Hysteroscopy

Hysteroscopy is a procedure used to treat and diagnose the cause of abnormal uterine bleeding. It allows a surgeon to look inside the uterus with a hysteroscope tool. Hysteroscope is a thin, lighted tube with a camera inserted into the vagina to examine the cervix and inside of the uterus.

It is a minor surgery performed in a hospital or the healthcare provider’s office. It is performed by local, regional, or general anaesthesia, or sometimes no anaesthesia is given.

Types of Hysteroscopy?

There are two types of hysteroscopy depending upon the circumstances Operative and Diagnostic hysteroscopy. An operative hysteroscopy might be needed by a woman undergoing diagnostic hysteroscopy.

Types of Hysteroscopy?

1. Diagnostic Hysteroscopy

It is a medical technique to identify structural irregularities in the uterus. In this, a tool called a hysteroscope is used to view a closer look at the potential problem.

It may also be used to confirm the results of other tests, such as hysterosalpingography (HSG). Sometimes other instruments or techniques are used with hysteroscopies, such as dilation, curettage (D&C), and laparoscopy.

3. Operative Hysteroscopy

It is a minimally invasive procedure involving inserting a hysteroscope through the cervix into the uterus to treat disorders that are detected during the diagnostic hysteroscopy.

Both diagnostic and operative hysteroscopy is performed at the same time to avoid the second surgery. This procedure treats infertility or removes growths from the uterine cavity. Conditions like abnormal bleeding, polyps, fibroids, adhesions, septum, etc., can be treated by an operative hysteroscopy.

Who Needs a Hysteroscopy?

Women need it when she is having abnormal uterine bleeding, heavy menstrual bleeding, irregular spotting between periods, or bleeding after menopause.

The doctor may also perform a hysteroscopy to diagnose and treat the following uterine conditions: –

1. Adhesion Removal

Adhesions are bands of scar tissue that may form in the inner walls of the uterus, leading to changes in menstrual flow and causing infertility. You may develop adhesions due to prior surgery, certain medical conditions, or infection. A hysteroscopy can identify these adhesions and help your doctor to locate and remove them.

2. Septum Removal

It can help in knowing whether one has a uterine septum. This is a defect of the uterus that’s present from birth. This means you have a membrane that divides the inner portion of the uterus in its middle, increasing the risk of miscarriage.

3. Polyps and Fibroids

It helps in locating and removing these uterine structural abnormalities. The surgical removal of a polyp is called a hysteroscopy polypectomy, and the surgical removal of a fibroid is called a hysteroscopy myomectomy.

4. IUD

When an IUD is implanted, one can feel the device’s “tail” or threads to ensure the device is in place. The IUD may have shifted position if these threads aren’t visible or palpable. A hysteroscopy is the best way to look for the device when it seems to have moved.

Diagnose the Cause of Repeated Miscarriage

The doctor may recommend a hysteroscopy to look for uterine abnormalities that may cause repeated miscarriage or infertility.

Ectopic pregnancy

When a pregnancy occurs outside the uterus is called an ectopic pregnancy. In such cases, the doctor may recommend this treatment to diagnose and, in some cases, remove the ectopic pregnancy. 

Infertility Issues

If you and your partner have problems regarding conceiving, you must consult a gynecologist. They will perform a hysterectomy to examine various issues of your uterine wall that create problems for your parenthood.

Things Doctors Perform Before a Hysteroscopy?

The doctor first ensures that you are an appropriate candidate for performing hysteroscopy. After confirming, the doctor will inform you about a procedure and clear all your doubts if you have any.

Then the doctor will give the following instructions to prepare you for the procedure.

  • The doctor will check your medical history and ask what medicines you take, including supplements and vitamins. It would help if you also stopped taking medications that prevent blood clotting.
  • After that doctor may examine you and perform specific tests like a pregnancy test, blood test, or other diagnostic test based on your procedure.
  • And then explain other essential things related to the procedure, such as how to prepare, what to eat, if you need to fast, etc.

What happens during a Hysteroscopy Procedure?

  1. You may be first given anesthesia or a sedative.
  2. And then, you will be positioned on the exam table with your legs in stirrups.
  3. The doctor will insert a hysteroscope through the vagina and cervix into the uterus.
  4. A liquid solution or carbon dioxide gas is gently sent into the uterus through this device to clear the surface and to help widen it slightly.
  5. The light from the hysteroscope allows doctors to view the uterus, uterine lining, and fallopian tubes clearly, diagnose any issues and perform the necessary surgical procedures.

This procedure can last five minutes to more than an hour, depending on the cause, why it is being performed, and its type. It also depends on whether an additional procedure like laparoscopy is done coincidently.

If diagnostic hysteroscopy is being done, it will take less time than operative hysteroscopy.

What Happens after the Procedure?

If a patient is given local anesthesia can go home soon after the procedure. But the patient who has been given regional or general anesthesia might be observed for several hours before they are released. Some patients may have cramping and light bleeding for one or two days after the procedure. One may also feel somewhat sick or faint immediately after the procedure.

What are the Benefits of Hysteroscopy?

Hysteroscopy is a minimally invasive and precise surgery. It allows the doctor to diagnose and treat the condition in one single surgery. This doctor can quickly locate the abnormalities and treat them without damaging the surrounding tissues. Recovery is also fast and quick, with minimal chance of any risk or complications.

Risks and Complications Involved in Procedure?

It is a safe procedure. Problems might occur in less than 1% of cases which includes the following: –

  • Infection
  • Heavy bleeding
  • Injury to the cervix or uterus
  • Side effects from the anesthesia
  • Fluid overload means when too much fluid is administered during the procedure

Cost of a Hysteroscopy?

The cost may vary from patient to patient as it is based on many things, such as the reason the procedure is being carried out, many other tests the doctor may advise depending on one situation and problem, etc.

The cost can be higher if one has a more extensive procedure, including surgery and general anesthesia. It also depends on whether it is done in an ambulatory surgical center or a hospital outpatient department.

Conclusion

There are several reasons why this surgery is being performed. The surgery involved in this procedure is very minimal. One can have a fast recovery with very low risks or complications. But before opting for any specific treatment, it is always better to consult your doctor and discuss all your issues and problems. And do as suggest.

Frequently Asked Questions (FAQs)

No, it’s a very safe procedure with minimal risk.

You should visit the doctor if you experience severe abdominal pain, heavy vaginal bleeding, fever, vomiting, shortness of breath, etc.

If a patient has abnormal bleeding, infertility, recurrent miscarriage, etc., diagnostic hysteroscopy is indicated. It is also required in a patient undergoing IVF ICSI treatment.

An operative hysteroscopy is done in patients with septum, polyps, adhesions, fibroids, etc.

One might bleed for 7 to 10 days after having the hysteroscopy procedure. This bleeding might be heavier than an average period and can stop and start. These variations are normal.

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