Laparoscopy

Hi, I had a laparoscopy and hysteroscopy to remove a polyp and see if I had Endo, the discharge Advice note states-Unable to enter uterine cavity due to scarring from previous ablation and found endo and diathermy it also said couldn't remove the polyp but took a biopsy of it. Would somebody know what it would mean by unable to enter uterine cavity please?

Sharron x

4 Replies

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  • Yes it means your cervix is too tightly closed or swollen so the equipment needed to go through the cervix to grab the polyp and twist it off , could not pass through it.

    It can happen with cervical erosion (if you have a history of heavy bleeding this can irritate the cervix wall causing swelling and closing up the tube too tight.)

    Another cause is yours where a previous surgical procedure has caused a build up of scarring and scar tissue which plugs the cervix and prevents anything passing in either direction.

    You can have a procedure called adhesiology to remove scar tissue and a specialist surgeon may be able to do this type of op if you want it done for any valid reason, but wait to see what the biopsy result is.

    Most polyps are benign and nothing to worry about and can be left there if needs be.

    If however the polyp test results show it to be malignant (cancer) or on the verge of becoming sinister (which a teeny tiny number might do) then you would probably be offered a full hysterectomy anyway to ensure that all suspect cells are well and truly removed and that would mean the cervix is removed entirely too.

    It's only 1 in 200 polyp cases which are cancer. Which means 199 in every 200 cases are not.

    Polyps can be rooted in the uterus end of the cervix and grow completely in the uterus,as mine does (it is coming out at the next op!)

    or it can grow in the other direction, from the cervix and protrude down in to the vagina where it would be very easy to remove a portion for a biopsy even if the cervix was obstructed with scarring or too swollen for the polyp to be removed from the root of it.

    Best of Luck for a great result from the biopsy - it certainly is good odds that it isn't anything to worry about.

  • Thank you for your response, the polyp was a endometrial polyp and I've been back for the results to gyne but they couldn't get a big enough sample to biopsy only managed to get a bit of blood/debris it said in the report. it was a different gyne then the one that operated on me and they seems to be a bit of confusion has on the discharge note it said has I've put above but the letter sent to my doctor said they managed to do the hysterescopy which I can't see how if they was unable to enter the uterine cavity that is what has confused me.

  • I think given the confusion that you might be best to write to the surgeon that mentioned the inability to enter the uterine cavity and ask for clarification on how the hysteroscopy was possible, but not the polyp issue.

    The hysteroscopy camera is a narrow tube so perhaps that was just about able to squeeze through but there wasn't enough 'stretchability' in the cervix dueto scarring, to get the polyp forceps device up there and do what needed to be done to grab hold of the polyp and twist it off. I'm guessing here, I don't know for sure either what could account for the confusing report, but that would be one possible explanation.

    It is certainly worth enquiring about, as you are the one who will now need a repeat surgery to get that polyp properly biopsied or removed which ever they can manage to do.

    It's your decision though if you do want to go through this again or take your chances on being in the 199 out of 200 that are benign polyps.

    That's the view I have taken. I know I need a surgery (in under 2 years now,) to replace the mirena - due to a deformed uterus, this does need a general anaesthetic to retrieve and replace it too, so my plan is to save that polyp removal to be done at the same time.

  • Thank you impatient.

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