Where is the uterine cavity?

The female uterine cavity is particularly prone to problems because this area is relatively sensitive. When having sexual intercourse with a man, if it is not cleaned beforehand, it is very likely that the male's sexual organs will carry some bacteria into the female's vagina. At this time, the female's uterine cavity will be infected with bacteria, resulting in some cervical diseases, which endanger the female's health. So where is the uterine cavity in women?

Hysteroscopy is a new, minimally invasive gynecological diagnostic and treatment technology. It is a fiber-light endoscope used for intrauterine examination and treatment. It includes a hysteroscope, energy system, light system, perfusion system and imaging system. It uses the front part of the scope to enter the uterine cavity, which has a magnifying effect on the observed area. It is the preferred examination method for gynecological hemorrhagic diseases and intrauterine lesions because of its intuitive and accurate nature.

Indications

1. Abnormal uterine bleeding before and after menopause;

2. Abnormal uterine sonographic findings (B-ultrasound, HSG, etc.);

3. Diagnose or decide whether submucosal fibroids or endometrial polyps can be removed through the cervix;

4. To investigate the cervical and/or intrauterine factors of infertility, habitual miscarriage and pregnancy failure;

5. Oligomenorrhea or amenorrhea;

6. Locating or attempting to remove a lost intrauterine device;

7. Diagnose uterine cavity malformation and uterine cavity adhesion and try to separate them;

8. Early diagnosis of cervical cancer and endometrial cancer.

Contraindications

1. Absolute contraindications

Acute and subacute inflammation of the reproductive organs and pelvic infections.

2. Relative contraindications

(1) Heavy uterine bleeding or menstruation;

(2) Those who wish to continue the pregnancy;

(3) Uterine perforation repair within 6 months;

(4) The uterine cavity is too narrow or the cervix is ​​too hard to dilate;

(5) Invasive cervical cancer;

(6) Patients with serious heart, lung, liver, kidney and other medical diseases who cannot tolerate uterine distension operation;

(7) Genital tuberculosis who has not received anti-tuberculosis treatment.

Clinical diagnostic significance

Hysteroscopy can directly examine intrauterine lesions and quickly make an accurate diagnosis of most intrauterine diseases. Some people estimate that performing hysteroscopy on patients with indications can increase the rate of intrauterine abnormalities detected by other traditional methods from 28.9% to 70%. Among these patients, the abnormalities found by hysteroscopy cannot be diagnosed using other traditional methods. In summary, hysteroscopy is mainly used in the following aspects in clinical practice:

1. Abnormal uterine bleeding

Abnormal uterine bleeding (AUB) is a common gynecological disease, which can affect normal life and work in severe cases. It includes abnormal bleeding during the reproductive period, perimenopause and postmenopause, such as: menorrhagia, frequent menstruation, prolonged menstruation, irregular bleeding, and uterine bleeding before and after menopause. Gynecological examinations often reveal no abnormalities, and B-ultrasound examinations or blind curettage often result in misdiagnosis or missed diagnosis, with missed diagnosis of intrauterine lesions reaching 10% to 35%. Interpretation of abnormal images from hysterosalpingography (HSG) is uncertain or even erroneous in 30% to 50%. The clinical application of hysteroscopy can not only accurately determine the location, size, appearance and range of the lesions, but also conduct a detailed observation of the tissue structure on the surface of the lesions and perform direct biopsy of suspicious lesions, greatly improving the accuracy of diagnosis of intrauterine diseases.

The most common lesions seen during hysteroscopy are uterine fibroids, endometrial hyperplasia, and endometrial polyps. The second most common diseases are endometrial atrophy and endometrial cancer.

2. Infertility or habitual miscarriage

The cervical canal, uterine cavity and bilateral fallopian tube openings are examined through hysteroscopy to detect lesions that interfere with the implantation and/or development of the fertilized egg. At the same time, the fallopian tubes are cannulated and insulated under direct hysteroscopy to understand the patency of the fallopian tubes.

Hysteroscopic examination revealed that the intrauterine factors leading to infertility and habitual abortion include congenital uterine malformations, submucosal and intramural uterine fibroids, intrauterine adhesions, endometrial polyps, intrauterine foreign bodies and fallopian tube obstruction.

3. Foreign bodies in the uterine cavity

Various abnormal echoes or space-occupying lesions in the uterine cavity seen by various abnormal sonographic examinations are all indirect examination results. Hysteroscopy can confirm, evaluate, and locate them to determine whether they can be removed using hysteroscopic technology.

The most common foreign bodies found in the uterus during hysteroscopy are intrauterine contraceptive devices (incarcerated, retained fragments) and retained embryonic material, followed by retained embryonic bones or endometrial calcifications, broken cervical dilator rods or seaweed rod residues, and non-absorbable sutures from cesarean section.