle after the hysteroscopy should be subject to the principles of healthy lifestyles, but with the amendment that the woman had surgery. The most stringent restrictions describe the recommendations regarding hygiene and water procedures. The anatomical structure of the female reproductive system predisposes to the easy penetration of infection from the external environment, so it is important to reduce to a minimum or completely eliminate the following aspects of the usual life:
- in the first month after the intervention you should not take a bath, it is better to give preference to the soul,
- going to the swimming pool should be replaced with a shower - in artificial reservoirs you can overcool or catch an infection,
- it is not recommended to go to the bath for 1-2 months, since an increase in body temperature can cause bleeding,
- sex life after surgery is excluded for at least 4-6 weeks,
- after hysteroscopy, it is allowed to load yourself with a maximum of three kilograms of burden, so the prerogative to lift weights, even if it is a small child, leave them close,
- To reduce the risk of thrombosis it is worth wearing compression stockings.
If, after the operation, the woman decided to go to the sea, she would have to give up swimming on public beaches, and would have to lie down to get a tan only in the shade in the morning and evening. To spoil the rest can other expert advice.
For example, you should observe the daily regimen: sleep at night, as well as rest during the day, avoid the bright sun, heat or cold. During the recovery period, you can not drink alcohol, drinks with artificial flavors, energy and other not always healthy drinks, as well as many exotic dishes.
As a rule, the majority of women manage to behave after hysteroscopy in accordance with the recommendations. However, rehabilitation can be overshadowed by cramps and heavy bleeding, which are considered normal. To facilitate them, a woman can enroll for a massage or undergo a course of physiotherapy. Magnet therapy, electrophoresis, galvanotherapy and other procedures will help to recover faster.
Important! The classic way to get rid of abdominal pain "like a woman", which advises keeping cold on the lower back and abdomen, can result in inflammation of the uterus and appendages. Therefore, it is worth giving up. Drinking alcohol to reduce pain is also not worth it, because it is not compatible with many medications that a woman will take several days after the operation.
What not to do after hysteroscopy
Almost all the restrictions after hysteroscopy relate to situations that can trigger the development of infection, inflammation or the occurrence of bleeding from the uterus. These include:
- activities that require physical effort and weightlifting,
- water sports, as well as relaxing on the beach and in the pool,
- staying in hot, stuffy rooms, including saunas, baths, unventilated residential and non-residential premises, open sun places,
- classes and activities that are accompanied by a strong vibration - driving on rough roads, driving special vehicles, cycling, equestrian sport.
In addition, it is strictly forbidden to use and ingest drugs with heparin and its analogues, foods that thin the blood, irritate the mucous membranes. First of all, it is alcohol, carbonated drinks, spices, fatty spicy dishes, coffee.
What is prescribed after hysteroscopy
Hysteroscopy is almost never used as an independent method of treating myomas and endometriosis, polyps and uterine synechia. For the complete elimination of these pathologies, after the manipulations, various medical preparations are prescribed. With their help, it is possible to achieve maximum effectiveness of therapy. It is based on hormonal pills and drugs that exclude infection of wounds in the uterus, stimulate the regeneration of the endometrium.
The first drug that the doctor recommends taking after hysteroscopy is Duphaston. It helps to normalize progesterone, thereby restoring hormones and the menstrual cycle. As a rule, “Duphaston” after hysteroscopy is started from the first day after the operation, or after the start of the first cycle. A gynecologist may advise him to take the hormone pills “Norkolut” instead, which contain the same substances, but in a different dosage.
Important! Before the appointment of hormonal drugs must be tested for sex hormones. Based on the results of laboratory diagnostics, the doctor will calculate the required dosage.
If as a result of surgery on the endometrium of the uterus a large wound has formed, estrogen preparations are prescribed for 3-4 weeks. Their dosage is also calculated individually.
In addition to hormonal drugs, it is recommended to take drugs from other groups:
- "Tranexam" - to prevent bleeding,
- "Wobenzym" - to speed up the regeneration of the endometrium,
- "Longidase" - to reduce the risk of postoperative adhesions,
- suppositories "Hexicon" - to prevent inflammation.
If the woman has not been prescribed hormonal contraceptives, and during the recovery period unprotected sexual intercourse has occurred, the doctor may advise you to take Postinor. However, this tool is used very carefully, as the combination of an open wound on the endometrium with its forced rejection can provoke profuse bleeding from the uterus.
Do I need to drink antibiotics and which ones are better
Taking antibiotics after hysteroscopy is indicated to all patients without exception. Drugs in this category are necessary for the prevention of postoperative infections and inflammations. How long and in what dosage antibiotics should be drunk is determined on the basis of the volume and complexity of the intervention, the current state of the woman and the existing health problems.
In most cases, antibiotic therapy after hysteroscopy of the uterus uses broad-spectrum antibiotics:
- "Amoxiclav" or "Azithromycin",
- "Klacid" and their analogues.
These antimicrobials are used in standard dosages. Sometimes it can change in accordance with the characteristics of the patient's body. Antibacterial effects are supported by taking NSAIDs, which minimizes the risk of postoperative complications.
Is it possible to put anti-inflammatory candles
After hysteroscopy of the uterus, candles are often placed that help to deliver drugs to problem areas without loss of effectiveness. In most cases, vaginal suppositories have precisely anti-inflammatory action. They are effective even in the presence of abundant vaginal discharge, so their use is welcomed by many gynecologists.
