Hysteroscopy
Hysteroscopy is a procedure performed to examine the inside of the uterus
(womb). The development of hysteroscopy has
allowed medical experts to deal with the reproductive health of a woman with greater control and skill.
The term
hysteroscopy refers to the process of inserting a tube, called a hysteroscope, into a female’s vagina in
order to obtain
a clear image of the female’s uterus.
Hysteroscopes are thin, flexible tubes that contain light and a camera at one end and are inserted into
the vaginal
canal. A monitor displays the image of the uterus as the hysteroscope moves through the uterus, from the
vagina to the
cervix to the uterus.
Dr. Amruta Jaiswal provides expert hysteroscopy treatment with
well-qualified experience to recommend
the best possible
course of action for your condition.
What happens during a hysteroscopy?
Your physician may ask you to place a vaginal medicine the night before your procedure. It is called
Cytotec or
misoprostol, and it helps soften the cervix. Depending on your doctor, you may be prescribed a sedative
or painkiller
before the procedure.
A hysteroscope is inserted through the vagina and into the opening of the uterus, called the cervix, on
the day of the
procedure. A small amount of saltwater is used to aid in seeing the uterine cavity and the openings to
the tubes after
the lens has been inserted in the uterus.
Your doctor may be able to discover the reason for abnormal bleeding once inside the uterus. It may also
be possible to
perform minor procedures, such as removing a polyp or placing the Essure microinsert, a permanent form
of contraception.
Who needs a Hysteroscopy?
Hysteroscopy is recommended for individuals who experience specific gynecological issues that need
closer examination or
treatment. Here are the common reasons someone might need a hysteroscopy:
- Abnormal Uterine Bleeding: Women who have heavy, prolonged, or irregular menstrual periods, as
well as those with
bleeding after menopause, may need a hysteroscopy to determine the cause.
- Infertility or Recurrent Miscarriages: If a woman has difficulty conceiving or has had multiple
miscarriages, a
hysteroscopy can help identify any structural problems in the uterus that could be contributing to
these issues.
- Suspected Uterine Fibroids or Polyps: When benign growths such as fibroids or polyps are
suspected, hysteroscopy
allows the doctor to see and sometimes remove these growths directly.
- Abnormal Pap Smears or Ultrasound Findings: For women who have had abnormal results from a Pap
smear or an ultrasound,
hysteroscopy provides a more detailed look at the endometrial lining to check for precancerous or
cancerous conditions.
- Intrauterine Adhesions (Asherman's Syndrome): This procedure can diagnose and treat scar tissue
inside the uterus that
may cause menstrual irregularities and infertility.
- Lost Intrauterine Device (IUD): If an IUD is misplaced or difficult to locate, hysteroscopy can
help find and remove
it.
- Congenital Uterine Anomalies: Hysteroscopy is used to diagnose and sometimes correct structural
abnormalities in the
uterus that have been present since birth.
- Chronic Pelvic Pain: For women with unexplained pelvic pain, hysteroscopy can help identify
uterine issues that might
be causing the pain.
What are the risks associated with the procedure of Hysteroscopy?
Hysteroscopy is generally considered a safe procedure, but like any medical procedure, it does carry
some risks. Here
are the potential risks related to hysteroscopy:
- Infection
: There's a small risk of developing an infection in the uterus or surrounding areas
after the procedure.
- Bleeding :Some bleeding or spotting is common after hysteroscopy, but heavy
bleeding can occur in rare cases, especially if a
biopsy or removal of growths like fibroids or polyps is performed.
- Uterine Perforation : Although rare, the hysteroscope can sometimes puncture the
wall of the uterus. If this happens, it might cause damage to
surrounding organs, such as the bladder or bowel, and could require further surgical intervention.
- Fluid Overload : During hysteroscopy, fluid is used to expand the uterus for
better visibility. In rare instances, too much fluid can be
absorbed into the bloodstream, leading to complications such as fluid overload or electrolyte
imbalances.
- Adverse Reaction to Anesthesia : If general anesthesia is used, there are risks
associated with its use, including allergic reactions, respiratory
issues, or other anesthesia-related complications.
- Cervical Trauma : The cervix may be stretched during the procedure, which can
cause temporary pain or, in very rare cases, permanent
damage.
