Hysteroscopy is a procedure that allows your doctor to look inside your uterus in order to diagnose and treat causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus. Hysteroscopy can be either diagnostic or operative.
What is a diagnostic hysteroscopy?
Diagnostic hysteroscopy is used to diagnose problems of the uterus. Diagnostic hysteroscopy is also used to confirm results of other examinations, such as hysterosalpingography (HSG).
What is an operative hysteroscopy?
Operative hysteroscopy is used to correct an abnormal condition that has been detected during a diagnostic hysteroscopy.
Your doctor may perform a hysteroscopy to correct the following conditions of the uterus:
♦ Polyps and fibroids. Hysteroscopy is used to remove these non-cancerous tumors found in the uterus.
♦ Adhesions, also known as Asherman’s syndrome. It is a scar tissue that can be formed in the uterus and lead to changes in the menstrual cycle, as well as infertility. With the help of hysteroscopy the doctor can find and remove adhesions.
♦ Partitions. Hysteroscopy makes it possible to determine if there are walls in your uterus, uterine defects (congenital).
♦ An abnormal bleeding. With hysteroscopy, the doctor can determine the cause of severe or prolonged menstruation, as well as bleeding between menstruation or after menopause. Endometrial ablation is one of the procedures in which a hysteroscope is used to destroy the uterine membrane for the treatment of certain causes of severe bleeding.
Сompared with other, more invasive procedures, hysteroscopy may provide the following advantages:
♦ Shorter hospital stay
♦ Shorter recovery time
♦ Less traumatic
♦ Avoidance of hysterectomy
♦ Possible avoidance of “open” abdominal surgery
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
♦ 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 you to plan hysteroscopy for the first week after menstruation.
How is hysteroscopy performed?
Hysteroscopy is performed under general (intravenous) anesthesia. Within 6 hours before the procedure (if it occurs under general anesthesia) you will be asked not to eat or drink. Before the procedure, it is necessary to make a series of analysis.
During hysteroscopy, incisions are not made. The hysteroscope is injected through the natural genital tract: the vagina, the cervix, the uterus, directly into the uterus. To expand the cavity of the uterus through a hysteroscope is injected fluid or Carbon dioxide gas under the pressure (it is needed to better view the uterus). The video camera and the light sensor of hysteroscope show on the screen enlarged in several times the image of the cavity of the uterus, the cervical canal, the holes of the fallopian tubes.
In diagnostic hysteroscopes, as a rule, there is a channel to insert additional tools: biopsy forceps, scissors, which can perform small intrauterine operation.
On average, diagnostic hysteroscopy lasts 10-30 minutes, surgical – depending on the type of operation, from 20 minutes to 1,5 – 2 hours. The length of the stay in the hospital after the hysteroscopy depends on the complexity of operation, but, of course, does not exceed 2-3 hours.
What should you expect after the procedure?
If general anesthesia is used during the procedure, you will have to remain under the supervision of a doctor for the first few hours. After the procedure, you may have a slight vaginal bleeding within one to two days and also experience general weakness. However, if you experience any of the following symptoms, be sure to contact your doctor:
♦ Severe abdominal pain
♦ Severe vaginal bleeding or discharge