What is hysteroscopy of the uterus polyp?
Hysteroscopy is considered a modern method for the treatment of uterine polyposis, known since the 20th century. Then the surgeons could only penetrate the uterus and remove the polyp based on the data of the examination of the internal genital organs of the woman through the optical system.
Improved technical capabilities today allow us to treat hysteroscopy not only as a method of surgical treatment, but also as an exhaustive diagnostic procedure.
Hysteroscopy allows you to assess the condition of the endometrium and the tissues of the uterine cavity using a video camera, fiber, magnification.
The method is widely used in modern surgical practice, gradually replacing alternative methods of treatment - curettage or abdominal surgery. Manipulation has its own characteristics, advantages, technique, contraindications, complications.
The nature and features of the procedure
Hysteroscopy (from the Greek. "Examination of the uterus") is an extended procedure for the study, as well as the treatment of the uterine cavity in cases of suspected infertility, bleeding of unknown origin, hyperplastic changes in the endometrial layer and many other diseases.
The method relates to endoscopic studies, has two main directions.:
- Outpatient or diagnostic
- Surgical or diagnostic and treatment (hysteroresectoscopy).
In the first case, the uterus cavity is diagnosed from the inside with a hysteroscope, and when abnormal lesions are detected, treatment is performed. The second case is aimed only at the healing process.
Hysteroscopy allows you to assess the condition of the endometrium and the tissues of the uterine cavity using a video camera, fiber, magnification.
Surgical hysteroscopy allows the removal of uterine polyp and other neoplasms with the thinnest forceps with their further histological examination. The operation is performed under general anesthesia and using a hysteroresectoscope.
Control and diagnostic is performed in order to study the state of the uterine cavity for pathological changes, tumors before or after surgery.
The hysteroscopic procedure has many indications, which is justified by a wide range of advantages.:
- Minimally invasive and short recovery period,
- The possibility of holding women of different ages (from 18 years old to the onset of age menopause),
- High accuracy of the procedure
- Wide-spectrum diagnostics of possible comorbidities (foreign bodies, oncology, infertility, endometriosis),
- Target biopsy, allowing pre-study the nature and characteristics of the pathological focus.
Other undoubted benefits of the procedure are:
- speed (up to 30 minutes),
- practical elimination of the risk of recurrence
- rare postoperative complications,
- rapid healing of uterine mucous membranes.
Hysteroscopic examination differs in purpose and technique.
Goals are determined on the basis of:
- complaints of a woman and her clinical history,
- the general condition of the patient,
- planned and urgent need.
There are the following types:
- Microhysteroscopy. An innovative method that allows for accurate surgical intervention, due to the multiple increase in what is happening on the computer monitor.
- Hysteroresectoscopy. Endoscopic method of research and treatment of the uterus in various diseases: polyps, synechia, fibroids, hyperplastic processes.
Removal of a polyp with a laser beam is a rare and expensive technique used in metropolitan specialized clinics.
According to the technique of emit:
- surgical (mechanical),
- electrosurgical (using currents of a certain frequency),
- laser hysteroscopy.
Removal of a polyp with a laser beam is a rare and expensive technique used in metropolitan specialized clinics.
Also, isolated simple and complex hysteroscopy:
- Simple. In the outpatient setting, simple manipulations are performed without the need for introducing anesthesia: small polyps, fibroids, removal of parts of the contraceptive coil, parts of the ovum, and more.
- Complex. Such manipulations require the presence of the patient in the hospital, general anesthesia. Sophisticated techniques are suitable for removing foreign bodies ingrown into the tissues of the uterus, dissecting mucous tissues.
Complex operations are usually carried out according to plan, after hormone therapy, often along with laparoscopic methods.
All types of operations involve vaginal access without additional punctures and abdominal incisions. All methods are carried out under general (rarely - local) anesthesia in the departments of specialized agencies.
Features of the procedure
Despite the minimally invasive method, the therapeutic hysteroscopy procedure requires:
- Careful preparation (if we are talking about a planned operation),
- Hospital stay after removal of polyps
- Compliance with all the requirements of a doctor in the early post-manipulative period.
Before treatment, diagnostic hysteroscopy is carried out, which allows to determine the presence of polyps and other changes in the structures of the genital organ.
A gynecological examination of a woman is necessarily carried out, the presence of concomitant pathologies of the cervical canal is determined with the help of mirrors, and biological material is collected for examination.
Be sure to conduct the following instrumental studies:
- Ultrasound of the abdominal organs and reproduction,
- x-ray examination of the pelvic region,
- MRI or CT scan,
- electrocardiogram or ultrasound of the heart,
During the preliminary examinations, women are found and studied.:
- clinical history
- complaints filed
- the presence of allergic reactions to drugs.
When confirming polyposis and other pathological neoplasms, they are removed.
Anesthesia is selected individually, taking into account the peculiarities of the age and body of a woman.
When do hysteroscopy?
When removing polyps in the uterus with a hysteroscope, the day of the menstrual cycle is important. Usually, all endoscopic treatment methods are performed on days 5–9 of the inactive phase of the menstrual cycle.
If the purpose of the manipulation procedure is to diagnose infertility, then the hysteroscopic examination is assigned to the phase of ovulation.
