Hysteroscopy

What is diagnostic hysteroscopy?

The surgeon undertakes a diagnostic hysteroscopy to identify the problems of the uterus based on hysterosalpingography results. Using hysterosalpingography, which is a dye-based x-ray test uterus and fallopian tubes are examined.

In laparoscopy, your doctor will insert an endoscope (a slender tube fitted with a fiber-optic camera) into your abdomen to view the outside of your uterus, ovaries, and fallopian tubes.

When is operative hysteroscopy used?

Your doctor may perform hysteroscopy to correct the following uterine conditions:

• Polyps and fibroids— Hysteroscopy removes non-cancerous growths found in the uterus.
• Adhesions—Also known as Asherman’s Syndrome, uterine adhesions are bands of scar tissue that can form in the uterus and may lead to changes in menstrual flow as well as infertility. Hysteroscopy can help your doctor locate and remove the adhesions.
• Septums—Hysteroscopy can help determine whether you have a uterine septum, a malformation of the uterus that is present from birth.
• Abnormal bleeding—Hysteroscopy can help identify the cause of heavy or lengthy menstrual flow, as well as bleeding between periods or after menopause. Uterine lining destruction using ablation in women with heavy bleeding.

What are the benefits of hysteroscopy?

Compared with other, more invasive procedures, hysteroscopy may provide the following advantages:

• Shorter hospital stay
• Shorter recovery time
• Less pain medication needed after surgery
• Avoidance of hysterectomy
• Possible avoidance of “open” abdominal surgery

How safe is hysteroscopy?

Hysteroscopy is a relatively safe procedure. However, as with any type of surgery, complications are possible. With hysteroscopy, complications occur in less than 1 percent of cases and can include:

• Risks associated with anesthesia
• Infection
• Heavy bleeding
• Injury to the cervix, uterus, bowel, or bladder
• Intrauterine scarring
• Reaction to the substance used to expand the uterus

When should the procedure be performed?

Your doctor may recommend scheduling the hysteroscopy for the first week after your menstrual period. This timing will provide the doctor with the best view of the inside of your uterus. Hysteroscopy diagnoses the causes of unexplained bleeding or spotting in postmenopausal women.

What type of anesthesia is used for hysteroscopy?

Anesthesia for hysteroscopy may be local, regional, or general:

• Local anesthesia–the numbing of only a part of the body for a short time
• Regional anesthesia–the numbing of a larger portion of the body for a few hours
• General anesthesia–the numbing of the entire body for the entire time of the surgery

 The place of surgery and any additional procedure decides the type of anesthesia. Patients are not allowed anything by mouth if the procedure is under general anesthesia.

How is hysteroscopy performed?

Prior to the procedure, your doctor may prescribe a sedative to help you relax. The procedure itself takes place in the following order:

• Cervical dilatation allows for hysteroscope insertion
• The hysteroscope reaches the uterus through the vagina and cervix
• Carbon dioxide gas or a liquid solution inserted into the uterus helps to expand it and clear blood or mucus
• Next, a light shone through the hysteroscope allows your doctor to see your uterus and the openings of the fallopian tubes into the uterine cavity.
• Small surgical instruments inserted through hysteroscope helps in doing the procedure

The time it takes to perform hysteroscopy can range from less than 5 minutes to more than an hour. Procedure duration depends on factors – diagnostic or operative and whether an additional procedure, such as laparoscopy, is done at the same time. In general, however, diagnostic hysteroscopy takes less time than operative.

What can I expect after the procedure?

Post the procedure, the patient may experience cramping or slight vaginal bleeding for 1-2 days. And the patient may experience shoulder pain due to gas used during the procedure.

Immediate medical consultation sought if there’s no reduction in pain even after taking analgesics or the patient experiences heavy bleeding requiring a frequent change of sanitary pads or there is the passage of clots or foul-smelling vaginal discharge.

Will I have to stay in the hospital overnight?

Hysteroscopy comes under minor surgeries not requiring a hospital stay. However, in certain circumstances, such as if your doctor is concerned about your reaction to anesthesia, an overnight stay may be required.

Who is a candidate for this procedure?

Hysteroscopy is not advised in few patients. A doctor who specializes in this procedure will consult with your primary care physician to determine whether it is appropriate for you.