Polyp endometrium how many are in the hospital. Endometrial polyp removal

I know that many people, having heard the diagnosis of uterine polyp or endometrial polyp, panic. Since the polyp must be removed by surgical intervention, so even with anesthesia.

If you do not read this post to the end (it will be a long one) I’ll just say that there is absolutely nothing to be afraid of.

What to do if you have such a diagnosis? The very first thing you need to check is that on which day of the cycle you did an ultrasound. Correctly do ultrasound 4-6 days from the beginning of the cycle (the beginning of menstruation). T to on other dates can be detected so-called premenstrual polyp

Therefore, if you do not have serious problems, wait for the desired date and sign up for an ultrasound scan again.

If you still have confirmed the polyp, and it is small, it may well fall off itself. When taking certain drugs. I will not say names here, and the doctor must prescribe this. But I can only say that there are completely harmless drugs that are prescribed for a period of only 10 days. So this, too, can not be afraid.

If you still have confirmed the polyp. Or if you are sent for surgery in an emergency mode, this is also not a big deal.

In the planned mode, you will need to pass a series of tests (there are many: smears, ecg, fluorography, and many blood counts). In some hospitals, you can do it in about a week or 1.5. Some require to pass these tests strictly before the start of the cycle.

You must come strictly on an empty stomach: do not drink or eat from 00:00. Let me say at once that it is impossible to drink categorically, that is, with the introduction of anesthesia, the water rises into the lungs, and you can suffocate.

On the operating table, you will most likely be asked once again about an allergy to the drugs. Anesthesia is not necessary to be afraid. First, you will enter a test dose from which you will not fall asleep. They will look at your reaction and only then slowly begin to add until you fall asleep. As a rule, everything falls asleep quickly within 3-5 minutes. I saw that they were writing somewhere that in this case, arms and legs were tied with straps to the couch so that in a dream you would not twitch by accident. It sounds scary) I, if they were attached somehow, already when I fell asleep.

I, like many, was afraid of anesthesia even more than the operation itself) Therefore, she asked me to wake up right afterwards. In general, the operation lasted about 10-15 minutes in total. According to the doctor, it was like this: a hysteroscope was inserted into the uterus so that everything could be examined. Next, the polyp was cut off, and the laser burned his leg. The cut polyp is sent for histology.

Of course, I was awakened after anesthesia) But as soon as I realized that I was awakened and everything was fine, I immediately passed out again. I was brought on a gurney to the ward, and I even transported myself to the bed. But I don't remember that. There were also various funny effects from anesthesia, but with them it was even more fun.

They put ice on their stomachs, which they had to keep for half an hour. I turned off for a whole hour, so he lay a little longer. Then I woke up and actually nothing else happened) All my roommates (4 more people) also quickly or even more quickly moved away from anesthesia. No one was bad. You can get up and eat in an hour.

The stomach was a little pulled (as during menstruation) until the evening. And there were no big bleeding.

Total: I arrived at the hospital at 9 am, at 5 pm I was already discharged.

After surgery, antibiotics are prescribed. This is the case when they must be taken t to they prevent blood infection after surgery. If your doctor has not prescribed something extra to restore your stomach flora, ask him about it additionally. I strongly recommend that you do this, since the likelihood of diarrhea is high after antibiotics, and so on.

Sex can not engage in 2 days before and 14 days after surgery. For the same reason - not to infect the infection. Also, you can not visit the bath, sauna and swimming pool. Only a warm shower.

I’ll also say that I read a lot about how to remove a polyp. And many doctors had it. Someone suggested simply scraping, someone a laser and the latter suggested a loop. The insurance company sent me to a great place to do it with the latest laser that leaves no scars. And I am very grateful for that. Feed in this hospital about 20 people a day. And all with polyps) So they have a full hand. In addition, they specialize in this. And, if we go for cash, they take God’s operation compared to other organizations, where, by the way, there is no such modern equipment and preparations (I mean anesthesia).

Of course, there is no 100% guarantee that you will not have a polyp again, but there is much hope for it.

