Hysteroscopy is a procedure performed by a gynecologist to inspect the insides of the uterine cavity using a thin tube with a light and camera attached to it. This device is called a hysteroscope. A hysteroscopy may be performed to diagnose pathologies in the uterus or a method for surgical treatment for uterine pathologies, this is called surgical or operative hysteroscopy.
Minor pain may be experienced during the procedure. Post-procedural pain and cramps are common and may need pain killers for management. If a hysterectomy is done to perform surgical procedures, intravenous sedation or general anesthesia would be administered; hence, there would be no pain during the procedure. Patients may experience pain and discomfort after the procedure once the anesthesia wears off.
Why is hysteroscopy done?
Hysteroscopy gives the doctor information about the patient’s reproductive health. It helps the doctor to closely study the reproductive organs of a woman for identifying abnormalities. A sample of abnormal tissues and lesions would usually be taken for testing; this procedure is called a biopsy. Sometimes an additional surgical procedure may be performed in certain conditions.
Hysteroscopy is indicated in the following:
- To confirm the diagnosis of conditions that are suspected based on clinical assessment and other radiological tests, such as endometriosis, uterine adhesions
- Abnormal Pap smear
- Heavy or prolonged menstrual bleeding
- Dysmenorrhea (severe pain and cramping during periods)
- Intermenstrual bleeding (bleeding between periods)
- More than one miscarriage (loss of pregnancy)
- Difficulty getting pregnant
- Bleeding after menopause
- To evaluate the uterus prior to performing an abortion
- To diagnose and aid in the removal of urine fibroids, uterine polyps, and uterus scarring
- To undergo surgery for permanent sterilization
- When the intrauterine contraceptive device (IUCD) displaces out of the uterus
How is hysteroscopy performed?
The anesthesia used in hysterectomy depends on whether the procedure is done for diagnosis or to perform a procedure. It is done when you are not in your menses. If the procedure is only performed for diagnostic purposes, no anesthesia is required. Anxious patients may receive intravenous sedation. If the procedure is performed to take a biopsy or to perform more invasive procedures, intravenous sedation or general anesthesia would be administered.
The doctor inserts the hysteroscopy device through the vagina, the cervix, and then into the uterus. A saline solution or carbon dioxide gas is passed into the uterus through the device to widen the uterus and make the diagnosis or perform surgical procedures easier. The procedure may take 5-30 minutes, depending on the purpose of the procedure.
The purpose for which the hysteroscopy was done determines the recovery period. If patients have not received anesthesia or just local anesthesia, they would be able to go home in 1-2 hours. Those who receive intravenous sedation or general anesthesia would have to stay in the hospital till they recover from the anesthesia, which may either take a few hours or up to 24 hours. Pain killers and antibiotics may be administered. After the procedure, the patients may experience the following:
What are the complications of hysteroscopy?
Hysteroscopy is a relatively safe procedure with minimal complications. Though complications are rare, like any procedure there are risks, which include:
- Injury to the cervix or the uterus
- Scarring of the uterus
- Reaction to the liquid used to clean the uterus
- Reaction to anesthesia
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