What is a hysteroscopy?

Hysteroscopy is a diagnostic procedure that helps to decide a treatment plan for any abnormality in the uterus. In this procedure, one end of the small scope, a light thin tube, is inserted through the vagina to view the insides of the uterus to the cervix.

Nowadays, hysteroscopy is used for small operative procedures like removing polyps or fibroids. Operative hysteroscopy treats any abnormality detected and thus avoids the need for a second procedure.

How is a hysteroscopy performed?

Before conducting the procedure, a doctor will ask the patient to empty the bladder and will give anaesthesia to prevent any pain. Depending upon the duration of the procedure, local or general anaesthesia might be given to the patient. Once under anaesthesia, the patient will be positioned on the table with her legs in stirrups. This position will help the surgeon to perform a pelvic examination and insert the hysteroscope through the vagina.

Ideally, a liquid solution is passed through the hysteroscope which gently expands the uterus and clears it of any blood or mucus. Once the uterus is cleared of all matter, the surgeon can view the fallopian tubes, uterine lining etc. In cases where any abnormality is detected, the surgeon may consult for the removal of these abnormalities. A hysteroscopy can last from a few minutes up to one hour depending on whether it's diagnostic or operative.

Who would need a hysteroscopy procedure?

Hysteroscopy is helpful in people that have uterine issues like abnormal bleeding, irregular spotting between periods or menopause. Hysteroscopy is used for the diagnosis and treatment of some uterine conditions mentioned below:

  • Polyps or fibroids: Polypectomy and hysteroscopy myomectomy are the medical procedures for the surgical removal of polyps and fibroids respectively.
  • Asherman’s syndrome: Uterine adhesions or bands of scar tissues formed on the uterine lining cause obstruction in menstrual blood flow. Operative hysteroscopy helps in removing these adhesions.
  • Uterine Septum: Determination of any defect in the shape of the uterus that may be congenital and causing issues.

Other conditions where hysteroscopy is used are:

  • Finding displaced intrauterine devices
  • Locating placental tissue after delivery
  • Abnormal Pap results
  • Locating and placements or birth control inserts into fallopian tubes
  • Biopsy

Why is a hysteroscopy conducted?

Hysteroscopy is carried out under below given circumstances:

  • Investigate symptoms like heavy bleeding, pelvic pain, repeated miscarriages, and postmenopausal bleeding
  • Abnormal growth on the uterine lining such as fibroids or polyps

In case, a patient is experiencing any of the above-mentioned symptoms, she should see her healthcare provider. Her doctor will talk you through the procedure and answer all related queries. Normally, the procedure is scheduled for the first week after the bleeding has stopped. In cases of irregular bleeding, the doctor will decide on an appropriate time for a hysteroscopy. If you wish to get examined, speak to the doctors about hysteroscopy or:

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Two major types of hysteroscopy

  • Diagnostic hysteroscopy identifies any irregularities or abnormalities which is causing an array of symptoms. Also, in some cases, hysteroscopy may be used to confirm the results obtained with other diagnostic tools like ultrasound or hysterosalpingography (HCG). HCG is a dye test for determining any blockage in fallopian tubes.
  • Operative hysteroscopy treats the irregularities detected during diagnostic hysteroscopy, removing the need for the conduction of the same procedure twice. The most widely carried out operative hysteroscopy is endometrial ablation which treats abnormal uterine bleeding by ablating the uterine lining.  

What are the benefits of hysteroscopy?

Earlier Dilation and curettage procedure was carried out for removing any issue from the uterus which was an extensive procedure. Nowadays, hysteroscopy is carried out which is a minimally invasive and majorly precise procedure that not only helps the doctor to diagnose abnormalities but helps to remove them without any major surgical procedure. Depending upon the procedure, patients recover within weeks and resume their regular lifestyle.

What are the risks or complications associated with hysteroscopy?

Generally, hysteroscopy is a safe procedure with minimal risks. Some of the risks associated are:

  • Accidental damage to the uterus
  • Accidental damage to the cervix
  • Accidental damage to fallopian tubes
  • Scarring of the uterine lining
  • Excessive bleeding during or after the surgery
  • Uterus infection
  • Feeling faint due to heavy blood loss
  • Reaction to anaesthesia
  • Reaction to a solution that is used for expanding the uterus

What are the complications associated with hysteroscopy?

  • Pregnancy
  • Pelvic infection
  • Bleeding

1. What precautions do we need to take after hysteroscopy?

A patient should not have intercourse or douche for at least 2-3 weeks or as advised by the healthcare provider. One should try to take as must rest as possible with no weight lifting.

2. What should you avoid before a hysteroscopy?

A patient should not use tampons, vaginal medicines, or any blood clotting medicines 24 hours before the hysteroscopy.

3. Does it hurt when you pee after a hysteroscopy?

Ideally, a patient will experience some discomfort like burning or pain while peeing for the initial two to three days after the procedure.

4. How long does it take to recover from a hysteroscopy?

Typically, the patient can return to normal activities including work, a day after having a hysteroscopy. However, depending on the treatment, type of anesthesia used and severity of the procedure and recovery may vary from case to case

5. Are there any side effects of the hysteroscopy procedure?

There are certain common side effects like cramps and vaginal bleeding which can last up to 2-3 days. Sometimes gas is generated during the procedure which can cause abdominal discomfort. Some patients may also feel fatigue and sick after the procedure.

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