Another very important! Do not wait a year for your polyp to fall off. I hear this phrase very often. It is not right at the root. This year he can grow much, and why do you need it. It is easier to remove a small polyp than to reach and cut off a large one.

I had a half a centimeter on the ultrasound, and in fact it turned out to be a half and a half !!! This is despite the fact that absolutely nothing bothered me! You can say casually discovered. It developed, most likely, on the background of reduced immunity.

And last, there are several types of polyps. You will find out what you have about 14 days after the surgery, when the histology results come. Some types of polyp need to be treated additionally with tablets so that they no longer form. There is nothing terrible in this either, so feel free to go to the doctor

Well, in general, I can say that everything passed positively and in some moments is even fun, surgeons know their work and amuse themselves as much as they can)) I wanted the review to be informative, and I could write everything very funny here) How about it was.

I did the surgery in Moscow. If someone needs contacts of the clinic - then here they are

Despite its minimally invasiveness (minimal invasion into the body), hysteroscopy is considered a surgical intervention and is an endoscopic examination of the uterus. This requires some preparation for the study and includes recovery after hysteroscopy.

Features of the procedure

Hysteroscope

Modern endoscopic equipment for this study allows you to visualize the internal state of the uterus. With it, you can accurately localize the pathological structures and remove them directly during the manipulation.

Indications for manipulation:

• Diagnosis of benign tumors, myomas, adenomyomas, endometrial polyp, diagnostic search and confirmation of the presence of malignant tumors.
• Bleeding from the uterus, the cause of which is not established.
• Cleansing the uterus from the remaining parts of the placenta.
• Infertility.
• Control of the treatment.
• Hormonal disorders.

Hysteroscopy is not performed in the acute inflammatory process in the uterus, during pregnancy, acute respiratory infections or SARS, exacerbation of somatic diseases and also during critical days.

Surgery is performed as a diagnostic and therapeutic measure.

Ultrasound examination of the uterus is often performed before hysteroscopy. Doing an ultrasound is necessary to confirm the preliminary diagnosis, to determine where the tumor is. Ultrasound can also be done to control the treatment, as it helps to monitor how the endometrium grew after performing a certain intervention.

Discharge and pain after removal of the polyp

The recovery period may be accompanied by pain of a different nature in the lower abdomen. As a rule, the patient is bothered by the pulling or aching pains that a woman usually experiences during menstruation. Such sensations are relieved with ordinary painkillers.

The condition of the woman after hysteroscopy is normal, the general state of health of the patient does not suffer. Basically she finds in her symptoms associated with the operation. For example, after removing polyps from the uterus, spotting is observed. This is because the hysteroscope damages the endometrium of the uterus (its inner membrane), causing minor bleeding. But there is very little blood, moreover, it quickly collapses, which explains the brown color of the discharge. No need to think that such a discharge occurs in every woman after surgery. Far from it. It all depends on the individual characteristics of the patient.

Discharge from the uterus after surgery may be normal!

After surgical removal of the endometrial polyp, discharge from the uterus is usually abundant and often prolonged. In this case, the doctor will prescribe drugs that have a hemostatic effect.

Patient after hysteroscopy

If after the removal of the polyp in the hospital more than three days have passed, and the bleeding does not stop, this is an occasion to consult a doctor. This is especially important if there are blood clots, the release of which is accompanied by pain. The integrity of the large vessels may have been damaged.

Menstruation after surgical hysteroscopy

It should be understood that the postoperative period of hysteroscopy of the uterus lasts a long time. After intervention in the body, the menstrual cycle may not immediately recover.

Endometrium should grow under the influence of hormones, but surgery also has a direct effect. The change in the structure of the endometrium due to hysteroscopy leads to the fact that the menstrual cycle will be restored within six months. In most cases, this happens quickly, and many patients note that the regularity of the cycle is restored immediately.

Changes in the cycle affect not only its duration, but also the duration of uterine bleeding, their profusion. The nature of menstruation can change to exactly the opposite: if they were abundant, they can become scarce.

