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- Hysteroscopy is the visualization of the inside of the uterine cavity by inserting special visualization instruments through the vagina and cervical opening.
- Hysteroscopy can be carried out to aid in diagnosis or to perform minor surgical procedures.
- In many cases hysteroscopy can be performed as an outpatient (same-day) surgical procedure.
- Complications of hysteroscopy are rare. The most commonly reported complication is perforation of the uterus.
What is hysteroscopy?
This procedure is a minimally invasive surgical procedure for viewing the inside of the uterus. Hysteroscopy is performed by inserting a visualizing scope through the vagina and into the cervical opening. Hysteroscopy allows visualization of the inside of the uterus, including the openings to the Fallopian tubes, as well as direct examination of the cervix, cervical canal, and vagina.
Why is hysteroscopy done?
Hysteroscopy can be performed for both diagnosis or also for treatment (therapeutic). Hysteroscopy is one of several procedures that your doctor may recommend to evaluate or treat abnormalities of the uterus or cervix. Since hysteroscopy examines the lining and interior of the uterus, it is not suitable for evaluating problems within the muscular wall or on the outer surface of the uterus.
Hysteroscopy may be recommended as one step in the evaluation of a number of gynecological problems, including:
- Abnormal vaginal bleeding
- Retained placenta or products of conception after a birth or miscarriage
- Congenital (inborn) anatomical abnormalities of the female genital tract
- Scarring, or adhesions, from previous uterine surgery or instrumentation such as dilation and curettage (D&C)
- Polyps or fibroid tumors inside the cervical canal or inside the uterine cavity
Hysteroscopy can also be used to help pinpoint the location of abnormalities in the uterine lining for sampling and biopsy. Hysteroscopy can also be used to perform surgical sterilization.
How is hysteroscopy performed?
There are a number of different sizes and types of hysteroscopes available, depending upon the type of procedure that is required. Some hysteroscopes are combined with instruments that allow surgical manipulation and removal of tissues if necessary.
Hysteroscopy may be performed in an outpatient surgery center or a hospital operating room, or a physician's office. A number of different methods for anesthesia and pain control may be used, depending upon the individual situation. Sometimes, hysteroscopy using narrow-diameter hysteroscopes that do not require dilation of the cervical opening can be performed without anesthesia. In other cases, a local anesthetic can be applied topically or given by injection. In certain cases, a regional or general anesthetic may be recommended.
A vaginal speculum is often inserted prior to the procedure to facilitate insertion of the hysteroscope through the uterine cavity. Depending upon the exact type of hysteroscope that is used, dilation of the cervical opening with surgical instruments may be necessary. After insertion of the hysteroscope, fluid or gas is injected to distend the uterine cavity and allow for better visualization.
Hysteroscopy should not be performed if a woman is pregnant or has an active pelvic infection. It is also not recommended if a woman has known uterine or cervical cancer. Certain conditions (abnormal position of the uterus, obstruction of the cervical canal or uterine cavity, scarring or narrowing of the cervical opening) may make hysteroscopy more difficult or impossible to perform in certain cases.
What are the risks and complications of hysteroscopy?
Women should expect to experience light vaginal bleeding and some cramping after the hysteroscopy procedure. Some cramping may be felt during the procedure, depending upon the type of anesthesia.
Complications of hysteroscopy are rare and include perforation of the uterus, bleeding, infection, damage to the urinary or digestive tract, and medical complications resulting from reactions to drugs or anesthetic agents. Accidental perforation of the uterus is the most common complication and occurs in 0.1% of diagnostic hysteroscopy procedures and 1% of therapeutic (surgical) hysteroscopies. Other rare complications are fluid overload or gas embolism (when gas bubbles enter the bloodstream) from the distending medium used in the procedure.
What is the outlook after hysteroscopy?
The outlook depends upon the individual case and the reason for hysteroscopy. Many minor surgical procedures can be successfully performed using hysteroscopy. Complications are rare, and most women recover with only minor post-procedure cramping and bleeding.
Women's Conditions Resources
Jansen FW; Vredevoogd CB; van Ulzen K; Hermans J; Trimbos JB; Trimbos-Kemper TC. Complications of hysteroscopy: a prospective, multicenter study. Obstet Gynecol 2000 Aug;96(2):266-70.
