Hysteroscopy

Hysteroscopy refers to a procedure where the inside of the uterine cavity is viewed with the help of a special pen like instrument (hysteroscope) that has a camera at the end. Hysteroscopy is useful as a tool in both diagnosis and treatment of problems within the uterine cavity.

What are the conditions for which hysteroscopy is beneficial?

Hysteroscopy is beneficial for the diagnosis and treatment of problems limited to the uterine cavity, such as the following:

Diagnostic hysteroscopy : In cases with unexplained infertility, recurrent pregnancy loss, abnormal uterine bleeding, absence of menses, hysteroscopy is used to view the inside of the uterus and find out the cause of the problem.

Removal of intrauterine growths : Growths within the uterine cavity such as polyps and fibroids can be removed using hysteroscopy, thereby avoiding open surgery

Septal resection : The uterus may carry an abnormal partition called septum that divides the uterus into 2 parts. It may go unnoticed until child bearing period when it may cause infertility or recurrent abortions. When a septum causes such problems, it needs to be removed. This can be done in a relatively atraumatic manner using hysteroscopy and specialized instruments.

Abnormal uterine bleeding

Release of adhesion : Adhesions may form within the uterus and obliterate the uterine cavity partially or completely. This may be a result of prior infection or instrumentation of the uterus. When this happens, the uterus cannot perform its role with regard to menstruation or conception. In such cases, hysteroscopic resection of adhesions is used to recreate the uterine cavity.

What do I need to do before a hysteroscopy?

• Pre- op preparation usually includes blood tests, urine test, ECG, chest X- ray
• Hysteroscopy will require you to have anesthesia. The anesthetist will see you prior to the surgery and will make sure that anesthesia is safe for you.
• You will be asked to get admitted one day before the surgery and advised liquid diet on that day
• On the day of surgery you will be kept nil per oral (without food or liquids) for approximately 8 hours and started on IV fluids as necessary

How is hysteroscopy done?

Hysteroscopy is done under general anesthesia and you will be unconscious during the procedure. The hysteroscope is introduced through the vagina and into the uterus without having to make any skin incision. The hysteroscope is connected to television monitor that will show images of the inside of the uterus. It can be used to visualize adhesions, septae, endometrial condition, polyps etc. If correction of one of these problems is required this can be done though hysteroscopy. Along with the hysteroscope, special instruments can be introduced through the vagina to carry out corrective procedures within the uterus. The procedure generally takes about 1 hour to complete.

What is Hystero-Laparascopy?

Laparoscopy can be easily combined with hysteroscopy in a single sitting. A comprehensive evaluation of the reproductive tract can be done when this technique is employed. A camera is placed through a tube from the front of the belly (laparoscopy) and another camera is placed in the cavity of the uterus through the vagina. This technique is particularly useful in cases of infertility.

What are benefits of hysteroscopy?

Hysteroscopy is a minimally invasive technique that uses the natural route to the uterus. Therefore, it has the following advantages:

• Shorter hospital stay
• Immediate recovery
• Less pain
• Possible avoidance of major surgery

What to expect after a hysteroscopy?

After the procedure, your consultant will explain in detail regarding the procedure. You will get to know the findings noted in the procedure and what the abnormalities were. You will also be apprised of any corrective procedures that were undertaken with hysteroscopy. Sometimes a biopsy may be taken while performing a hysteroscopy. It will generally take 1 week to get the results of the biopsy test.

Hysteroscopic view of the inside of the uterus (uterine cavity)

How is the recovery after hysteroscopy?

You will be given pain medicines after the procedure to keep you comfortable. We generally keep you under observation for 1 day in the hospital after which you will be discharged. You can usually resume normal work and diet from the first postoperative day.

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