If, after hysteroscopy, there are problems with the monthly cycle, then it is necessary to consult a doctor

It is possible to consult a doctor if menstruation does not stop at 7-10 days and is accompanied by severe pain. The specialist must guide the patient who performed the operation.

Recovery

As mentioned above, after surgery, the patient is worried about pain in the lower abdomen and minor bleeding. The sick-list is given only for 2-3 days. Under favorable conditions, a woman is discharged early, literally on the same day. On what day the patient will be discharged, how many days she will spend in the hospital depends on her condition.

The first time, within a few weeks, is not recommended:

• Engage in sex.
• To visit the public pool, bath.
• To take a bath.
• Use drugs that include acetylsalicylic acid or heparin.
• Do douching.
• Use tampons instead of sanitary pads.

Compliance with bed rest is not required, so the patient will not be allowed to stay in hospital for a long time.

After the woman is discharged from the hospital, she will be prescribed antibiotics as a prophylactic course. Sometimes you may need the appointment of hormone therapy.

A large endometrial polyp can also be removed using a flexible hysteroscope scissors. A hysteroscope for this is brought to the base of the polyp, with the scissors inserted into the operating channel of the hysteroscope, the leg of the polyp is cut off under visual control. After that, forceps are inserted into the operating channel of the hysteroscope, they fix the polyp under visual control and remove it from the uterine cavity.

Pathological formations of the mucosa, protruding above its surface and connected with it by the stem or its base, are single or multiple formations of irregular round or oval shape. The base of the polyps may be thick, but its diameter is always smaller than the body of the polyp.

The surface of the polyps is smooth or folded. In color, polyps are in most cases different from the surrounding mucosa. Usually they are pale pink, with a grayish or yellowish tinge and much lighter than the surrounding endometrium, which allows us to distinguish polyps from the folds of the mucous membrane. Often on the surface of a polyp on the general pale background of its surface a vascular pattern is well pronounced. The uneven development of the vascular network can cause malnutrition of individual parts of the polyp, which is hysteroscopically manifested in the form of dark-purple or bluish-purple patches.

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

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

Endometrial Polyposis Removal Technique

After the diagnostic stage of hysteroscopy and the detection of endometrial polyps, small polyps are removed, making curettage with a sharp curette. When scraping, the curette is held loosely, gripping it with fingers, like a writing pen or bow. Entering the curette to the bottom of the uterus, bring it back to the internal os, pressing on the wall of the uterus and scraping the endometrium. Repeated movements remove the mucous membrane from the bottom, from the front, back and side walls of the uterus. Scraping from the uterus is removed with a curette, removing it from time to time from the uterus, but not with each movement towards the uterine mouth. When polyps of the mucous membrane of the body and cervix are detected, separate curettage is performed. In the beginning, the mucous membrane of the cervical canal is scraped without going beyond the inner throat, then the mucosa is scraped from the walls of the uterus.

After curettage and removal of scraping from the uterus, control hysteroscopy is performed.

Having introduced a hysteroscope into the uterine cavity, they perform a consistent inspection of the walls of its cavity, especially careful in the places where polyps are found. Making sure that the polyps are removed, the procedure is terminated.

Upon detection of the remaining polyps or their parts in the uterine cavity, targeted curetting is again performed, followed by control hysteroscopy.

When a large endometrial polyp is detected, if necessary, an additional dilation of the cervical canal is performed up to No. 13-15 with Gegar's dilators. After additional expansion of the cervical canal, forceps are inserted into the uterine cavity, a polyp is seized by them, turning the forceps around its axis in one direction, unscrewing the polyp and removing it from the uterus. When controlling hysteroscopy carefully inspect the place of attachment of the polyp, when detecting residues of the base of the polyp, remove them with a curette.

Removal of endometrial polyps is carried out in the first phase of the menstrual cycle.

At the stage of preparation for endoscopic surgery, it is important to know: after removing polyps in the uterus, how much to stay in the hospital and what will be the limitations in everyday life? The attending physician of the Clinic will answer  to all questions and give the necessary recommendations that will be effective prevention of complicated postoperative course.

