Hysteroscopy is a medical procedure performed to diagnose and operate inside the uterus by inserting a hysteroscope through the vaginal opening into the cervix and directly into the uterus. Hysteroscopy is essentially conducted to diagnose the cause of abnormal bleeding, irregular periods, miscarriages, unknown cause of infertility, etc. 

Hysteroscope is used to get a view of the uterine cavity. It is a modern gynaecological apparatus used as a diagnostic and therapeutic device. It’s a special rod with a light source, camera, eyepiece, and other media channels (for surgical tools). It gives a clear visualization of the inside of the uterus on a screen for diagnostic purposes.  

Why is Hysteroscopy needed?

When a woman has a complaint of abnormal bleeding (with or without menses), irregular spotting, menopausal bleeding, etc., Hysteroscopy can be performed to locate and treat the cause. However, firstly ultrasound or hysterosalpingography (HSG) and some other tests are taken to get the patient’s medical background. Hysteroscopy is a safe procedure but can be a little invasive, so patients have the right to consent to treatment and choose other diagnostic options. But remember, Hysteroscopy is favoured as it is precise and causes very little to no side effects. 

Note: Hysteroscopy is rarely executed during pregnancy, menstruation, and if you have endometrial infections. 

What Can Be Diagnosed with Hysteroscopy?

There are a lot of reproductive medical conditions which can be determined and intervened by Hysteroscopy. But not every woman can get a hysteroscopy. It will be very considered by the doctor as well as the patient. These are some situations under which Hysteroscopy is utilized:

  • To find and remove endometrial/uterine polyps and fibroids. Uterine structural abnormalities can also be resolved by hysteroscopic myomectomy. 
  • To surgically remove Uterine adhesion or Asherman’s syndrome – a band of scar tissues on the uterine lining.
  • To cure Uterine septum – malformation of the uterus usually exist from birth.
  • To locate IUD – Intrauterine device.
  • Endometrial cancer
  • Cause for multiple miscarriages
  • Cause of unknown infertility, such as blocked fallopian tubes
  • To locate and remove placental tissues after giving birth.
  • Before performing laparoscopy or D&C
  • To perform hysteroscopic tubal ligation, etc.

As many uterine anomalies can cause infertility, often infertile women are suggested for Hysteroscopy by their fertility specialist to plan a fertility treatment accordingly. 

Types of Hysteroscopy

There are two types of Hysteroscopy; Diagnostic or investigative and Therapeutic Hysteroscopy. 

Diagnostic Hysteroscopy: As the name suggests, Diagnostic Hysteroscopy is used to investigate the uterus for structural abnormalities and malformations – that might have been altering the menstrual flow and causing infertility. 

Therapeutic Hysteroscopy: Operative Hysteroscopy can be performed alongside diagnostic Hysteroscopy if any endometrial abnormalities are detected. The detected deformity is destroyed with the help of a surgical tool. 

Is Hysteroscopy necessary?

Well, it depends on the patient’s medical circumstances and problem. If other diagnostics like ultrasound determines the matter of issue, then Hysteroscopy may not be needed. Moreover, if surgery is required, you might have to prepare for Hysteroscopy. 

Talk to your healthcare provider regarding the alternatives, complications, and complete procedure of Hysteroscopy if you have any doubts. 

During what time is Hysteroscopy performed

It can be performed in the first week after your period ends (if you have regular periods). If you aren’t having your periods regularly, your doctors will predict the right time for Hysteroscopy- from your tests and screening results. For menopausal women, Hysteroscopy can be executed at any time. 

Note: Hysteroscopy is rarely executed during pregnancy, periods, and endometrial infections. 

Do I have to be hospitalized for a hysteroscopy?

No, usually, Hysteroscopy is an outpatient treatment that can be carried out at your doctor’s office or hospital. It’s a minor surgical process that can take 5 minutes to 1 hour, depending on whether it is diagnostic or operative. 

Will I feel pain during a hysteroscopy?

This factor varies from patient to patient. Generally, you don’t feel much pain during and after Hysteroscopy, but minor cramps and discomfort are normal. If you are anxious or feel discomfort, you will be given local or general anaesthesia or sedatives. 

Preparation for Hysteroscopy

Before the day of the Hysteroscopy, you are not allowed to have sexual intercourse or to put anything inside your vagina. If you are under medications, then that’ll be reviewed by your surgeon, and you shouldn’t take any anticoagulants like aspirin 24 hours before Hysteroscopy. Pregnancy tests, blood tests, and pelvic exams may be carried out. You might have to abstain from food on the day of the Hysteroscopy. Just before the procedure, you’ll have to empty your bladder, change into a comfortable gown, and you will be administered anaesthetics as per your choice and condition of Hysteroscopy. 

Procedure of Hysteroscopy

You’ll have to lie on a surgical bed with your legs stirrup. The doctor will run a pelvic exam before starting the procedure:

  • Firstly, the cervix will be dilated so the hysteroscope can be inserted easily inside.
  • The hysteroscope will be inserted inside the uterus via the cervix through the vagina. A liquid solution is excreted through the hysteroscope to expand the uterus and clean the blood or mucus inside. 
  • Now, your surgeon will have a clear view, and they can inspect your uterus, uterine lining, and opening of the fallopian tube. The image will appear on the screen, and your surgeon can thoroughly examine the uterus for any disfigurement or abnormality. 
  • If surgery is required, the surgeon can insert the surgical tools through the hysteroscope to operate on the specific area and remove irregularities. 

Sometimes, the diagnostic Hysteroscopy is performed, followed by Laparoscopy or D&C. 

Post Hysteroscopy and Risk

After the Hysteroscopy, you’ll have to wait sometime for recovery (if you are under sedatives). Otherwise, you can leave if you don’t feel any abnormal pain. There are rare cases where a patient might faint or feel sick. For a few days, you’ll feel cramping, and you might have some bleeding and a little fever. Your doctor may suggest avoiding swimming or other physical labour and must refrain from inserting anything inside your vagina. 

Here are some side effects for which you should contact your doctor immediately:

  • If bleeding lasts for more than a few days and the flow is too heavy
  • Too much fever
  • Infection
  • Too much pain
  • Fluid overload, heavy bladder, etc.

These side effects could result from reactions to the substances used during Hysteroscopy. Only 1% of cases result in severe side effects like intrauterine scarring and injury to the cervix or uterine lining. The risk is definitely low, but it shouldn’t be overlooked. You must follow your doctor’s guidance.  

Hysteroscopy at Risaa IVF

Risaa IVF practices a safe and cautious procedure for all treatments. Our specialists take very good care of the patients well being. If the patient feels any discomfort or pain, we prescribe them some painkiller or sedative before the procedure. The Hysteroscopy is performed only if it is very necessary and consented. 

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