Hysteroresectoscopy

Preparation for Hysteroresectoscopy

Proper preparation for hysteroresectoscopy is an important step, determining the safety of the procedure, its outcome, and the speed of recovery. Although the procedure is minimally invasive and is often performed in a single-day setting, the procedure requires a standard preoperative examination and adherence to the doctor's recommendations.

Examinations and Tests

Before the procedure, you must undergo blood tests (complete blood count, biochemistry profile), a coagulation profile to assess clotting, and an infection screening. Instrumental tests typically prescribed include a pelvic ultrasound, ECG, fluorography, or chest X-ray. In some cases, a colposcopy is also performed. This approach allows us to assess your overall health and plan treatment appropriately.

Specialist Appointments

A consultation with a gynecologist and anesthesiologist is mandatory; if you have any concomitant conditions, a consultation with a general practitioner or cardiologist may be necessary. The doctor will review your medications: anticoagulants, NSAIDs, and hormonal medications are discontinued or adjusted only with the specialist's approval.

Restrictions and Organizational Matters

It is recommended to refrain from eating 6-8 hours before surgery and from drinking 2-3 hours before. On the day of the procedure, please arrive at the clinic early, bringing your passport, test results, change of shoes, and personal hygiene items. Compliance with all preparation steps makes hysteroresectoscopy as predictable and safe as possible for the patient.

Anesthesiologist Consultation

An anesthesiologist consultation is a mandatory part of preparation for the procedure. During the consultation, the doctor will thoroughly review the patient's health status, including any chronic illnesses, previous surgeries and types of anesthesia, possible allergies, and a list of current medications. This information allows for an early assessment of individual risks and the selection of the safest anesthesia option.

Using a modern approach, the anesthesiologist determines the optimal anesthesia option – most commonly, short-term intravenous sedation or general anesthesia, which ensure comfort and painlessness during the procedure. Properly chosen anesthesia reduces the risk of cardiovascular and respiratory complications and ensures reliable medical care at all stages of the procedure.

Special attention is paid to fasting and fluid restriction before the procedure. These measures are necessary to prevent aspiration of gastric contents during anesthesia and are an important condition for surgical safety.

On what day of the cycle is hysteroscopy performed?

The optimal time for hysteroscopy is considered to be the period immediately after the end of menstruation – usually from days 5-7 to 10-12 of the menstrual cycle. At this time, the uterine lining is still thin, allowing the doctor to thoroughly examine the uterine cavity, clearly visualize the endometrium, and identify even small pathological changes, such as polyps or areas of hyperplasia.

Performing the procedure in the first phase of the cycle also reduces the risk of bleeding and facilitates therapeutic procedures. However, in some situations, exceptions are possible: in emergency situations, with acyclic bleeding, or to clarify the diagnosis, the doctor may recommend performing hysteroscopy on other days of the cycle. The final decision is always made individually, taking into account the clinical picture and the objectives of the examination.

Diagnostics and preparation for surgery

Hysteroresectoscopy is often called a “weekend” procedure. This is quite understandable; after the operation, the patient has practically no traces. However, it is necessary to undergo all necessary preoperative tests. To get a complete picture of the patient’s health, she needs to visit an anesthesiologist, therapist, cardiologist, and gynecologist. The following instrumental diagnostic methods are used: fluorography/X-ray, pelvic ultrasound, electrocardiogram, and colposcopy. Thanks to a complete diagnosis, all the features of the clinical case will be taken into account, which will allow planning the operation.

How is a hysteroresectoscopy procedure performed?

The procedure is performed in stages and is structured to ensure the surgery is as precise, safe, and comfortable as possible for the patient. This step-by-step algorithm allows the doctor to fully control the process, assess the condition of the uterine cavity, and, if necessary, immediately begin treatment. This method eliminates unnecessary tissue trauma and, in most cases, does not require a lengthy hospital stay.

Induction of Anesthesia

The procedure begins with the anesthesia phase. After the patient is placed in the operating room, monitoring is initiated – blood pressure, pulse, blood oxygen levels, and respiration are monitored. Medication-induced sedation or short-term general anesthesia is then administered. The patient falls asleep quickly and gently, without experiencing pain, anxiety, or discomfort.

The induction phase typically takes several minutes. The patient's condition is constantly monitored by an anesthesiologist throughout the procedure, allowing for prompt response to any changes and maintaining stable well-being.

Surgical Stage

After anesthesia has been administered, the doctor begins the main stage of hysteroresectoscopy. A hysteroresectoscope—a thin optical instrument with a camera and microsurgical attachments—is inserted through the vagina and cervical canal into the uterus. A highly magnified image is displayed on a screen, allowing the specialist to examine the uterine cavity centimeter by centimeter.

If a pathology is detected, the doctor can perform targeted removal of the identified lesion—a polyp, submucosal myomatous node, areas of hyperplasia, or adhesions. The manipulations are performed carefully, preserving healthy endometrial tissue; if necessary, coagulation of the vessels is performed to prevent bleeding. Depending on the extent of the procedure, the surgical phase lasts on average 20 to 40 minutes.