If before the procedure there was no hormonal treatment, then hysteroscopy is performed on the 6-7 day of the end of menstruation. This is due to the particular subtlety of the endometrium during this period.
In case of hormonal therapy with drugs of the antigonadotropin group, treatment is prescribed at the end of the medication course of correction.
If a woman has taken GnRH antagonists, then hysteroscopy is prescribed 6 weeks after the end of treatment.
Before manipulation, data from laboratory and clinical studies should be examined to rule out the likelihood of factors hindering hysteroscopy.
Женщинам обязательно следует сдать следующие анализы:
- анализ крови, мочи,
- мазок из цервикального канала на цитологическое исследование,
- изучение свёртываемости крови,
- исследование крови на ВИЧ, СПИД, сифилис, вирусные гепатиты,
- volume of glucose bilirubin, hepatic transaminases.
After examining all the data of laboratory and instrumental studies, the doctor determines the feasibility of hysteroscopy and assigns the date of the proposed therapeutic manipulation.
What kind of anesthesia and how is the operation performed?
Before therapeutic hysteroscopy, they conduct an additional examination, consultation with the anesthesiologist. Most commonly used intravenous general anesthesia, the duration of which does not exceed 30 minutes.
Under local anesthesia, only diagnostic manipulations are usually performed, since the action of such an anesthetic is short-lived, and if necessary, additional manipulations may require an increase in the dose of the drug.
After examining the doctor, the woman goes to the surgery room, is located on the couch, which resembles the usual gynecological chair.
The genitals produce an antiseptic solution, after which anesthesia is administered.
Next comes the manipulative process.:
- Expansion of the cervix to ensure the conductivity of the flexible tube of the hysteroscope.
- Filling the uterus with gas or liquid.
- Determination of the location of polyps and their removal. For large tumors, a surgical loop is used.
- Treatment of the wound on the mucous membrane.
- Removing the hysteroscope.
- Completion of the operation and placement of the woman in the ward.
On the first day, the woman is supervised by the medical staff (awakening from anesthesia, general well-being, special medications are prescribed).
Basic recommendations for recovery
The woman after a successful hysteroscopy is in the hospital for 2-3 days, after which she is sent home for further recovery.
Among the main recommendations there are:
- Continuing antibiotic therapy to prevent infection.
- Regular measurement of body temperature.
- Compliance with thorough hygiene of the genital organs after the toilet (regular washing with soap and water).
- If pain persists, take non-steroidal anti-inflammatory drugs (normally, the pain is moderate and lasts for 3-5 days).
- Control over urination regularity.
- Elimination of weight lifting.
- Sexual rest up to 30 days.
During rehabilitation it is important:
- Follow a balanced diet to prevent constipation.
- Avoid swimming in open water, visiting the solarium, hot saunas or baths.
If you follow all recommendations, the recovery happens quickly and, after 3 months, the woman can lead a normal life.
Contraindications can be absolute and relative.
The main obstacles to performing hysteroscopy are:
- Pregnancy or lactation,
- The active phase of the menstrual cycle, bleeding of a different genesis,
- Cervical stenosis,
- Acute inflammation (surgery is performed only after complete cure),
- Infectious diseases of the genitourinary system,
- Severe pathology of the liver, kidneys,
- Diseases of the cardiovascular system,
- Oncological neoplasms.
If a woman has absolute contraindications, then the operation is carried out by alternative methods or continue observation.
With relative contraindications, manipulation is carried out after the exclusion of obstructive factors.
See how the removal of a large glandular polyp of the uterus by hysteroscopy in a young unborn woman:
Treatment of uterine polyposis with endoscopic equipment is an effective and low-impact method. When the first disturbing symptoms appear, the woman should consult a doctor for a more accurate diagnosis and appropriate therapy. Women of reproductive age should especially look after their health in order to fully realize motherhood and avoid numerous complications.
Recovery after surgery
After the operation on excision of the node on the mucous walls of the vagina, granulation tissues can be diagnosed, which can bleed. Often, doctors take them for a granulation polyp and cauterize them with lapis.
If a patient has an ovarian dysfunction, hormone replacement therapy is required.
The recovery period after hysteroscopy usually takes about six months. During this period it is important to constantly be on your guard and be examined by a gynecologist about once a month.
This is due to the possibility of the reappearance of small polyps in the uterus. After the operation itself, for a speedy recovery and normalization of the reproductive system, the woman is given a whole range of therapies:
All medical procedures are carried out simultaneously. Planning a pregnancy cost only after six months after the intervention and the completion of postoperative recovery. This is necessary so that the body can fully prepare for the new load.
Monthly begin after 2 months, in individual cases, this period may be longer. The cycle is fully normalized after a couple of months.
Hormones to speed recovery
Often, polyps in the uterus are formed due to hormonal imbalance. It can be caused by severe stress, intensive treatment of a disease, an abnormal lifestyle. Hormones are prescribed to avoid the reappearance of polyps. Doctors often prescribe:
If the patient does not undergo hormone therapy, then there is a big risk to negate the treatment. When polyps reappear, the same operation will be performed, and more formations may appear. The hormonal complex should also be chosen by a physician, some individually inappropriate means can only worsen the condition of the woman. Particular care should be taken if the patient has fibroids.
Many experts recommend putting the hormone coil "Mirena".