Advises the head of the clinic, head of the gynecological department number 2 Ph.D. Zhumanova Ekaterina Nikolaevna.

Primary consultation is free!

Highly qualified medical assistance for FREE under the policy OMS!

Please note that all analyzes provided at the Clinic must be originals or certified copies.

Polypectomy: what are the possible options

The duration of stay in the clinic is significant the technique is affected  surgical removal of endometrial polyps. Possible types of operations include:

• separate scraping of the cervical canal and uterine cavity, which is performed without visual endoscopic control;
• diagnostic hysteroscopy with examination of the inner surface of the uterus and subsequent separate scraping;
• liquid hysteroresectoscopy (removal of polypoid formations under the constant control of an endoscopic device);
• liquid or gas hysteroscopy using the method of laser coagulation of the vascular pedicle.

An effective method of treatment for endometrial polyposis is hysteroscopy, which can be used to accurately detect polypoid masses in the uterine cavity and perform targeted removal with the obligatory laser cautery of the vascular bed of the polyp.

Fig. Polypectomy

Hospital treatment: how long will it take

In addition to the surgical technique, the duration of inpatient treatment may increase due to the applied method of anesthesia and the presence of postoperative complications.

Anesthesia Variants

The choice of anesthesia method is the prerogative of the anesthesiologist. In standard cases, an intravenous anesthesia technique is used, when, before performing a hysteroscopic surgery, the doctor injects a drug into the venous vessel that provides complete and short anesthesia for the entire period of surgical intervention. 2-3 hours after the procedure, the woman is able to leave the hospital on her own. Local anesthesia for polypectomy is not applicable.

Risk of complications

During any operation, there may be unpleasant consequences associated with the technical features of the procedure or the state of health of the woman. To linger for a few days in the hospital will force the following complications:

• uterine bleeding;
• damage to the uterine wall during the procedure (perforation);
• severe pain associated with fluid accumulation in the uterine cavity during cervical spasm (atresia of the cervical canal);
• exacerbation of chronic inflammation (endometritis,);
• severe anemia in the case of abundant blood loss (anemia), which requires a blood transfusion or long-term drug therapy.

When using modern surgical techniques in the Clinic with experienced specialists, the risk of complications is minimal, so the time spent in the hospital is limited to the day of surgery.

Fig. Adnexitis

With proper preparation for surgery and the use of highly effective types of treatment (hysteroscopy with laser coagulation), the duration of stay in the hospital will be no more than 3-5 hours. On the day of surgery and the first week of the postoperative period, the following recommendations should be strictly followed:

• avoiding any physical activity (sports, weight lifting, long walking);
• mandatory intimate hygiene;
• the use of medicines prescribed by a doctor (it is unacceptable to engage in self-treatment and use drugs that affect blood clotting);
• complete rejection of any vaginal interventions (tampons should not be used, douche, live sex).

When leaving the hospital on the day of the polypectomy, the doctor will tell you about the risk of possible complications and prescribe medication. With careful adherence to medical recommendations, you can continue rehabilitation therapy at home.

Hysteroscopy is a safe surgical procedure that takes no more than 20-30 minutes, allows you to get rid of the disease without high risk of complications and creates conditions for discharge from the hospital on the day of surgery.

Obstetrician-gynecologist, PhD Zhumanova Ekaterina Nikolaevna.

Removal of the endometrial polyp is a procedure familiar to almost every fifth woman. As a rule, hysteroscopy is used for excision of a uterine polyp, it is considered to be more benign and less traumatic. This method is also an excellent diagnosis that will help determine the nature of the polyp, the presence or absence of cancer cells in its structure. Quite often, women are interested in what consequences arise after the removal of a uterine polyp.

General information about hysteroscopy

That hysteroscopy is considered the newest and most effective diagnostic method in gynecology. With the help of an optical instrument of a hysteroscope, a doctor can visually examine the condition of the uterine cavity, the endometrial mucous layer and the cervical canal. This method greatly facilitates diagnosis, its confirmation, as well as in some cases, the treatment of many intrauterine pathologies.

