Hysteroscopy: Procedure, Risk & Recovery

Written By: Dr. Agatha Ruby Moniz

Dr. Agatha Ruby Moniz, specialist in obstetrics and gynaecology with focus on minimally invasive surgery is posted at Medcare Women & Children Hospital- Dubai. Her impressive credentials include an MBBS from University of Mysore, India, DGO and MD (Ob/Gyn) from University of Mangalore, India, and MRCOG and FRCOG from UK. 

Updated On:May 23, 2024

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What is Hysteroscopy? 

The main purposes of hysteroscopy are to identify and address the causes of irregular uterine bleeding. During the surgery, your surgeon will use a hysteroscope to view the interior of your uterus. A surgeon will use a narrow, illuminated tube called a hysteroscope to see into your uterus and at your cervix via your vagina.

Both the diagnostic and operative processes might be involved in a hysteroscopy.

Using a diagnostic hysteroscopy, your uterus' structural issues that might be causing abnormal bleeding are found. Additionally, hysteroscopy can be used to validate the outcomes of other exams such an ultrasound or hysterosalpingography (HSG). To determine whether your fallopian tubes are obstructed, an X-ray dye test called an HSG is performed. It might be challenging to get pregnant if your fallopian tubes are blocked.

An anomaly found during a diagnostic hysteroscopy is treated with an operational hysteroscopy. In order to minimize the necessity for a second surgery, your doctor could conduct both a diagnostic and an operational hysteroscopy simultaneously. Your surgeon uses a tool during operational hysteroscopy to remove anomalies that might be causing irregular uterine bleeding.

Purposes of a Hysteroscopy 

Hysteroscopy is generally used to diagnose and treat diseases that result in high menstrual flow, irregular spotting between periods, abnormal uterine bleeding, and bleeding after menopause.

The following uterine disorders may be diagnosed and treated via hysteroscopy: 

  • Hysteroscopy is used to discover and remove polyps and fibroids, which are uterine structural abnormalities. A hysteroscopy polypectomy is the medical term for the surgical removal of a polyp. A hysteroscopy myomectomy is the medical term for the surgical excision of a fibroid.
  • Uterine adhesions, often referred to as Asherman's syndrome, are bands of scar tissue that can develop in your uterus. They may alter the flow of your menstrual period and result in infertility. Your doctor can find and get rid of the adhesions with the use of a hysteroscopy.
  • Uterine septums are a congenital (existing at birth) uterine abnormality that can be detected with hysteroscopy.

In addition, hysteroscopy can be utilized for

  • Determining the reason for ongoing reproductive issues or losses
  • Finding an IUD (intrauterine device)
  • After delivery, identifying and eliminating placental tissue.

Hysteroscopy Procedure 

Before a Hysteroscopy 

Your doctor will check to see whether you're a suitable candidate for a hysteroscopy, go over the process with you, and address any concerns you might have. You'll get instructions to help you get ready for the treatment.

Your doctor might inquire about the following: 

  • Ask what medications you are taking, including vitamins and supplements, and take a medical history. You might need to stop taking aspirin and other anticoagulants, such as blood thinners, before the surgery.
  • Conduct a physical examination, pelvic examination, and pregnancy test. Depending on the particulars of your operation, you could be required to undergo a blood test or other diagnostic procedures.
  • Provide instructions on how to be ready, including what to dress for the surgery, if you need to fast beforehand, and whether you'll need a driver to get you home after the procedure.

During a Hysteroscopy 

You'll be required to change into a hospital gown and empty your bladder on the day of the treatment. To make you more relaxed, you could be given sedatives or anesthetic. Whether the hysteroscopy will be performed in a hospital or at your surgeon's office, as well as whether additional procedures will be carried out concurrently, will determine the sort of anesthetic you will get.

Your legs will be in stirrups as you lay on the exam table. When you are situated, your surgeon will:

  • Examine the pelvis.
  • To make room for the hysteroscope to be implanted, dilate (open) your cervix.
  • Through your vagina and cervix, insert the hysteroscope into your uterus.
  • Send a liquid solution into your uterus through the hysteroscope to gently stretch it and take out any blood or mucus. This procedure enables your surgeon to see your fallopian tubes, uterus, and uterine lining.
  • Examine the apertures of your fallopian tubes and uterus. Your surgeon can see clearly more easily thanks to the hysteroscope's illumination.
  • If surgery is required, insert surgical tools via the hysteroscope that can be used to remove any unusual abnormalities.

The length of a hysteroscopy might range from five minutes to more than an hour. Whether the operation is diagnostic or surgical, as well as whether another one, such as laparoscopy, is performed concurrently, determines how long it takes. Typically, diagnostic hysteroscopy takes less time than an operation.

After a Hysteroscopy 

If you underwent anesthesia for your hysteroscopy, you could be kept under observation in the recovery area for a number of hours. You can have short-term cramps or minor bleeding. Additionally, it's normal to have some dizziness or nausea after your treatment.

Hysteroscopy Recovery 

Your recovery period will vary on how involved your procedure was, such as whether your hysteroscopy involved both diagnostic and surgical procedures. Following a hysterectomy, patients are frequently instructed to refrain from douching, sexual activity, and introducing anything into their vagina (such as tampons) for two weeks. During your rehabilitation, you could be told to stay away from hot tubs, swimming, and bathing.

Depending on your particular circumstances, heed the advice of your surgeon.

Hysteroscopy Benefits 

With the use of hysteroscopy, your surgeon may be able to identify any problem and fix it all at once. Hysteroscopy also offers accurate, less invasive surgery. Your surgeon may be able to find abnormalities and remove them using hysteroscopy without causing damage to the tissue around them.

References 

Bettocchi, S., Nappi, L., Ceci, O., & Selvaggi, L. (2003). What does ‘diagnostic hysteroscopy’mean today? The role of the new techniques. Current Opinion in Obstetrics and Gynecology, 15(4), 303-308.
Bradley, L. D. (2002). Complications in hysteroscopy: prevention, treatment and legal risk. Current Opinion in Obstetrics and Gynecology, 14(4), 409-415.
Cicinelli, E. (2010). Hysteroscopy without anesthesia: review of recent literature. Journal of minimally invasive gynecology, 17(6), 703-708.
Emanuel, M. H. (2013). New developments in hysteroscopy. Best Practice & Research Clinical Obstetrics & Gynaecology, 27(3), 421-429.
Jansen, F. W., Vredevoogd, C. B., Van Ulzen, K., Hermans, J. O., Trimbos, J. B., & Trimbos-Kemper, T. C. (2000). Complications of hysteroscopy: a prospective, multicenter study. Obstetrics & Gynecology, 96(2), 266-270.

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