Hysteroscopy

WHAT IS HYSTEROSCOPY?

Hysteroscopy is the examination of the internal surface of the uterus using a flexible endoscope inserted through the cervix.

WHY SCOPE A MARE’S UTERUS?

Treatment of endometrial cysts

This is the most common reason for performing hysteroscopy.  Endometrial cysts are fluid filled structures that usually project inwards from the lining of the uterus and are therefore clearly visible with a scope.  Endometrial cysts are not uncommon, particularly in older mares, and may reflect age-related and progressive changes of the uterus. A few small cysts do not generally affect fertility, however, removal of very large/extensive cysts may we warranted, if they are considered likely to interfere with embryo mobility, embryo attachment to the uterus, or normal placentation. Endometrial cysts are visible on ultrasound also and your veterinarian will advise whether they feel your mares’ cysts should be treated.

Diagnostic aid

Hysteroscopy can be useful in the diagnosis and treatment of some less common uterine conditions such as intractable or focal infections, foreign bodies, congenital abnormalities, adhesions, abscesses and tumours.

Endometrial biopsy

Hysteroscopy can be used as a means to directly visualise the area to be biopsied, in contrast to a conventional uterine biopsy which is done ‘blind’ i.e. without scoping the uterus. Visualisation is particularly useful in cases where there is a localised pathology, so that one can be sure that the biopsy sample is representative of the abnormal area. Similarly, visualisation enables biopsy forceps to be used to remove persistent endometrial cups, in abnormally cycling mares.

THE PROCEDURE

Hysteroscopy is performed in a standing sedated mare and typically the procedure is completed within less than 1 hour. A sterile endoscope is passed through the cervix and the uterus is distended with air or fluid, to enable visualisation of the entire uterine surface. Samples such as biopsies, fluid aspirates, or samples for bacterial culture, can be obtained through the endoscope. The laser fibre for cyst ablation is also passed through the scope.  At the end of the procedure the air/fluid is removed from the uterus and the uterus is flushed immediately after the procedure and in most cases, for several days following.  The time between the hysteroscopy being performed, to when the mare should be bred varies depending on the procedure performed.

Please do not hesitate to contact B&W Stud and Reproduction Services if you have further questions regarding hysteroscopy.