Remove the endometrial polyp. Hysteroscopy - Causes, symptoms and treatment. MF.

Hysteroscopic picture of endometrial polyposis:

Pathological mucosal structures protruding above its surface and associated with its pedicle or its base. They look in the form of single or multiple formations of irregular round or oval shape, rising above the general level of the mucosa. The base of the polyps may be thick, but its diameter is always less than the polyp body. The surface of the polyps is smooth or pleated. The color of polyps in most cases differ from the surrounding mucosa. Usually they are pale pink with a grayish or yellowish hue and much lighter than the surrounding endometrium, which makes it possible to distinguish polyps from mucous folds. Often on the surface of the polyp on the overall pale background of its surface is well expressed vascular pattern. Uneven development of the vasculature can cause disturbances in the nutrition of individual parts of the polyp, which is hysteroscopically manifested in the form of dark purple or cyanotic-purple spots.

When using the washing method of hysteroscopy, it can be noted that the polyps under the action of the fluid current can shift relative to their base, and also change their shape.

In the diagnosis and treatment of endometrial polyps, hysteroscopy plays a special role, since it allows not only to specify the localization of these pathological formations, but also to perform their targeted removal. In addition, which is especially important, it also allows you to check the completeness and thoroughness of polyp removal.

Endometrial Endometrial Removal Technique:

After the diagnostic stage of hysteroscopy and the detection of endometrial polyps, small endometrial polyps are removed by scraping with an acute curette. The curette is held freely when scraping, grabbing it with fingers, like a writing pen or a bow. Entering the curette to the bottom of the uterus takes it back to the internal throat, pressing on the wall of the uterus and scraping the endometrium. Repeated movements remove the mucosa from the bottom, from the anterior, posterior and lateral walls of the uterine cavity. Scraping from the uterus is removed by the curette, removing it from time to time from the uterus, but not with every movement towards the uterine throat. When the polyps of the mucous body and the cervix are found, a separate scraping is performed. In the beginning, at the same time, the scraping of the mucous cervical canal is performed, without entering the internal pharynx, then the mucosa is scraped away from the walls of the uterine cavity.

After end of scraping and removal of scraping from the uterine cavity, a control hysteroscopy is performed.

Introducing a hysteroscope into the uterine cavity, perform a sequential examination of the walls of the uterine cavity, especially careful in the detection of polyps. After making sure that the polyps are removed, the procedure is stopped.

If any remaining polyps or parts of them are found in the uterus cavity, scraping is performed again, followed by a control hysteroscopy.

If a large polyp of the endometrium is found, if necessary, an additional cervical canal extension to No. 13-15 of the Gegar dilator is made. After additional expansion of the cervical canal into the uterine cavity, forceps are inserted to remove the polyp, they grip the polyp by turning the forceps around their axis in one direction, unscrewing the polyp and removing it from the uterine cavity. When the control hysteroscopy is carefully examined the place of attachment of the polyp, if a remnant of the polyp is found, they are removed by the curette. You can also remove a large polyps of the endometrium with a flexible scissors hysteroscope. A hysteroscope for this is fed to the base of the polyp, with scissors inserted into the operating channel of the hysteroscope, the polyp stalk is cut off under visual control. Then insert the forceps into the operating channel of the hysteroscope, fix the polyp under visual control and remove it from the uterine cavity.

The operation is similar to abortion, it occurs under anesthesia so it does not hurt - after removing the polyp it is just possible to become pregnant, but if you do not remove it - pregnancy is impossible. If not treated, there is the danger of degeneration into a cancerous tumor.

The removal of endometrial polyps is carried out in the I phase of the menstrual cycle .