This is one of the most convenient methods of treating diseases for the female part, in addition it performs the function of a contraceptive, it is put for a period of 5 years. It releases all the hormones that are necessary for sustaining recovery in the uterus, and they are not absorbed into the blood itself. This spiral has virtually no side effects, which is another plus.
Soothing and painkillers
Often, surgery to remove a polyp can cause significant damage to the tissues of the uterus or cervical canal. This happens with large polyps or when there are many. In such a situation, women may begin to be disturbed by the pain of a pulling character in the lower abdomen. To help eliminate the painful symptoms of the postpartum period will help painkillers. Best help:
- analgin and its derivatives,
Doctors recommend taking a course of sedation, as during the operation and after it the female body is under severe stress. This may hinder recovery, because for this you need peace and rest. To relieve stress, you can drink teas based on mint, valerian, lemon balm. The use of medicines for this purpose is also permissible.
This includes the means that stimulate the body to restore itself. One of the basic aspects of such therapy are:
- taking vitamin complexes (in the first weeks after the operation, great emphasis is placed on taking vitamins C and A),
- supplemental feed dietary supplements,
- good and good sleep.
This charge helps the body to bring all the metabolic processes in order.
As a result, the body is more likely to recover.
Methods of traditional medicine in this situation are unacceptable, we need a full-fledged approach with medical and therapeutic measures.
The medical complex at permission of the attending physician can be combined with methods of phytotherapy. They consist in taking different infusions. The most common use of celandine and boron uterus.
Nutrition after surgery
Also one of the important stages of therapy. With nutrition, the body receives a large amount of minerals, trace elements and vitamins. A balanced diet will give the body even more strength for rehabilitation. To build your meal plan is taking into account such moments:
- It is necessary to increase the caloric intake of food at the expense of animal proteins. It can be poultry meat, beef, fish saturated with healthy fats, eggs.
It is important to remember that almost every patient has some kind of disorder or chronic illness. Therefore, the power scheme should be taken into account and line up according to existing restrictions.
They are very helpful in restoring a depleted organism. After surgery, many experts prescribe:
- ultrasound therapy
- magnetic therapy
They are used for rehabilitation mainly after the traumatic method of removing polyps. Physiotherapy measures help to avoid the appearance of adhesions in the uterus and fallopian tubes, which very often occurs during the formation of polyps.
May additionally prescribed drugs containing iron. This is done if anemia has developed due to the large loss of blood and the woman. Additional treatment lasts about 3 months.
So after scraping some patients may be disturbed by the discharge. Usually they are bloody, have a brown color.
Such secretions are normal, it comes out ichor from the wound.
It is important that such a phenomenon is not accompanied by unpleasant sensations when pressed, so that it does not hurt to sit down or move.
If they are, refer to a gynecologist, it can be a signal of infection or secondary inflammation.
Understanding a polyp
Uterine polyps are a consequence of the pathological proliferation of the endometrium (hyperplasia), which can be caused by various provoking factors. As a result of the pathological process, a tumor is formed, which may be different:
- shape: mushroom-shaped with a wide base on a thick stalk or round on a thin stalk,
- by color (from light pink and pale to maroon and purple),
- by structure: depending on the cells prevailing in the tumor, fibrous, glandular, fibrous glandular polyps and adenomatous types are distinguished (the latter is considered to be a precancerous tumor),
- by quantity: single or multiple (polyposis).
Dimensions are in millimeters, they can be small, barely noticeable from a few mm or large to 25 mm. That size is one of the main criteria for the appointment of the operation. The choice of tactics is also influenced by the results of histology (determination of the structure) and features of the course (asymptomatic, with bleeding, etc.).
The causes of the formation of polyps are different. The main hormone disorders are considered (a shift in the balance of normal hormonal background, in which estrogen is in excess, and progesterone is in deficiency). The reason for the violation of hormonal stability can be physiological changes (puberty, pregnancy, menopause). Or pathological (diabetes, obesity, thyroid disease, pituitary, adrenal glands). Or taking hormonal drugs, including for contraception.
Additional factors provoking the pathological process in the uterus, are:
- gynecological diseases (endometriosis, cyst, fibroids, ovarian pathology, etc.),
- injuries and microtraumas (obtained during examination, childbirth, abortion, use of intrauterine devices of contraception, sexual intercourse),
- pathological processes of different etiology: infectious and venereal diseases, inflammations, disorders of the microflora composition.
Constant stress, depression, overwork can also be factors provoking the development of a neoplasm, there are also cases when it is not possible to identify the specific etiology of endometrial polyp development (unclear etiology). Women, in the history of which there is at least one of the risk factors, it is especially important to regularly undergo medical examinations. According to statistics, 70% of all detected cases of polyposis (multiple neoplasms) develop on the background of one of the above listed diseases. In such cases, the treatment is complex: they are removed and therapy is prescribed to eliminate risk factors and associated diseases. This is necessary to eliminate the risk of recurrence, since the removal solves only the current problem, and the elimination of its cause is the main one.
Symptoms in the early stages of polyp development may be absent, so women should regularly visit a gynecologist. With the further development of pathology may appear:
- bleeding (outside menstruation) and significant cycle changes,
- any discharge (bloody, brown, whitish, etc.),
- nagging pains, including during sexual intercourse,
- problems with conception or the threat of miscarriage.
