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Hysteroscopy?

What is Hysteroscopy?

Hysteroscopy is used in the diagnosis and treatment of intrauterine problems (fibroid, polyps and adhesions). A hysteroscope is a long, thin, lighted device inserted through the vagina into the uterus. It projects an image on the screen and allows the physician to see and treat uterus. Intrauterine disorders have negative effects on embryo implantation. Therefore, eliminating these problems is effective in increasing the chance of success in IVF treatment.

When is hysteroscopy used for infertility treatment?

In terms of infertility treatment, uterine fibroid, polyps, intrauterine adhesions, uterine septum (congenital intrauterine tissue) can be used effectively in hysteroscopy. Infertility disorders can be diagnosed and treated by this method:

Rahim Perdesi Septum

In the embryological period, the so-called Müller channels (right and left) form the uterine cavity by resorbing in the middle after forming both halves of the uterus.

In some cases, these formations do not disappear and remain as a veil in the middle of the uterus, causing the following complications:

  • Infertility (Infertility)
  • Abortion in early pregnancy
  • Recurrent pregnancy losses
  • Fetal growth retardation
  • Position anomalies in fetus
  • Early birth
Uterus Shape Disorders (Y / T Shaped Uterus)

Normally, the triangular shaped cavity is cylindrical tubular and has curvature towards the cavity on both side and top walls. Due to the inability of the uterine tissue to thicken enough, especially the embryo to hold into the uterus leads to failure.

It causes the following complications:

  • Infertility (infertility)
  • Recurrent embryo attachment failures
  • Abortion in early pregnancy
  • Recurrent pregnancy losses
  • Fetal growth retardation
  • Position anomalies in fetus
  • Early birth

Treatment

  1. The upper and lateral walls of the uterus are expanded hysteroscopically
  2. 1 month spiral application into the uterus
  3. Balloon application
  4. Hormone Therapy
Unicornuate Uterus

In the embryological period, half of the uterus may be seen as a result of the absence of any Müller canals (right or left). In some cases, a small part of the uterus that is not functional may remain on the other side. If the unilateral uterus is well developed, a normal pregnancy may occur.

Unicornuate uterus causes the following complications:

  • Mass formation in the abdomen
  • Infertility (infertility)
  • Abortion in early pregnancy
  • Recurrent pregnancy losses
  • Fetal growth retardation
  • Position anomalies in fetus
  • Early birth

Unicornuate uterus treatment

  • The upper and lateral walls of the uterus can be expanded hysteroscopically
  • 1 month spiral application into the uterus
  • Balloon application
  • Hormone Therapy
Endometrial Polyps

Endometrial polyps are benign tumorous formations of the normal endometrial layer covering the uterus. The most common findings are excessive menstrual bleeding or irregular non-menstrual bleeding. It is known to prevent implantation (embryo attachment into the uterus) during IVF treatment.

Treatment: Hysteroscopic polypectomy

Hysteroscopic Fibroids

Submucous fibroid are benign tumorous formations of the myometrium that grow into the uterine cavity and often present with abnormal bleeding (such as excessive menstrual bleeding, non-menstrual bleeding), and groin pain. It is known to prevent implantation (embryo attachment into the uterus) during IVF treatment.

These fibroid are prone to growth during pregnancy, causing the following complications:

  • Infertility (infertility)
  • Recurrent implantation failures
  • Abortion in early pregnancy
  • Early birth
  • Severe pain in pregnancy

Treatment: Hysteroscopic Myomectomy

Intrauterine Adhesion (Uterine Syndrome)

The most important causes of adhesions that occur in the uterus are previous operations (termination of pregnancy by abortion or attempting to remove tumor formations such as polyps, fibroids by abortion without being seen with the camera system) and infections. In both cases, the inner layer of the uterus may be damaged and adhesion may form on all or part of the uterine walls. Uterine synechiae are among the pathologies that can cause infertility.

Treatment:

  • Hysteroscopic removal of adhesions
  • 1 month spiral application into the uterus
  • Balloon application
  • Hormone Therapy

When we examine the causes of female infertility, we know that the most common problems are the problems listed above: Most mothers who apply to our clinic after multiple unsuccessful infertility trials are confronted with the fact that hysteroscopy has not been performed properly or hysteroscopy has not been performed correctly. We believe that effective hysteroscopy is necessary to increase the chances of success in infertility and IVF treatment. Learn more about the importance of hysteroscopy in the treatment of infertility.

Laparoscopy

The condition of the ovary, uterus and tubes is examined with the light camera device that is delivered to the abdominal cavity. Operative procedures are performed through minimal incisions, also known as bloodless or knife-free surgery. The length of hospital stay after laparoscopy is short and usually discharged on the same day. The patient can return to normal life the next day in diagnostic applications and 7-15 days in operative applications.

Laparoscopy, which can be applied in gynecology for many different purposes, is capable of performing all kinds of gynecological surgical procedures including cancer surgery.

Laparoscopy, which is critically important in the treatment of infertility, can be used in the diagnosis and treatment of intrauterine tube obstructions effectively and can provide couples who have difficulty in having a child naturally. In some cases, laparoscopy prior to assisted reproductive treatments is critical to the success of treatment.

When is laparoscopy used to treat infertility?

