Hysteroscopy is a procedure performed to view the inside of the uterine cavity and the fallopian tubes using x-ray screening. The imaging of the uterine cavity and the fallopian tubes is obtained by introducing a contrast medium through the woman’s birth canal.

THE AIMS OF TESTING
The treatment allows to investigate the shape of the uterine cavity, assess lesions in its mucous membrane (endometrium) as well as the patency and the shape of fallopian tubes as well as changes around the uterine appendages. The aim of the test is to recognise or determine the pecularities of a present disorder more closely.

INDICATIONS FOR TESTING
Infertility diagnostics to determine the patency of fallopian tubes and exclude pathological changes around the uterine cavity. Assessing the effectiveness of tubal obstruction treatment and carrying a baby to term.

The investigation is carried out following a doctor’s recommendation.

BEFORE AND AFTER THE PROCEDURE
The following tests are required: gynaecological and ultrasound investigations of the reproductive organ, a microbiological vaginal smear test (to exclude infections) or Chlamydia trachomatis tests as well a short morphology including a leucocytes test (raised count of white blood cells if infection present) and CRP (C-reactive protein). A light dinner is recommended on the day before surgery.
Prior to the procedure the Patient is given painkillers and spasmolytic drugs. Please let the person carrying out the procedure know the date of your last period and any allergies against contrast agents. Please also report any sudden complaints (e.g. pain, breathlessness, nausea).

The procedure is carried out immediately after the end of the period, during the first phase of the cycle and until day 10-12 at the latest (from the first day of bleeding). It cannot be carried out during the period, even in the case of slight bleeding from the opening of the external vaginal part of the cervix.

The procedure usually takes 20 minutes. After the procedure, the Patient should remain for up to two hours under a doctor’s or nurse’s observation.

It is a surgical method allowing to perform complicated surgeries without opening the abdominal cavity. What is important for the patient is that no traces are left on the skin following the procedure. Giving up the traditional method of laparotomy (i.e. large incision of the abdominal wall) decreases the risk of post-surgical complications, is associated with low risk of post-surgical adhesions and allows for considerably quicker recovery. Nowadays laparoscopy is applied for numerous surgical and gynaecological operations.

Gynaecological laparoscopy is a diagnostic and surgical method consisting of performing two or three minor incisions, through which an optical system and small size surgical devices are introduced into the abdominal cavity. The examination allows to view the outer surface of the organs of the abdominal cavity and to perform various gynaecological procedures such as the removal of ovarian cysts or uterine fibroids, as well as diagnostics and surgical infertility or endometriosis treatment.

THE AIMS OF TESTING
In gynaecology, laparoscopy is used because it is less traumatic than surgical opening of the abdominal cavity. Many gynaecological surgeries do not require a large operative field – a “keyhole” view, made possible thanks to laparoscopy, is sufficient for diagnosis or to perform surgery.

BEFORE AND AFTER THE PROCEDURE
The preparations for laparoscopy cover the same steps for the Patient, as for any other surgery: lab analyses (blood count, electrolyte levels, INR and ECG) and being on an empty stomach (last meal at 10 pm.). After the surgery, the surgical devices, troakars and the laparoscope are removed from the abdominal cavity. Sometimes a special liquid or gel is introduced into the abdominal cavity to prevent adhesions. Minor incisions are sewn with single stitches and those, which are insoluble, are removed after 5-7 days.

Hysteroscopy is a procedure performed to view the enlarged inside of the uterus using an optical device called hysteroscope, introduced through the vagina into the cervix and then into the uterine cavity. Thanks to additional devices introduced by the hysteroscope into the uterine cavity, it is possible to collect samples of the mucous membrane for histopathological examinations as well as perform surgery inside the uterine cavity (surgical hysteroscopy). The patient is qualified for the surgery by a gynaecologist on the basis of an interview, gynaecological examination and transvaginal ultrasonographic examination. The surgery is usually performed under intravenous general anaesthesia.

THE AIMS OF TESTING
The treatment allows to assess changes in the endometrium (mucous membrane of the uterus) as well as the inside of the uterine cavity and to determine the scope of these changes. The technology allows to view the inside of the uterus. The examination might be combined with a simultaneous therapeutic surgery, e.g. the removal of intrauterine adhesions, fibroids or polyps.

BEFORE AND AFTER THE PROCEDURE
Hysteroscopy may be performed after the end of the menstrual bleeding, until the middle of the menstrual cycle (ca. day 15 of the cycle). In women with irregular periods it is best to perform the examination between the bleedings or at a time when the bleeding is least intense. In patients treated because of infertility, it is recommended to perform the examination of vaginal biocenosis or the screening for Chlamydia trachomatis. The procedure can be performed in a hospital and the preparations before the surgery are individually discussed with the doctor during the qualification visit. On the day of the surgery the patient must be on an empty stomach and should bring a nightdress, a gown and slippers. The patient is hospitalised, usually for two days. After the procedure, the patient should be picked up from hospital and escorted home.