When one of the symptoms appears, you should immediately consult a doctor for diagnosis and appropriate treatment (most often removal). The profile specialist conducts an examination, assigns additional tests (histological examination of the pathological focus is necessary). According to the results obtained, the removal tactic is chosen.
Do I need to delete?
Is it necessary to remove tumors? In some cases, surgery is mandatory, sometimes doctors recommend a deferment. In the early stages, patients are given a choice.
To make the right decision, it is necessary to analyze the features of the pathology:
- At first, a polyp can be asymptomatic for a long time: but if the provoking factor is not eliminated, then the tumor will grow in size. Then various threatening symptoms may appear (for example, anemia may develop on the background of persistent bleeding). And further more traumatic operation will be required. Therefore, even if it does not bother, the pathological focus should be completely removed.
- With increasing symptoms: a progressive disease will become a problem for a woman, and the tumor itself does not resolve and cannot be cured only by conservative methods. Without surgery, the polyp will provoke a further deterioration in general health, threaten the fertility function, may lead to the development of polyposis, in the worst case - to oncology.
- When using hormone therapy and symptomatic treatment: if you do not remove, and try drug therapy, it will not lead to full recovery. For example, hormone therapy will help balance the hormones, but when it is canceled, the growth of the growth usually resumes. That is, it is necessary to eliminate not only the cause (hormonal imbalance), but also the consequences - the tumor itself.
- The risk of rebirth: a polyp can degenerate into adenomatous form (precancer) and provoke endometrial cancer of the uterus. Therefore, to do the operation or not, the question is not, the risk of developing oncology is a sufficient basis for surgical intervention.
- Patient's age: in postmenopausal patients, the risk of developing an adenomatous polyp and a transition to oncology increases. Therefore, older women definitely need to remove the tumor.
Having considered what consequences may appear in case of refusal from surgical treatment, each patient will be able to decide whether to remove the growth or not. Or try other options (therapy, folk remedies). The only thing that is definitely unacceptable is the lack of treatment as such. Since most of the factors that provoke the development of a tumor are pathological, experienced gynecologists form a general plan for managing such patients. It aims to eliminate concomitant diseases and surgery to remove a tumor.
Dimensions for operation in millimeters
The size of the tumor is of great importance for choosing the tactics of the patient. Polyp is considered:
- small if not reached 5 mm
- average, if the size is from 5 to 15 millimeters,
- large if more than 15 mm.
A small polyp may not be removed immediately if it does not threaten health (no bleeding, does not provoke a threat of miscarriage, etc.). In any case, the clinical picture is assessed comprehensively, an individual treatment plan for provoking factors is selected. A woman with a tumor is at risk, should be regularly examined, and during rapid development, the tumor is immediately removed.
Medium size is a standard indication for surgery. The indications for emergency surgery will be both a calm course and the increase in symptoms, the growth of the tumor itself, and histological changes. A large neoplasm is removed as quickly as possible.
Indications and contraindications
The operation to remove a polyp is often the joint decision of the patient and the doctor. The doctor determines the degree of risk and explains all the consequences of failure. In some cases, immediate surgery is the only option.
Indications for immediate surgery:
- Medium and large tumor
- the pathological process is actively progressing: symptoms are increasing, size is increasing, histology is changing,
- the ineffectiveness of drug treatment: the bleeding does not stop, the tumor does not decrease in size, the woman can not get pregnant,
- neoplasm of adenomatous type (precancer) or detection of cancer cells in the endometrium,
- risk of miscarriage,
- The patient's age is over 40: hormonal changes will provoke the growth of a polyp, the risk of developing oncology increases.
Отложить лечение и использовать медикаментозную терапию можно:
- при беременности, если нет угрожающих симптомов,
- if the tumor is small in size, its size diminishes under the influence of therapeutic treatment, the course of the disease is sluggish and asymptomatic,
Contraindications for immediate surgery will be:
- diseases of the external genital tract of any etiology (infectious, venereal, fungal),
- pathology of the cervix, in which it is impossible to carry out an operation (stenosis, cancer, etc.),
- acute infectious diseases
- chronic diseases in the stage of exacerbation (high sugar level in diabetes, increased blood pressure in hypertension, exacerbation of gastric ulcers, thrombophlebitis, etc.),
- severe bleeding caused by other gynecological diseases until it stops.
In such cases, first eliminate the cause of the delay, and then conduct surgery.
Before you remove a polyp, some preparation is usually required. It is simple and goes through several stages:
- first of all, tests are prescribed,
- if they are normal, the day of the operation is selected taking into account the menstruation schedule,
- preoperative preparation is needed,
- on the day of surgery it is forbidden to eat and drink (if we are talking about surgery under anesthesia).
If the tests are normal and there are no other contraindications, the day of the surgery is appointed. Before hysteroscopy and other methods of removing a uterine polyp using anesthesia, it is necessary to refrain from drinking alcohol. Smoking women are advised to abstain from smoking or reduce the number of cigarettes. On the eve it is recommended to adjust the nutrition and switch to easily digestible food, in the last meal in the evening it is better to drink a glass of kefir.
Now consider how to prepare for the operation in more detail. The examination is carried out on the eve of the operation; the doctor determines which tests to pass. Usually prescribed:
- blood and urine tests
- smear (determined by the degree of purity),
- in the presence of chronic diseases, it is recommended to consult a specialist.