Types of hysteroscopy:

• In order to diagnose. The main goal of this procedure is to thoroughly examine the entire mucous membrane of the uterus, in particular its inner layer of the endometrium, so that the doctor can confirm or deny the presence of pathology. Fabrics are not injured.
• Surgical type. This method is used if it is necessary to perform endoscopic surgery, removal of a polyp of the endometrium, or in order to eliminate some deviations in the uterine cavity. For example, using such a procedure, it is fairly easy to remove myoma nodes and polyps.
• Microhysteroscopy. Meaning - a multiple increase in the visual image, so that you can conduct accurate endoscopic intervention. You can also do a study of the epithelium of the endometrium at the cellular level.
• Control. Such a procedure is important in order to observe and track the course of treatment. Monitoring helps determine if drug therapy is effective or not. You can also monitor the recovery of the mucous walls of the uterus after surgery.

In order to carry out the procedure, the uterine cavity is necessarily stretched using gas or a special liquid. Also, depending on the type of hysteroscopy that is used to remove the endometrial polyp, the effects that can occur immediately after surgery, as well as in the postoperative period, depend.

What to expect after hysteroscopy?

If the removal of the endometrial polyp was performed under local anesthesia, the woman can rely on discharge after a few hours. When using general or regional anesthesia, the patient is under close supervision of medical personnel for about 2-3 hours.

During this period, the only thing that is necessary after the procedure is rest. If hysteroscopy is associated with the removal of a polyp or myoma, a sick-list is issued.

The consequences directly depend on the physiological characteristics of the female body, its reserves and the volume of the operation:

• several days may be disturbed by pains of a whining and pulling character, as during menstruation;
• allocation of the first days will definitely be, so you need to use pads;
• meteorism is possible, it is associated with the management of anesthesia and the effect of gas on the internal organs;
• painful sensations on the top of the abdomen and in the shoulders, also indicates that gas enters the abdominal cavity.

The above symptoms should disappear in 3-7 days.

• not having sexual intercourse for 2 weeks after removal of the endometrial polyp, the risk of infection increases;
• do not use tampons, hygienic pads only, do not douch;
• plan conception after 6 months after the procedure, when the cycle is restored and becomes regular;
• month not to play sports and not to lift weights.

Removal of endometrial polyp using hysteroscopy: consequences and complications

Of course, the consequences depend on the type of surgery and the surgeon who performed the removal of the growth. As a rule, complications may occur after surgical hysteroscopy, and in all other serious consequences a rare case.

Possible complications can be divided into five groups:

• Complications of a surgical nature: they can appear during surgery, as well as in the postoperative period.
• Consequences after anesthesia.
• Problems caused by cervical dilation.
• Air embolism.
• Complications provoked by the long, forced position of the patient during the operation.

Also distinguish complications of early and late type.

• inflammation in the uterus and abdominal cavity 90% (pelvioperitonit and endometritis);
• hemolysis inside the vessels;
• bleeding 5%.

• pyometra formation;
• in the presence of chronic adnexitis - hydrosalpinxes;
• cavity defects;
• exacerbation of chronic inflammations;
• incomplete removal of intrauterine neoplasms.

As a rule, the most frequent consequences are: perforation of the uterus, endometritis and bleeding.

Consider each of them:

• Perforation of the uterus - rarely happens, in violation of the technique of operation of the uterus wall can be punched through. Mucous may not recover and then infertility is possible. Symptomatology pronounced: pressure drops, sharp, severe pain is possible until the pain shock and fainting. There is general malaise and weakness.
• Bleeding - such complications occur frequently. It usually occurs when an endometrial polyp or fibromatous node is removed. It may also occur when the wrong wall research technology. It is dangerous when the discharge is abundant, intense and lasts about two days.
• Gynecological disease - endometritis. In simple words, it is an inflammation that originated in the uterus. Bacteria can enter the cavity already during surgery on non-sterile medical instruments. Consequences may not occur immediately, as a rule, it takes several days. Endometritis has characteristic symptoms: pain in the lower abdomen, blood vaginal or interspersed with blood (pus) discharge.