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Acetaminophen treats a variety of diseases or other medical problems that cause pain or fever. Examples of conditions acetaminophen treats include, headache, minor arthritis pain, back pain, tooth pain, menstrual cramps, PMS, osteoarthritis, common cold, tension headache, chronic pain, hip pain, shoulder and neck pain, sore throat, sinus infection, teething, TMJ, bites and stings, and sprains and strains.
Acetaminophen generally has no side effects when taken as prescribed. When side effects are experienced, the most common are headache, rash, and nausea.
In 2014, the FDA recommended that doctors and other health care professionals only prescribe acetaminophen in doses of 325 mg or less. This warning highlights the potential for allergic reactions, for example, face, mouth, and throat swelling, difficulty breathing, itching, or rash. This action also will help reduce the risk of severe liver injury and serious allergic reactions associated with this drug. Other possible serious side effects adverse effects include anemia, kidney damage, thrombocytopenia (a reduced number of platelets in the blood), and liver problems.
Other patient information. Do not take more than one product that contains acetaminophen at the same time. Do not take more than one acetaminophen-containing drug than directed. Do not drink alcohol while taking medicine that contains acetaminophen due to severe liver damage.
REFERENCE: FDA Prescribing Information.
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- and perforation of the uterus.
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MenstruationMenstruation (menstrual cycle) is also referred to as a "period." When a woman menstruates, the lining of the uterus is shed. This shedding of the uterine linking is the menstrual blood flow. The average menstrual cycle is 28 days. There can be problems with a woman's period, including heavy bleeding, pain, or skipped periods. Causes of these problems may be amenorrhea (lack fo a period), menstrual cramps (dysmenorrhea), or abnormal vaginal or uterine bleeding. There are a variety of situations in which a girl or woman should see a doctor about her menstrual cycle.
Miscarriage Causes and SymptomsMiscarriage is the medical term for the spontaneous loss of pregnancy from conception to 20 weeks gestation. Risk factors for a woman having a miscarriage include cigarette smoking, older maternal age, radiation exposure, previous miscarriage, maternal weight, illicit drug use, use of NSAIDs, and trauma or anatomical abnormalities to the uterus. There are five classified types of miscarriage: 1) threatened abortion; 2) incomplete abortion; 3) complete abortion; 4) missed abortion; and (5 septic abortion. While there are no specific treatments to stop a miscarriage, a woman's doctor may advise avoiding certain activities, bed rest, etc. If a woman believes she has had a miscarriage, she needs to seek prompt medical attention.
Nonsteroidal Antiinflammatory DrugsNonsteroidal antiinflammatory drugs (NSAIDs) are a class of drugs are used to treat inflammation, mild to moderate pain, and fever. Examples of the most common NSAIDs include: aspirin salsalate (Amigesic), diflunisal (Dolobid), ibuprofen (Motrin), ketoprofen (Orudis), nabumetone (Relafen), piroxicam (Feldene), naproxen (Aleve, Naprosyn,) diclofenac (Voltaren), indomethacin (Indocin), sulindac (Clinoril), tolmetin (Tolectin), etodolac (Lodine), ketorolac (Toradol), oxaprozin (Daypro), celecoxib (Celebrex).
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Uterine fibroids that remain small and do not grow usually do not need treatment; however, surgery to remove the fibroid may be necessary. Uterine fibroids do not cause cancer; however, there is a rare, fast-growing cancerous called leiomyosarcoma.
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- Abdominal pressure and pain
- Pelvic pain
- Pain during intercourse
- Pain during bowel movements
Diagnosis and treatment of benign uterine growths depends upon the type of growth.
Vagina PictureThe vagina is an elastic, muscular canal with a soft, flexible lining that provides lubrication and sensation. See a picture of the Vagina and learn more about the health topic.
Normal vaginal bleeding (menorrhea) occurs through the process of menstruation. Abnormal vaginal bleeding in women who are ovulating regularly most commonly involves excessive, frequent, irregular, or decreased bleeding. Causes of abnormal may arise from a variety of conditions that may include:
- Uterine fibroids
- Pelvic inflammatory disease
- Emotional stress
- Anorexia nervosa
- Polycystic ovary syndrome (PCOS)
- Early pregnancy
The treatment for abnormal or irregular vaginal bleeding depends upon the cause.