It is a way by which the doctor can look inside the uterus directly through the cervix after introduction of a liquid or a particular gas inside the uterine cavity to open it.
Uses of hysteroscopy:
1-Hysteroscopic Adhesiolysis
Adhesions between the walls of the uterus accompanied by irregularity in the menstrual cycle ,also infertility or abortion may occur
These adhesions are formed as a result of uterine infection or uterine surgery such as myomectomy . these intra uterine adhesions are diagnosed and removed by hysteroscope.
2-Removal of endometrial polyps or submucous fibroids
3- Hysteroscopic uterine repair of congenital anomalies of the uterus
presence of uterine septum may be a cause of abortion.It can be repaired surgically by Hysteroscopy.
4- Hysteroscopy to locate the position of the IUD or remove it
it’s very rare but may occur that a part of the IUD may remain inside the uterus during its removal , this part can be removed by hysteroscopy.
also it can be done to remove the IUD from an abnormal position.
5-Hysteroscopy for endometrial ablation
in some cases of uterine bleeding, the doctor may remove the endometrium to stop bleeding . in most cases, amenorrhea occurs and if not The period comes very light , and it is a very good solution, as most cases are afraid of hysterectomy.
After Hysteroscopy , You may feel mild abdominal pain, minimal vaginal spotting
Dr.Wael El Banna determines the type of the cyst which varies from just functional cyst to chocolate cyst , dermoid cyst or even cancerous cyst.
The plan of treatment is determined according to basic ultrasound and advanced imaging , and determining the best way in management of These ovarian cysts.
Either by:
aspiration of the cyst without any surgical intervention and in a short time (just 10 minutes) ,
or surgical intervention by laparoscopic cystectomy if the cyst affects the function of the ovary or may damage the ovarian reserve.
But in case of huge cyst or cancerous cyst , it needs open surgical intervention.
Dr.Wael El Banna is one of the most famous doctors in the Arab countries in the management of uterine fibroids and he has done many rare cases and brought back the dream of motherhood to the patient that was told before the she needs hysterectomy , which made the Arab Media calling Dr.Wael ( The Fibroid Hunter).
Advantages of resection of the fibroids (myomectomy) with a laparoscope:
-Less pain and smaller wounds than open surgery
-Less recovery period , and return faster to normal life
-Less adhesions than that of open surgery
Disadvantages of resection of the fibroids (myomectomy) with a laparoscope:
. -longer time than open surgery
. -intestinal perforation may occur which may lead to colostomy in 0.5 % of cases
-ureteric injury in 0.025 – 2 % of cases .
– urinary bladder injury in 0.02 – 8.3 % of cases .
-injury of blood vessels in 0.3 – 0.5 % of cases .
– gas leak under the skin may occur in 2% of cases .
-Hernia at the site of laparoscopy incisions in 0.17 – 0.2 % of cases .
– acidosis may occur in 5.5 % of cases due to Co2 used in abdominal inflation .
-it may be difficult to complete the surgery by laparoscope , so we have to do open surgery.
There are no scientific known reasons of specific causes for fibroids , but there are some risk factors:
1- Genetic factor:
The incidence of fibroids is higher in black Africans , or if there is a history of the disease in the relatives .
also the age may be one of the risk factors: mostly fibroids occur between the age of 35-50 .
2- Hormones
Fibroids are very sensitive to Estrogen hormones due to presence of more estrogen receptors over the fibroids , so its size increases more rapidly than the normal uterine cells specially during pregnancy.
also increase in estrogen hormones specially during the period of induction of ovulation make the fibroids increase in size rapidly . For unknown cause ,these fibroids shrinks during pregnancy.
Delay in the age of marriage or infertility increases the risk of fibroids because she is not exposed to the progesterone hormone which is released heavily during pregnancy.
3- Obesity
4- Eating too much red meat in some of the medical theories is associated with increasing the risk of fibroids because obesity increases the level of Estrogen in the blood .
These assumptions are still under search and are not confirmed by a strong evidence
hysteroscopic or laparoscopic myomectomy is done in small or medium sized fibroids, but huge or multiple ones are removed by open surgery.