Completion and Recovery

After all procedures are completed, the instrument is removed, and the patient is transferred to the short-term observation room. Recovery occurs gradually and is typically without significant discomfort. Medical staff monitor the patient's general condition, blood pressure, and well-being for 2-4 hours.

If the patient's blood pressure is stable and there are no complications, she can leave the clinic on the day of surgery as an outpatient. On the day of the procedure, it is recommended to avoid physical activity, driving, and making important decisions. These measures allow the body to recover calmly and reduce the risk of postoperative discomfort.

How is surgery performed

Operation time – 20-40 minutes. A flexible optical instrument, a hysteroresectoscope, is inserted directly into the uterine cavity. It has a range of microsurgical instruments.

The patient is under medical sedation during the procedure. She will not feel any pain.

An image that is enlarged many times is transmitted to the monitor screen. Any movement of a specialist has precise precision. The uterine cavity is examined centimeter by centimeter. During the operation, healthy tissue is not damaged. Depending on the extent of the surgical intervention, the operation can last from twenty to forty minutes.

Operation result

Hysteroresectoscopy eliminates pathological formations in the uterine cavity and in the cervical canal before abdominal surgery is necessary. The woman forgets about pain and bleeding and can prepare to conceive a child.

Postoperative Period

After hysteroresectoscopy, the recovery period begins, which in most cases is easy and does not require lengthy treatment. Immediately after the surgery, the patient remains under medical observation and can return home the same day. During the first few days, nagging pain in the lower abdomen, similar to menstrual pain, as well as moderate bloody or brownish discharge, are normal reactions to the procedure.

It is important to closely monitor your well-being. A fever above 38°C (100.4°F), increasing or heavy bleeding, severe pain not relieved by prescribed medications, and an unpleasant odor from the discharge are reasons for urgently contacting a doctor. Prompt medical attention allows for the rapid elimination of possible complications and adjustment of monitoring strategies.

Most patients return to their normal lifestyle and work within 1–2 days, provided they avoid physical activity. Thanks to a modern approach and the minimally invasive nature of the procedure, recovery is quick and comfortable.

Recovery Recommendations

During the postoperative period, it is especially important to follow your doctor's recommendations to ensure the uterine lining recovers properly after the removal of abnormal tissue. During the first 7-10 days, it is recommended to:

• Use only sanitary pads, avoid tampons
• Perform intimate hygiene and wash gently
• Limit physical activity and heavy work
• Avoid sexual intercourse until your follow-up examination
• Avoid swimming pools, saunas, and steam rooms
• Avoid douching or using vaginal products without a doctor's prescription
• Make sure to have a follow-up examination with your gynecologist 7-10 days after the procedure

Following these guidelines reduces the risk of infection, ensures proper healing of the uterus, and allows the body to recover as safely and comfortably as possible.

Rehabilitation period after hysteroresectoscopy

After the operation, the patient is transferred to a specially prepared ward, where she will be under the supervision of a doctor. A few days after hysteroresectoscopy, the patient may experience certain pains that resemble pain during menstruation, and brown discharge is also possible. This reaction of the body to surgery is quite common.

For 7 days it is advisable to adhere to the following recommendations:

• Try not to have sex
• Do not visit swimming pools, saunas and baths
• Do not douche
• Do not use vaginal tampons

Possible Complications

Hysteroresectoscopy can cause the following complications:

• Bleeding
• Perforation, when the uterine wall is accidentally damaged by the instrument
• Infection
• Allergic reactions to the solutions used
• Adhesion formation

Possible Complications and How to Avoid Them

To reduce the risk of complications after surgery, it is important to strictly follow all your doctor's recommendations. After the procedure, monitor your discharge and body temperature – any sudden increase in bleeding, unpleasant odor, or fever are signals for immediate medical attention. Ignoring these symptoms can lead to serious health consequences.

When removing lesions, it is important that all tissue is sent for histological examination. This not only confirms the benign nature of findings but also helps promptly identify atypical changes that require further monitoring or treatment.

Restrictions on physical activity, intimate activity, and visiting swimming pools, saunas, and steam rooms promote proper healing of the uterine lining and prevent infection. Never tolerate a worsening condition – early consultation with a doctor allows for timely treatment adjustments and minimizes the risk of complications.

The correct combination of careful surgery, adherence to postoperative recommendations, and regular health monitoring makes hysteroresectoscopy a safe and effective treatment for uterine pathologies.

Advantages of hysteroresectoscopy

Among the advantages of the procedure:

• High precision. Optics allows you to examine the cavity in detail and identify pathological changes
• Simultaneous diagnosis and treatment. The doctor can not only detect pathology, but also eliminate it, be it removal of polyps, fibroids or adhesions
• Minimal risk of complications if all protocols are followed
• Fast recovery. Most patients return to their normal rhythm of life within 3–5 days after the procedure
• Preservation of reproductive function

In most cases, the intervention is performed on an outpatient basis and does not require a long hospital stay. Additional advantages of the procedure include the possibility of performing it under local anesthesia. It is also suitable for patients with contraindications to more traumatic surgical interventions.