As part of preoperative preparation, the doctor may prescribe hormones or antibiotics (if indicated, to reduce the risk of complications). It is advisable to abstain from sex or use a condom for a week. Douching, medicated tampons, ointments, suppositories and creams are best not to use (they can distort the smear results for cleanliness).
On the eve and on the day of the operation, a cleansing enema is done, hair is removed from the external genitalia. Immediately before the procedure, it is desirable to empty the bladder. This is the standard preoperative period. More details about the preparation procedure will tell the attending physician.
On which day of the cycle a polyp is removed.
In most cases, this is a planned operation. The doctor has the opportunity to choose which day to do it and adjust the date to suit menstruation. This is important, because in the period after the end of bleeding in the endometrium restorative processes occur. The exception will be older women with an unstable cycle or lack of menstruation (with the onset of postmenopause). In this case, it does not matter on which day the surgery is performed.
It is better to remove polyps on the third day after the end of menstruation, when the menstrual rejection of the endometrium ends completely, and the process of its restoration is not yet completed. This helps to avoid possible complications, such as bleeding, which is sometimes accompanied by hysteroscopy. The best day of the cycle, when the removal occurs with minimal injury to the female body, is considered 6-9 from the onset of menstruation. It is during this period that the tumor is clearly visible and as accessible as possible.
How to remove
In modern medicine, different methods of removing polyps inside the uterus are used. The choice of method depends on the clinical picture, the amount of pathology, the type of tumor, its shape and size. Currently used:
- diagnostic curettage
- hysteroscopy (there are several subspecies of this operation),
- laser burning,
- instrumental removal (including, with the help of modern tools, for example, electric fans),
- radio wave removal.
The need for pain relief (anesthesia)
Does it hurt to delete? It depends on the way the endometrial polyp will be removed. Also important is the peculiarity of the course of pathological processes in each specific case, the type of polyp, the individual pain threshold. Even within one method, anesthesia may be different or not used at all. For example, there is the concept of "office hysteroscopy", anesthesia with it is not required (all techniques will be discussed in detail in the section "Common Methods").
Local anesthesia is practically not used, preference is given to the general. When using a laser and radio waves, anesthesia is not performed at all. These tumor removal techniques are painless. When using a laser, the removal occurs in the hospital, but after 3 hours, if there are no complications, the woman can go home.
In some clinics under local anesthesia, diagnostic curettage can be performed. General anesthesia is used for hysteroscopy, and in 95% intravenous is recommended, and only in 5% of patients, with individual intolerance or other contraindications, epidural anesthesia is used.
The choice of method depends on the volume and characteristics of the revealed pathology, as well as on the technical capabilities and equipment of the clinic. In modern medicine, some methods are practically not used, since they are ineffective and are considered obsolete. Next we look in detail at all ways to remove.
DIAGNOSTIC SCRAPTURE. Today, diagnostic curettage is often used not as an independent method of treatment, but as an auxiliary after hysteroscopy. It helps to assess the condition of tissues, to obtain material for histology. This is due to its unreliability. The risk of relapse after the procedure is quite high (about 30%). Most often used in medical institutions with insufficient modern equipment, where there are the most simple tools (curette, uterine expander).
The method is quite traumatic, the surgeon can not completely control the removal process (this explains the high percentage of relapse). But it is recommended for emergency surgery, when you need to stop the bleeding and prevent significant blood loss.
HYSTEROSCOPY. The most common and frequently used method. He is considered the main method of surgical treatment of this pathology. Since there are different techniques for the operation, we will consider it separately and in more detail (see chapter Hysteroscopy).
REMOVAL OF POLYPES IN THE MATT LASER. At the moment - the most effective technique. Its advantages can be considered:
- the ability to adjust the intensity of the beam, which excludes damage to healthy tissue,
- lack of scars, which minimizes the risks of complications such as infertility,
- non-contact method, which virtually eliminates bleeding after surgery,
- does not require anesthesia, which allows you to leave the clinic within a few hours after surgery.
An additional advantage would be the use of a hysteroscope, which allows visualization of the operative field and accurately viewing all pathological changes.
RADIO WAVE REMOVAL. In terms of efficiency, safety and technique, it is similar to the laser method. Only the effect on the neoplasm occurs with the help of directional radio waves. They, like the laser, destroy the tumor tissues in layers, without touching the surrounding tissues, and without damaging the mucous membrane.
TOOL METHOD. Removal occurs with scissors or forceps, a more modern version is the electric wire, which allows you to cauterize the base of the tumor and prevent blood loss. This option is often offered, if we are talking about a single polyp on the leg, you can simply "unscrew".
Duration of surgery
How long does the surgery take? With a conventional surgical procedure, removal usually takes no more than 1 hour. Laser and radio wave procedures take no more than 10-30 minutes. Hysteroscopy, even with a large amount of pathology - no more than 45 minutes, the standard time is 15 - 30 minutes. The longest will be the elimination of polyposis, when multiple tumors require more time to destroy them. The shortest operations are considered to unscrew a single polyp on the leg, they take about 10 minutes.
Uterine hysteroscopy - removal of a polyp using a special hysteroscope device. This is the most common technique that allows you to get a visual picture of the pathological process. At the end of the insertion tube is a video camera that transmits an image from the uterus to the monitor. The diameter is small, inside the tube is hollow, through it access to the uterus is provided (instruments are inserted).
