Hysteroscopy

What is Hysteroscopy?

Hysteroscopy is a surgical procedure which is performed to examine uterus and cervix, wherein a health care professional inserts a narrow tube like device through the vagina. This telescopic tube has a light and camera over it, which assists in reflecting the images of uterus, fallopian tube, ovaries and cervix on the doctor's monitor screen.

When does a hysteroscopy needed?

There are numerous reasons as to why a patient might need hysteroscopy. Here we are discussing a few major medical case scenarios where a hysteroscopy is required:

• To diagnose any abnormalities in uterus.
• Find out reasons for unexplained bleeding post menopause.
• Severe pelvic pain.
• Heavy bleeding during periods.
• Bleeding between two menstrual cycles.
• Frequent miscarriages.
• If the IUD (Birth control device) came out of its position.
• Great substitute for Dilation and Curettage (D&C) procedure.
• If there are any polyps.
• Existence of any fibroids.
• Malformation of uterus (Septums).
• Asherman's Syndrome (Adhesions).
• To confirm the results of Hysterosalpingography (HSG).
• Removal of leiomas (fibroids), polyps,etc.
• To fetch a sample tissue for further examination (Endometrial Biopsy).
• To know more about overall reproductive health of an individual.

Types of Hysteroscopy

Hysteroscopy can be broadly divided into two categories:

1. Diagnostic hysteroscopy:

This procedure is performed

• To obtain a clear view of uterus lining;
• To establish the fact whether or not any polyps, fibroids, scar tissues, etc are in existence;
• To verify results of HSG;
• To make other conclusive observations about fallopian tubes opening, cervix, etc.

2. Operative hysteroscopy:

Usually while conducting a diagnostic hysteroscopy if abnormalities like adhesions, myomas (fibroids), etc are observed then an operative hysteroscopy can performed at the same time to remove them. Doing so helps both the doctor and the patient to avoid need for a second surgery.

Tests you might need to get done before a Hysteroscopy:

• Blood test
• Diagnostic test
• Pap test
• Any other test as deemed necessary by your medical practitioner.

What are the benefits of a Hysteroscopy?

Compared to other medical procedures:

• Hysteroscopy is a minute surgical procedure
• Does not require longer hospital stay
• Speedy recovery
• Diagnosis and treatment under one procedure
• Might avoid the need for hysterectomy, open abdominal surgery, other invasive operations.
• No special care required after surgery.

How hysteroscopy is performed?

While carrying out hysteroscopy your health care service provider will use a speculum (a medical instrument) to hold open your vagina and then insert a thin tube like device to perform further procedure.

Generally saline is released into the uterus to help expand it, so that any blood or mucus can be cleared.

When can Hysteroscopy be performed?

Usually, a week after your menstrual cycle is considered to be the best time for conducting a hysteroscopy, however this time line may differ if you have reached menopause, etc. The idea is to get most clear view of the inside of your uterus.

Where can Hysteroscopy be performed and how long does it takes to carry out the same?

Hysteroscopy can be performed at a doctor's office or in an operation theatre setup depending upon the complication of an underlying case. Generally a diagnostic hysteroscopy takes about five to ten minutes, however if it involves operative hysteroscopy too then it might take more than thirty minutes to conclude.

Who cannot opt for Hysteroscopy?

Hysteroscopy cannot be performed if you are pregnant.

What are the conditions that might cause discrepancy during hysteroscopy?

Following medical situations of a patient can cause interference while conducting a hysteroscopy:

• Bloated bladder
• Cervix inflammation
• Vaginal discharge
• Pelvic inflammatory disease.

Things to remember before going for Hysteroscopy:

• Inform your doctor if you are consuming any anti coagulants or other medications that affect blood clotting.
• Details about any history of bleeding disorder or hormonal malfunctiong.
• If you are nervous about the procedure, talk to your doctor and discuss about the type of anesthesia (local, regional or general) you would want to prefer during hysteroscopy.
• If you are going for general anesthesia, make sure you do not eat or drink anything before the procedure as recommended by your doctor.
• Confirm whether or not you are pregnant.
• Wear comfortable clothes while heading out for hysteroscopy.
• Follow instructions (if any) provided by your medical practitioner.

How would you feel after hysteroscopy?

Depending upon the nature of anesthesia, you will be kept under observation as long as needed. You might feel:

• Sick
• Cramps
• Vaginal discharge
• Slight bleeding
• Constipation
• Shoulder pain.

What are the alarming symptoms after hysteroscopy which demands for doctor's consultation?

After the procedure you should contact the doctor immediately if you are having:

• A constant fever
• Heavy vaginal bleeding/ discharge
• Abdominal pain
• Infection

What are the precautionary measures to be followed after Hysteroscopy?

Once the hysteroscopy is concluded:

1. You should take proper rest, so as to get off the effect of anesthesia.
2. Consult with your doctor to take sedatives before or after hysteroscopy to deal with cramps.
3. You can resume your regular diet after the procedure.
4. Rest a few days if your body demands.
5. Visit your doctor as and when prescribed.
6. Take consultation from medical practitioner before you resume having sex.

Are there any risks associated with hysteroscopy?

Usually, a hysteroscopy is a very safe procedure involving no life threat. However like any other medical treatment this process also have certain risk of complications. Here we are discussing the scenarios wherein a hysteroscopy might get complicated and may call for adoption of other procedures as well:

• Problems from anesthesia: A person might have allergic reaction to the type of anesthesia being used.
• Patient may suffer from an infection
• In rare cases, cervix might get damaged.
• Allergy from the gas or substance used for expanding the uterus
• Damage to the uterus and a separate operation might be needed to do things right and in rare cases uterus can be removed.
• Damage to bowel, ovaries, etc.
• Pelvic inflammation.