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Hysteroscopy:
What it is, when and how it is used, and what options it offers.

Hysteroscopy:
What it is, when and how it is used, and what options it offers.

You may already sense the significance of this innovative surgical method. Read here, in brief, what hysteroscopy is, for which symptoms and causes it is used, and why treatment by Asst. Prof. Dr. Resmiye Ermis might also mean a new life for you.

Brief overview: What is hysteroscopy and when is it recommended?

Hysteroscopy is a procedure used to examine the uterus and perform minor interventions. For this purpose, a thin instrument called a hysteroscope – similar to an endoscope – is inserted through the slightly dilated cervix.

With hysteroscopy, diagnosis and treatment are possible in a single procedure – and in a minimally invasive way, meaning without any incisions. For patients of Asst. Prof. Dr. Resmiye Ermis, this represents a particularly gentle treatment method.

This is why Asst. Prof. Dr. Ermis values hysteroscopy. In the following two conditions, hysteroscopy is particularly promising:

Due to a malformation involving a vaginal septum, the uterus may be divided into two halves (uterus septus). This is the most common congenital malformation of the uterus. In this case, as well as in cases of exceptionally heavy menstrual bleeding that cannot be explained by myomas or polyps, hysteroscopy can achieve the desired therapeutic outcome.

If the uterus is divided into two parts, the miscarriage rate increases on average to over 60%. And up to 20% of all pregnancies end in premature birth.

Heavy menstrual bleeding that cannot be explained by either myomas or polyps represents a psychological burden and also weakens affected women physically. In both cases, Asst. Prof. Dr. Ermis has been able to achieve successful treatment outcomes with the help of hysteroscopy.

A common cause of a uterine malformation with a septum is a disturbance in embryonic development, in which the partition wall is not, or only incompletely, resorbed after the fusion of the two Müllerian ducts.

In cases of heavy menstrual bleeding whose cause cannot be attributed to myomas or polyps, removal of the uterus is often recommended. Even though this may be appropriate in some situations, Asst. Prof. Dr. Ermis always first examines alternatives that are in line with the patient’s wishes, are less invasive, and preserve the uterus.

In both cases – uterine malformations as well as the heavy menstrual bleeding described above – hysteroscopy is increasingly proving to be a targeted and promising approach.

The examination instrument is inserted vaginally and without any incisions. Malformations such as tissue walls within the uterus (septum) are separated again using a laser.

In cases of heavy menstrual bleeding, the uterine lining is removed via hysteroscopy – also known as endometrial ablation. The advantage: because only the lining bleeds, the uterus itself and the pelvic floor remain untouched with this method.

The procedure: In this case, general anesthesia ensures a symptom-free intervention. After dilating the cervix, a resectoscope is carefully advanced. The uterine cavity is expanded with a special fluid. The upper portion of the uterine cavity and the corners with the openings of the fallopian tubes are then cauterized. Subsequently, the remaining inner lining of the uterus is removed using an electrosurgical loop. The uterine wall can then be cauterized to ablate both the superficial and deeper layers of the endometrial lining. As a result, the monthly regrowth of the uterine lining no longer occurs. The procedure takes only between 15 and 30 minutes.

If Asst. Prof. Dr. Ermis identifies myomas or polyps during this procedure that were not detected in previous ultrasound examinations, these can be removed at the same time.

After correction of a uterine malformation by Asst. Prof. Dr. Ermis, the uterine cavity once again forms a single space. By dividing the septum using hysteroscopy, the live birth rate is increased to 80%. And the dream of a healthy baby comes within tangible reach.

After therapy for heavy menstrual bleeding through cauterization of the uterine lining, around 40% of all patients no longer experience menstrual bleeding. The remaining women report a significantly reduced menstruation. Failure of the method, meaning no improvement of symptoms, is rare and reported in only about 5% of cases. Menstrual pain is usually favorably influenced.

In the presence of small myomas, menstruation may remain painful. The procedure has no negative effects on the organism. However, it cannot be reversed and therefore represents a permanent limitation of fertility. On the other hand, its contraceptive effect is not reliable enough to forgo additional contraception.

Long-term follow-up studies have shown that the method can be successfully applied in approximately 70–80% of women. In about 20–30% of women, however, it must be expected that a hysterectomy may later become necessary due to recurrent bleeding problems.

How much freer could your life be after a successful hysteroscopy? Get in touch with Asst. Prof. Dr. Ermis now—she will take care of you: 069-407 15 50. Or write a message to gynaekologie@rotkreuzkliniken.de.

Ovarian cysts:

Answers to the questions that really matter.

Ovarian cysts:

Answers to the questions that really matter.