In fact, any modern surgery for detecting a tumor in the uterus can be considered hysteroscopy. Only the instrument by which it is eliminated is changed. The hysteroscope is used with the laser and radio wave method, using other instruments.
With the help of a hysteroscope, not only surgery, but also the so-called “office hysteroscopy” is performed. It is rather a diagnostic method, in which the doctor gets the opportunity to examine the pathological focus in detail, to determine its volume, quantity and shape of the tumor. And then, in accordance with the information received, the tactics of surgical intervention is chosen. That is, it is determined exactly how the operation will take place. Although the diagnosis is called hysteroscopy, it is just an instrumental method of examination, which is carried out using a hysteroscope and without anesthesia.
How is the operation:
- the patient is given anesthesia,
- external genitals are treated with a special aseptic solution,
- the cervical canal is “stretched” with the help of dilators for the free insertion of the hysteroscope tube,
- so that the walls of the uterus are flattened, its cavity is filled with liquid or gas,
- through the channel of the hysteroscope, an instrument is inserted that was chosen for polypectomy,
- the place where the tumor was located, "cleaned". For this, a curette can be used (curing of the endometrium located under the removed tumor). Or treated with special means (a preventive measure to eliminate the risk of relapse). For this they can use the cryogenic method, and to stop bleeding - electrocoagulation.
The resulting material (remote tumor and tissue scraping) are sent for histological examination. What method to perform hysteroscopy is usually decided by the doctor on the basis of diagnostic data. After the end of the operation, the patient is delivered to the ward, where she moves away from anesthesia (if used).
Possible consequences and methods of their elimination
Complications after removal are not a frequent occurrence, they are usually caused by certain causes. Women need to know in advance about the possible consequences of hysteroscopy. They may be normal, that is, a natural reaction to surgery, and abnormal. Understanding this will help to promptly seek medical help in case of complications in the postoperative period.
Normal reactions include:
- slight smearing discharge within 2 to 3 days,
- discomfort or pain in the lower abdomen, including during sexual intercourse.
Possible complications, their causes and methods of elimination:
- Copious bloody discharge after removal of a polyp: may indicate perforation. This complication is most common with "blind" scraping. Recommendations: consult a doctor if the specialist determines that there is no danger, Oxytocin is prescribed,
- Temperature: characteristic of women who had a history of infectious diseases of the genitourinary system before the intervention. Usually the temperature does not rise above 38 0. Recommendations: check the condition of the endometrium for infection, anti-inflammatory drugs are prescribed,
- Long delays of the next menstruation: it is necessary to consult a doctor if the delay is more than 3 months,
- Adhesions, scarring, sterility: usually the result of curettage. Recommendations: pre-select other equipment for the operation,
- Hematometer: accumulation of blood in the uterus. Dangerous complication, therefore, for any delay, you should immediately contact a gynecologist. Otherwise, there is a risk of severe complications up to death as a result of sepsis,
- Endometrial cell regeneration: this risk exists initially, especially in older patients. Recommendations: regular monitoring by a gynecologist.
- Another risk is relapse. It does not depend on the type of surgery. Recommendations: elimination of provoking factors and preventive measures.
Treatment after removal of the polyp is prescribed in accordance with the results of the surgical intervention. The state of health of the patient also matters, the presence of chronic diseases requires additional treatment. Usually after 10-14 days the patient is examined again. At the same time, the results of histological examination of the removed tumor and tissues are ready.
If there are no complications, and the histology has not revealed malignant cells, then the recommendations in the postoperative period are standard. If complications begin, then curettage can be prescribed, and if oncology is detected, a second operation can be performed to remove the pathological focus.
Treat mainly begin diseases that provoked the development of a tumor.
- Antibiotics: can be prescribed for the treatment of identified infections, and for the prevention of infection in the postoperative period,
- Antispasmodics: usually appointed in the first days after surgery for the purpose of prevention,
- Hormone therapy: most often used in the postoperative period. This is due to the hormone-dependent etiology of tumor development. Hormone therapy is prescribed as prevention of recurrence, as well as a contraceptive (pregnancy in the first three months is undesirable). After this period, if all the processes were normal, women are advised to use the "withdrawal syndrome" - the chance of getting pregnant increases. Or put the intrauterine device with gestagens. It will avoid unwanted pregnancy and restore the endometrium faster.
- Herbal medicine: applied according to indications, in the postoperative period folk remedies and herbal therapy shows a good result.
A visit to the gynecologist every 2 months, treatment of chronic diseases, gentle treatment (it is desirable to exclude physical and psycho-emotional stress) will be mandatory.
Can blood and how much?
Bleeding is considered normal if it is not large and lasts no more than 3 days. It may not even exist if one of the modern methods of surgical intervention was used (laser, radio waves).
Why blood? This process is associated with recovery from endometrial injury. As healing progresses, this process quickly ends. Even small blood smears serve as a basis for going to a gynecologist and finding out the cause of the bleeding.
What to do if the bleeding does not stop depends on the cause of the phenomenon. The main cause is trauma during surgery - perforation of the uterus. An inspection will show which tactic will be effective. Small punctures will heal on their own, large ones need to be sutured.