In women suffering from infertility, laparoscopic operations are successfully applied for the indicated conditions and significantly increase the chances of infertility treatment. The application of laparoscopic laser surgery in the treatment of infertility resulting from the problems in the tubes increases the success before assisted reproductive treatments.

  • Removal of adhesions around the tubes and ovaries (Adezyolizis)
  • End-to-end ligation of ligated tubes (Laparoscopic tubal re-anastomosis)
  • Clogging of tubes
  • Removal of tubes before IVF treatment
  • Ectopic pregnancy operations
  • Endometriosis
  • Uterine Cysts
  • Removal of fibroid (Myomectomy)

Laparoscopic laser surgery is critical for success in infertility treatment. Learn more.

Laparoscopic Suture in recurrent cervical insufficiency

Cervical insufficiency, usually 16-24. It causes low or very premature births as a result of opening the cervix without pain between the first and second weeks. The diagnosis can often be made after the loss in the first pregnancy.

More Information

In the treatment of cervical insufficiency, the operation should be planned for the 13-14. weeks of pregnancy, before cervix gets wider. The first preferred method is vaginal suturing (cerclage). However, in some special cases, an open or preferably laparoscopic suture can be performed by making an incision in the abdomen that matches the caesarean section.

In which situations should laparoscopic cerclage be planned?

  • In cases where vaginal cerclage has failed in previous pregnancies (at least 2 times)
  • In cases where the cervix is ​​too short or irregular
  • For patients with a large portion of the cervix removed due to early cervical cancer or dysplasia

When should laparoscopic cerclage be planned?

The smallest period of uterine womb before pregnancy is the most appropriate period. Pregnancy is recommended 6 weeks after the procedure. If there is an existing pregnancy, the procedure can be performed in the first 3 months of pregnancy.

What are the advantages of laparoscopic cerclage?

With this method, it is possible to reach much higher cervix and suture there. It can be easily performed by entering 3 small holes without the need for an incision such as cesarean section.

  • Our patients may be discharged on the same day in the evening.
  • 90% of pregnancy occurs after the 34th week of pregnancy.
  • Stitching does not prevent you from getting pregnant.
  • It can be used for subsequent births by leaving the suture in its place after birth.

Only Laparoscopic Laser Surgery in Turkey

Unlike conventional laparoscopy operations, the laser system is connected to the tip of the laparoscope in addition to the camera in laparoscopic laser surgery. With the laser energy controlled by the surgeon, procedures such as cutting, burning and stopping bleeding in the abdominal organs can be performed.

The laser light is used as a knife in the abdomen to allow operation. With this technique, simple operations such as connecting the tubes for birth control can be performed as well as advanced operations such as removal of uterine fibroid and uterine removal.

The use of lasers gives many advantages to laparoscopic surgery and significantly shortens the operation time. The shortening of the operation time allows the patient to get less anesthesia and to recover more quickly.

Laparoscopic laser surgery is performed only in our center in our country. Professor Dr. Yucel Karaman, has carried out over 30,000 laparoscopic and hysteroscopic surgery in the UK, Belgium and Turkey in his 39 years of experience. Get detailed information about laparoscopic laser surgery.

Reference center for advanced endoscopic surgery

One of the first practitioners of IVF treatment in the world, Prof. Dr. Yücel Karaman successfully applied his expertise in endoscopic surgery to infertility treatment and performed more than 30.000 laparoscopic and hysteroscopic surgeries in Brussels, London and Istanbul and became one of the leading scientists in this field.

Endoscopic surgery is critical prior to some cases requiring infertility treatments (assisted reproductive treatments). Learn more about the importance of a personalised approach to assisted reproductive treatments.

Frequently Asked Questions About Endoscopic Surgery

Does hysteroscopy improve success in IVF treatment?

Intrauterine disorders have negative effects on embryo implantation. Therefore, eliminating these problems is effective in increasing the chance of success in IVF treatment.

Which operations can be performed with laparoscopy?

Laparoscopic surgery can be performed easily in 95% of gynecological operations when performed by experienced teams.

The main operations that can be performed are:

  • Uterine Diseases
  • Which operations are performed for women who have problems in their tubes?
  • Diseases Related to Ovaries
  • Endometriosis and Endometriosis
  • Bladder Prolapse (urinary incontinence)
What are the advantages of laparoscopic surgery?

The operations are performed without wide incision, that is, without opening the abdomen. So the operation does not end up with remaining large surgical scar on the skin. All operations are performed through the umbilicus and 3 small points opened in the groin area.

Since laparoscopy operations are performed with micro-surgical principles, minimal damage occurs in the abdomen and surgical areas and recovery is easier and quicker.

After laparoscopy, adhesions in the abdomen due to operation are less. Since more adhesions occur in open surgeries, especially laparoscopy should be recommended especially for mothers who are considering having children. Occasionally, blockages occur after open surgery due to adhesions in the tubes.

Since the most difficult areas to be observed in the abdomen can be easily seen by laparoscopy, treatment in assisted reproductive health and success is increasing.

After laparoscopic surgery, the patient's pain is less and the patient's general condition is better. There is no need to use painkillers.

Hospital stay is shorter after laparoscopic surgery. They are usually discharged on the same day or the next day. It is easier and faster for the patient to stand up and regain normal physical activity. As the abdominal wall is not opened, the patient heals faster.

The period of return to work is only 1 week. This period takes 6-7 weeks in classical operations.