Hysteroscopy – What all to expect

A hysteroscopy is a medical procedure that is carried out to diagnose and treat problems linked to a female’s uterus or womb. The procedure is carried out with a thin, telescope-like camera inserted into the uterus via the vagina. The camera has a light on the end and is known as hysteroscopy.

There are two types of hysteroscopies, diagnostic hysteroscopy, and therapeutic hysteroscopy. Diagnostic hysteroscopy is performed in order to investigate abnormal uterine bleeding. Abnormal uterine bleeding is when the menstrual periods become heavier and is happening more frequently or the period cycle is lasting longer than it regularly is. Abnormal bleeding can also happen in case the female is in the prepubescent or postmenopausal state. Bleeding observed in-between period is another abnormality faced in such cases.

The other type of hysteroscopy performed is therapeutic hysteroscopy. The therapeutic hysteroscopy involves the use of the hysteroscope as a surgical instrument.

A female cannot undergo hysteroscopy if she is having her period. Hysteroscopy is generally performed in a hospital or in a doctor’s clinic and does not require the female to stay overnight at the hospital. The female is discharged after a hysteroscopy procedure and is able to go home shortly after the procedure has been completed. A hysteroscopy is a safe procedure with rare cases of complications. 

What is a hysteroscopy?

Hysteroscopy procedure

Hysteroscopy is the medical procedure that is performed by doctors to look inside the uterus of the patient to diagnose and treat the causes behind abnormal uterine bleeding. Hysteroscopy is performed using a hysteroscope. A hysteroscope is a thin, lighted tube which is inserted inside the patient’s vagina in order to examine the cervix and inner lining and inside of the uterus. Depending on the condition of the patient, hysteroscopy performed can either be diagnostic or therapeutic.

 

What is Diagnostic hysteroscopy (D&C)?

Diagnostic hysteroscopy is performed in order to diagnose the abnormalities and problems of the uterus. This procedure can also be used to confirm the results of other tests, such as hysterosalpingography (HSG), an X-ray dye test which is used to diagnose and check the uterus and fallopian tubes of the female. Diagnostic hysteroscopy is often be performed in one sitting.

Moreover, hysteroscopy can be used along with other procedures like laparoscopy or before procedures like dilation and curettage (D&C). In the laparoscopic procedures, the doctor inserts a thin tube with a fiber-optic camera on its top, known as the endoscope, into the abdomen of the patient to observe the outside of the uterus, ovaries and fallopian tubes. The endoscope is inserted inside the patient through an incision which is made through or below the patient’s navel.

What is Therapeutic hysteroscopy?

Therapeutic hysteroscopy is performed to treat an abnormal condition that has been detected during the diagnostic hysteroscopy. If an abnormal condition has been detected at the time of the diagnostic hysteroscopy, a therapeutic hysteroscopy can then be performed at the same time. This would save the patient’s time and also avoid the need for another surgery. During the therapeutic hysteroscopy, small surgical instruments are inserted through the hysteroscope and are used to treat the condition.

 

When is Operative Hysteroscopy used?

Doctors performing Hysteroscopy on a female

Hysteroscopy is performed to correct the following uterine conditions in a female:

  • Polyps and fibroids: Hysteroscopy is carried out to remove the non-cancerous polyps and fibroids growths found in the uterus.
  • Adhesions: This condition is also known as Asherman’s Syndrome. This leads to changes in menstrual flow and also infertility With this condition, the female gets very less or even no period. She may also have severe pain and cramps at the time she was supposed to have her period. Hysteroscopy also lets the doctor locate and remove the adhesions causing the troubles.
  • Septums: Hysteroscopy can help diagnose if the female has a uterine septum. Uterine Septum a malformation of the uterus which is naturally present right from birth but later has some defects, leading to the condition of the uterine septum.
  • Abnormal Uterine bleeding: Hysteroscopy can help diagnose the cause of heavy menstrual flow, long-period cycles or bleeding between the period cycle or after bleeding after menopause. Endometrial ablation is a procedure during which the hysteroscope and other surgical instruments are used to destroy the uterine lining with the purpose of treating the cause of heavy bleeding.

Also Read: Therapeutic and Operative Hysteroscopy

 When is hysteroscopy needed?

The doctor may recommend undergoing hysteroscopy after the first week after the patient’s period cycle. At this time, the doctor will be able to have the best view of the inside of the uterus. Hysteroscopy is also carried out in order to determine the reason behind unexplained bleeding or spotting in after menopause in women.

Who can undergo Hysteroscopy?

Even though there are many benefits linked to hysteroscopy, but, it may not be suggested to some patients. The doctor makes a proper examination of the patient to make sure if she is fit to undergo hysteroscopy or not.

What is the procedure of hysteroscopy?

Before the procedure, the doctor may give the female a sedative to help her relax and remain comfortable during the procedure. The procedure takes place in the order mentioned below:

  • The doctor firstly dilates the cervix to make space for the hysteroscope to be inserted.
  • The hysteroscope is then inserted inside through the vagina and cervix and then into the uterus.
  • After that, carbon dioxide gas or a liquid solution is inserted into the uterus through the hysteroscope. This is done with the purpose of expanding the uterus and clear away any blood or mucus inside the uterus.
  • The doctor then firstly examines the uterus and openings of the fallopian tubes.
  • In the end, if surgery is required, small surgical instruments are inserted inside the uterus through the hysteroscope to treat the condition.

The time taken to perform the hysteroscopy ranges from less than five minutes to more than one hour. The duration of the procedure depends if it is diagnostic or therapeutic. The time of the procedure can also vary if an additional procedure, like laparoscopy is to be performed at the same time. In general, however, diagnostic hysteroscopy takes less time than therapeutic.

Benefits of hysteroscopy

What are the benefits of Hysteroscopy?

  • Short hospital stay
  • Short recovery time
  • Fewer pain killers needed after surgery
  • An alternate of hysterectomy
  • Possibly avoids the need for open abdominal surgery

Is Hysteroscopy a safe procedure?

Hysteroscopy is generally a safe procedure. However, as just like any other type of surgery, there is a risk of complications. But, there is just a 1 percent risk of complications. Such complications include:

  • Risks linked to anesthesia
  • Risk of Infection
  • Bleeding
  • Damage or injury to the cervix, uterus, bowel or bladder
  • Scarring
  • Reaction or allergy used to expand the uterus

What to expect after a hysteroscopy?

If local or general anesthesia is given to the patient during the hysteroscopy, the doctor will advise the patient to remain in the hospital under observation for several hours. After the procedure, the female may have mild cramping or slight vaginal bleeding for one or two days. The female may also have shoulder pain in case the gas was used during the hysteroscopy. It is also usual to feel faint nauseous or sick. In case the patient has other symptoms as the ones mentioned below, it is suggested to consult your doctor:

  • Fever
  • Severe abdominal cramps or pain
  • Heavy bleeding or discharge

Hysteroscopy is generally a minor safe and surgery and does not require the patient to stay overnight in the hospital. However, in some cases, if the doctor observes complications or reactions with anesthesia, an overnight stay may be suggested for better recovery and care.

Also Read- 

When and Why is Hysteroscopy D&C performed?

 

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