What are the risks of hysteroscopy?

Hysteroscopic technology is an advanced gynecological diagnosis and treatment technology that has developed rapidly in recent years, but you can often see opinions about the "horror of hysteroscopic and laparoscopic surgery" on the Internet. Do you really understand hysteroscopic and laparoscopic surgery? However, you may not know that hysteroscopy is not omnipotent. The higher the expectations, the greater the disappointment. Here, let's discuss the risks of hysteroscopic surgery.

1. Damage

(1) Excessive stretching and dilation of the cervix can cause cervical damage or bleeding.

(2) Uterine perforation. The rate of uterine perforation in confirmatory hysteroscopic and laparoscopic surgery is about 4%. Severe intrauterine adhesions, uterine scars, excessive uterine protrusion or retroflexion, postoperative cervical surgery, contracted uterus, and uterus during lactation are all prone to uterine perforation.

Sometimes the perforation cannot be detected, and further surgery may cause serious intestinal damage. Most of the holes occur at the bottom of the uterus. In addition, laparoscopic surgery can reduce the occurrence of perforations. Once a rupture occurs, the operation should be stopped, the equipment should be withdrawn, the condition of the rupture should be assessed, and abdominal pain and vaginal bleeding should be carefully observed.

A 5 mm rupture of the scope has no significant complications, but a rupture during hysteroscopy requires consideration of laparotomy or laparoscopy.

The perforations caused by electrocoagulation and laser generators used in recent years should be treated with special caution. During intrauterine electrosurgical resection, the energy transmitted may damage the intestines attached to the surface of the uterus, or the electrocoagulator may break through and enter the abdomen, burning the intestines, urethra, and bladder.

During hysteroscopic electrosurgical resection, laparoscopic surgery can be used at the same time to help eliminate the intestines, eliminate bladder pain, and reduce the occurrence of complications. Bilateral fallopian tube catheterization under hysteroscopy may damage the uterine cornu, carbon dioxide gas inflation of the uterus may cause hydrosalpinx rupture, and gas may enter the latissimus tendon to cause emphysema.

2. Bleeding

There is usually a small amount of vaginal bleeding after hysteroscopy, which usually stops within a week. Hysteroscopic laparoscopy may cause heavy bleeding due to excessive laser cutting, poor uterine contraction or incomplete blood circulation during the operation. Blood circulation can be stimulated by electrocoagulation or by compression of Foley tube for 6 to 8 hours.

3. Infection

The incidence of infection is low. Grasping the indications and contraindications, using antibiotics appropriately before and after surgery, and strictly disinfecting instruments can prevent the occurrence of infection.