Hysteroscopy is the visual examination of the canal of the cervix and interior of the uterus using a thin, lighted, flexible tube called a hysteroscope. The device is inserted through the vagina. Hysteroscopy may be used for both diagnostic and therapeutic purposes.
The hysteroscope allows for easy visual access to the interior of the cervix and uterus to assess the lining of these structures. Therapeutic maneuvers, such as taking a tissue sample (biopsy), removal of polyps or fibroid tumours, or preventing bleeding with cautery (destruction of tissue by electric current, freezing, heat, or chemicals) may be performed during a hysteroscopy procedure.
Hysteroscopy may be performed in women who have an abnormal Pap test, abnormal uterine bleeding, or postmenopausal bleeding. It may be used to help diagnose causes of infertility or repeated miscarriages. Hysteroscopy may also be used to evaluate uterine adhesions (Asherman’s syndrome), polyps, and fibroids, and to locate and remove displaced intrauterine devices (IUDs). Hysteroscopy is also used to place small inserts in the fallopian tubes that are a permanent method of birth control.
Therapeutically, hysteroscopy may be used to help correct uterine problems. For example, small adhesions, polyps, or fibroids may be removed through the hysteroscope, often eliminating the need for open abdominal surgery. Endometrial biopsy or ablation (removal of the endometrial lining) may be performed via hysteroscopy. The term “operative hysteroscopy” may be used in these situations.
Hysteroscopy cannot be performed during pregnancy. The procedure is best performed about 1 week after menstruation.
Female Pelvic Organs
The organs and structures of the female pelvis are:
Before the Surgery
During the Surgery
A hysteroscopy may be performed on an outpatient basis or as part of stay in a hospital. Procedures may vary depending on the patient’s condition and the doctor’s practices.
Generally, a hysteroscopy follows this process:
After the Surgery
The recovery process will vary depending on the type of anesthesia that is given. If general anesthesia or a sedative was used, blood pressure, pulse, and breathing will be monitored until they are stable and the patient is alert. When stable, the patient will be discharged home. Hysteroscopy is usually performed on an outpatient basis.
There is generally no special type of care following a hysteroscopy. The patient may experience cramping and vaginal bleeding for a day or two after the procedure. In case the patient observes any of the following symptoms, it should be reported to the doctor:
The patient may experience flatulence (gas in the digestive tract) and pains resulting from the gas administered during the procedure for about 24 hours. Patient may also feel pain in the upper abdomen and shoulder. Pain relievers can be taken for soreness as recommended by the doctor. Aspirin or certain other pain medications may increase the chance of bleeding. Hence, recommended medications should be taken. The patient may be instructed to avoid vaginal douching and sexual intercourse for two weeks after the procedure, or for an alternate period of time recommended by the doctor. Other activities and normal diet may be resumed unless the doctor advises differently.
Risks / Complications
As with any surgical procedure, complications may occur. Some possible complications of hysteroscopy may include, but are not limited to, the following:
The patient may experience slight vaginal bleeding and cramps for a day or two after the procedure.There may be other risks depending on the patient’s specific medical condition. Certain factors or conditions may interfere with a hysteroscopy. These factors include, but are not limited to, the following:
You should be able to go home shortly after the procedure. If you had general anaesthesia, you may need to wait until its effects have worn off.
It is normal to have some mild cramping or a little bloody discharge for a few days after the procedure. You may be given medication to help ease the pain. If you have a fever, chills, or heavy bleeding, you should consult with the doctor
Dilation and curettage (D&C) is a surgical procedure. Your cervix is opened (dilated) and an instrument is used to remove some of the lining of your womb (curettage). Hysteroscopy is where your doctor uses a camera to look at the inside of your womb. They may then use special instruments to take a sample of tissue or treat a gynaecological condition. You would usually have a hysteroscopy first to examine the womb, with the D&C then following this if necessary.
D&C can be used to take a sample of the lining of your womb. This can help to diagnose and treat a condition that may be causing any abnormal bleeding. You might also have a D&C after a miscarriage, to remove any tissue that’s left behind in your womb.
D&C is used less and less, now that newer techniques have replaced it.
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