If blood is flowing, be sure to consult a doctor. Especially dangerous is her sudden stop amid increasing spastic pain. This phenomenon is a sign of hematometer (its danger has been described earlier, see the section Possible Effects and Methods to Eliminate Them).
Is relapse possible?
The risk of relapse remains forever. Re-development of the tumor is not associated with the method of its removal, if the operation was carried out correctly. Otherwise, not removed pathological focus can provoke repeated development. The main cause of relapses are hormonal disorders. If they are not eliminated, the risk of new tumors remains.
How much to stay in the hospital after the intervention
How many days are in the hospital - usually the period of hospitalization does not exceed 3 days, when complications appear, the patient is left in the hospital for their removal and observation in the postoperative period.
In the hospital do not lie at all, if the operation occurs by the method of laser hysteroscopy. Then the procedure takes place in a semi-hospital setting, without anesthesia, and after a few hours the patient can go home. How much to lie in the hospital is usually determined by the attending physician, based on the actual clinical picture in the postoperative period.
When can you sleep with your husband
Despite the apparent ease and relatively rapid recovery after surgery, the operation is a rather serious burden on the woman's body. После нее необходимо дать время эндометрию на восстановление, поэтому в первый месяц вводятся серьезные ограничения.
Первый месяц сексуальные контакты категорически запрещены. Если осложнений не возникло, то следует избегать незащищенных контактов, чтобы исключить риск инфицирования молодой ткани и избежать беременности в первое полугодие. When you can have sex is better to check with your doctor.
The possibility of natural pregnancy and IVF
Natural pregnancy is possible both before surgery (the presence of a tumor does not always lead to infertility), or immediately after it. Most often, hormone preparations, including contraceptives, are prescribed to women during the postoperative period. With their cancellation, hormonal activity increases, so women are even recommended to conceive at this very moment.
If after surgery there are difficulties with conception, you can try IVF. Artificial insemination is usually successful, and the pregnancy proceeds normally, especially if there is no relapse.
Histology of remote education
The histology results after removal are usually ready in 10 days. Both the tumor itself and the tissues obtained as a result of curettage are sent for analysis. This is an important point that can determine the further tactics of the patient.
The results of the histological study show not only the structure of the removed neoplasm (benign or malignant), but also help to assess the risk of rebirth in the future. In older women, risk factors include a precancerous adenomatous tumor. According to the results of histology of adjacent tissues in the place of removal of the polyp, a decision is made on further actions. Detection of atypical cells requires immediate treatment of an oncological disease. Most often we are talking about surgery.
I am one of those who experienced surgical removal. Before the operation I tried to get pregnant for 2 years, it did not work. Thanks to my doctor, he underwent an operation, and then described in detail all the procedures in the postoperative period. Immediately after the abolition of contraceptive hormones, a long-awaited pregnancy began. We are already 4 months old, gave birth by herself and without complications.
Svetlana, 28 years old
I read reviews of those who survived the operation. Girls, if your health is dear to you, choose a laser. 6 years have passed since the operation. I have no negative consequences. The procedure itself is painless, at home it was already in the evening. After that gave birth. My doctor says that I don’t need to visit him so often, there is no relapse, everything is in order. I recommend this method.
Anyone who has not yet deleted education, it will be useful to learn about my experience. The first time I got on the operating table 12 years ago, after curettage, I could not recover for a long time, I was disturbed by severe pains. The result is a reoperation after 11 months. Less than a year, again on the operation. Three months ago, during a routine inspection, they found another polyp. I was terrified. But now I can say that there is progress in gynecology. Everything went fine, no pain, no bleeding. After the hysteroscopy I woke up in the ward and was discharged home two days later. All my fears were in vain, medicine became humane and safe. I hope that I will not face a relapse again.
Polyp was discovered during the second pregnancy. I was very scared, I was afraid of everything: to lose a child, complications during childbirth, the operation itself. Thanks to my doctor, insisted on hysteroscopy. In the operating room I spent exactly 15 minutes (I was lucky, the polyp was on the leg, it was just unscrewed). The tone of the uterus returned to normal when the time came, gave birth to herself.
Patients who are to undergo surgery are usually interested in its price. In this case, it is important to understand that several factors will affect the cost simultaneously. Finding out the cost of the removal is easiest for your doctor. He knows exactly the extent of the pathology and the possibilities of his clinic in choosing the method of the operation.
You can find out the pricing policy on the Internet. Just go to several sites to compare the standard prices for the desired method.
We give some quotations. The following prices are set for different methods in private clinics:
- diagnostics using a hysteroscope - from 5 to 15 thousand rubles.
- abdominal surgery to remove - from 9 to 25 thousand rubles.,
- scraping - from 5 to 7 thousand rubles.,
- laser removal - from 11 to 36 thousand rubles.
The price of operations in private clinics and medical centers depends on the status, qualification of the operating surgeon, the level of equipment. As well as the complexity of the operation, the cost of staying in the hospital. The cost of the same services may vary in regions, even within the same city you can find hospitals with different price levels. In state medical institutions surgery is free. But at the same time there may be a large queue for the operation. If the course of the disease is not threatening and the tumor does not progress, then you can postpone the removal until the specified period. But it is necessary to be monitored by a gynecologist. In the event of a threatening development, an operation may be performed for emergency indications. Or offer the patient to undergo treatment in a private clinic.