Technology Used in Hysteroscopy
- Hysteroscope : The primary tool used in hysteroscopy is the hysteroscope, a thin,
lighted tube equipped with a camera. It is inserted
through the cervix into the uterus, allowing the surgeon to see the uterine cavity on a monitor.
- Light Source and Camera : The hysteroscope is connected to a high-definition
light source and camera system, providing clear and magnified images
of the uterine cavity.
- Fluid or Gas Distension Media : To get a clear view inside the uterus, the cavity
is expanded using fluid (saline solution) or gas (carbon dioxide).
This helps to separate the walls of the uterus and improves visibility.
- Operative Instruments : Various specialized instruments can be passed through the
hysteroscope for performing biopsies, removing polyps,
fibroids, or other abnormal tissue, and for treating uterine adhesions. These instruments include
scissors, forceps,
resectoscopes, and lasers.
- Electrosurgical Devices : These devices use electrical energy to cut tissue or
control bleeding during the procedure. They can be attached to the
hysteroscope for precise operative interventions.
Recovery Process for Hysteroscopy
Recovering from a hysteroscopy typically involves a few key steps to ensure you return to normal
activities safely and
comfortably.
Immediate Post-Procedure Care:
- Observation : After the procedure, you'll be monitored in a recovery area for a short period to
ensure you’re waking up safely from
any sedation or anesthesia.
- Cramps and Spotting :
It is normal to experience mild cramping or light spotting for a few days. These symptoms usually
subside quickly.
Pain Management:
- Over-the-Counter Pain Relief : Medications such as ibuprofen or acetaminophen can help manage any
discomfort. Follow the dosage instructions provided
by your healthcare provider.
- Prescription Medication : If necessary, your doctor might prescribe stronger pain relief.
Activity Restrictions:
- Rest : Plan to rest on the day of the procedure. Most people can resume normal activities within a
day or two.
- Avoid Strenuous Activities : Refrain from heavy lifting, vigorous exercise, and sexual intercourse
for a few days as recommended by your doctor.
Diet and Hydration:
- Normal Diet : You can usually resume your normal diet immediately after the procedure.
- Stay Hydrated : Drinking plenty of fluids is important, especially if a saline solution was used
during the procedure.
Signs to Watch For:
- Heavy Bleeding : If you experience heavy bleeding (heavier than a normal period), contact your
doctor.
- Severe Pain : Intense or persistent pain that isn’t relieved by over-the-counter medications should
be reported.
- Fever or Chills : A fever over 100.4°F (38°C) or chills may indicate an infection and should be
addressed promptly.
What happens after the hysteroscopy?
After the Hysteroscopy Surgery, you will be able to go home. In order to prevent bacterial growth, your
vagina should be
kept clean for two weeks (no sexual intercourse, tampons, or douching).
As the cervix is dilated or opened wider to ease the passage of the hysteroscope during the procedure,
you may
experience minor cramping, bleeding, or discharge.
Two weeks after the procedure, your doctor may schedule a follow-up appointment with you. In case of any
complications
after the procedure but before your next appointment, please contact your doctor. The following problems
should be
reported to your doctor:
- Severe, persistent pain.
- High body temperature of more than 100.4°F.
- Bleeding lasts longer than a period when you are not expecting your period.
- Foul-smelling discharge from the vaginal area.
- Pregnancy symptoms.
What can you expect?
You can expect:
- During the procedure, you may feel sleepy if you are given general anesthesia.
- Upon recovering from this procedure, you should be able to resume your usual activities within a few
hours or one or
two hours.
- Your doctor can tell you when it is safe to resume a normal diet.
- For a day or two, you might experience uterine cramps, which can usually be managed with
over-the-counter pain
medications.
- There is a possibility of spotting or minimal-to-moderate vaginal bleeding.x
- It is possible to feel gaseous distension and pain in your belly or shoulder for up to 24 hours
following the
procedure due to the gas used during the procedure. Some painkillers can relieve the pain.
Follow the instructions provided by your doctor.
- Your doctor may recommend pain relievers for your soreness.
- You should avoid aspirin and some other medicines in case you bleed.
- For the next two weeks, do not douche with water or have sex.
- Avoid tampons for a few weeks.
