Dr Komalas Women Clinic - Hysteroscopy

Overview

Hysteroscopy is a minimally invasive surgical procedure used both for diagnosis and treatment. Hysteroscopy is done with a small tubular telescope-like instrument called a hysteroscope. Hysteroscope has a light and camera with which doctors see the internal environment of your uterus and cervix. The images captured by the hysteroscope are visible on a screen. The entire duration of a diagnostic hysteroscopy lasts for 5 to 10 minutes, sometimes even less.

Introduction

The doctor prescribes a hysteroscopy if he suspects any abnormalities inside your womb. The hysteroscope is inserted into your womb, and through a monitor nearby, the doctor sees your womb from inside. Diagnostic hysteroscopy is also used as a part of other diagnostic tests such as hysterosalpingogram, biopsies, etc.

Indication for the Use of a Hysteroscopy

A hysteroscopy is ordered for various reasons. The majority of them are: 

  1. Investigate bleeding problems such as heavy bleeding periods, post-menopausal bleeding, miscarriages, abnormal bleeding with pelvic pain, or intrauterine device (IUD) associated bleeding.
  2. For investigating and treating benign conditions such as fibroids, polyps, and cysts (non-cancerous)
  3. For chronic conditions such as uterine wall adhesions, following a severe infection (walls of uterus stick together causing infertility and zero periods)
  4. Misplaced/lost intrauterine devices or any IUD-related complications
  5. Infertility and recurrent miscarriages (tubal blockages)
  6. Congenital organ deformities such as the septal uterus (layer of tissue dividing the uterus into compartments), etc.
  7. For abortions, uterus cleaning, and contraceptive procedures

 

Many more investigational and interventional procedures are also carried out through a hysteroscopy. 

Preparations for Hysteroscopy

Doctors will share certain preparation protocols that must be followed the day before the hysterectomy. It involves a prophylactic antibiotic prescription, pain medications, and local anaesthesia. The local anaesthesia will help numb the cervix so that you do not feel pain during the procedure. Not everyone needs pain medication since the level of pain will be around 2 or 3 on a scale of 0 to 10, considering 0 as no pain and 10 as the worst pain. Antibiotics are prescribed to prevent minor infections. 

Diagnostic Hysteroscopy

The procedure starts by inserting a speculum into your vagina. You will be in a dorsal lithotomy position, where you will be asked to lie on your back with your legs widely flexed and rested on a footrest. Your knees will be at an angle of 70-90 degrees raised above the hip level. The speculum inserted will open your vagina wide. Then a skilled doctor will insert a hysteroscope through your vagina into your uterus via the cervix. Then a liquid or harmless gas, such as carbon dioxide, is filled in the uterus. Now through a monitor placed nearby, your doctor will see your uterus and the opening of the fallopian tubes into the uterine cavity. 

The doctor will take multiple normal pictures, and also, a dye or a contrast liquid is injected to get an x-ray-like picture of your uterus and fallopian tubes. This picture is known as a hysterosalpingogram. It is used to check the presence of blockages or cuts in the uterus and the fallopian tubes.

Your doctor will ensure to evaluate the walls of the uterus and provide imaging favorable to your diagnosis. The entire procedure will take around 15-30 minutes, where most of the time will be spent comforting you and readying the instruments. The actual time for diagnostic hysteroscopy is around 5-10 minutes. You will be sent home within a few hours.

Post-hysteroscopy Take-home Information

Hysteroscopy is a minor invasive procedure, and it does not require a long hospital stay. You will be sent home after a few hours of observation. Most people will be able to return to daily activities the same day or the following day. It is up to you to take as many rest days as you wish. You can eat and drink immediately after the procedure; just ensure to take simple and easily digestible foods.

You may have the following symptoms for a day or two:

  • Period-like abdominal pain
  • Mild bleeding or panty spots
  • Mild body pain (especially shoulder pain)
  • Stomach fullness
  • Headache, nausea, and lightheadedness
  • Mild fever

If you have heavy bleeding, severe pain, high temperature, and unbearable abdominal pain, consult your doctor for further investigation and treatment.

You can return to your daily activities after a day or two and resume sexual activity once the bleeding stops. Do not forget to take your prescribed medicines and comply with the follow-up schedule. Recovery after this procedure is speedy, and the hospital stay is relatively short.

Difference between Diagnostic and Operative Hysterectomy

The diagnostic procedure aims to determine the reason or cause for a particular medical issue. On the other hand, operative hysterectomy aims to rectify the cause and treat the medical issue. Diagnostic is much simpler and less time-consuming compared to operative hysteroscopy. The diagnostic procedure will not require general or regional anaesthesia, but operative hysteroscopy needs general anaesthesia. Diagnostic procedures can be carried out in a doctor’s office, while interventional hysteroscopy is performed in a sterile environment, preferably an operation theatre. 

Possible Complications of Hysteroscopy

Although hysteroscopy is a common and safe procedure, it still has some uncommon complications. They are:

  • Infections
  • Heavy bleeding
  • The uterus or fallopian tube perforation
  • Anaesthesia-related side effects
  • Uterus or cervix injury and scarring

Conclusion

Diagnostic hysteroscopy is a minor invasive procedure used to determine abnormalities of the uterus and the fallopian tubes in the female reproductive system. It is a simple outpatient procedure that does not take much time. The risks and complications of the procedure are extremely low. The recovery is so quick that you might even return to normal activities on the same day.

Laparoscopy and hysteroscopy are two different procedures, but both instruments look alike. Hysteroscope is specifically designed for the diagnosis and treatment of abnormalities related to the female reproductive system.

No, you need not wait that long. Patients usually heal quickly after most diagnostic hysteroscopy procedures. You can resume your sexual activities once the pain and bleeding stop. The bleeding stops in less than three days. If you feel you need a break, do not hesitate to talk about this with your partner

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