Hysteroscopy

Hysteroscopy is a method for examining the lining inside your uterus by your doctor wherein a slender screening device hysteroscope is used.

The pointed edge of the hysteroscope is placed in your vagina and softly moved through the cervix into your uterus. The hysteroscope is attached with a camera and light to enable your doctor view the endometrium (uterine lining) on the computer screen.

A hysteroscopy may also be performed for finding the reasons of bleeding or abnormal bleeding happening in you even after attaining menopause. At times, it is performed for diagnosing the issue in your uterus, which is preventing you to achieve pregnancy and causing infertility.

A hysteroscopy may be utilized for removing unwanted growths in your uterus, like polyps or fibroids.

Your doctor may like to take a biopsy (a small tissue sample). The biopsy is scrutinized with the help of a microscope for any kind of issues.  One more surgery, a laparoscopy, similar to that of a hysteroscopy may also be performed in case there is an infertility issue.

Why Is Hysteroscopy Done?

A hysteroscopy is performed for:

  • Finding the reason of harsh cramping or unusually heavy menstrual bleeding. Your doctor may insert heated devices through the hysteroscope for stopping your bleeding.
  • Looking for an issue in the size and shape of your uterus or examine whether the scar tissue(s) in your uterus is the reason for your infertility.
  • Examining the uterine openings of the Fallopian Tubes. If the tubes are found to be blocked, your doctor may like opening the tubes with some special devices inserted through the hysteroscope.
  • Finding the probable reason of frequent miscarriages. For this, other examinations may also be performed.
  • Locating and removing  a lost  intrauterine device (IUD)
  • Locating and removing small polyps or fibroids.
  • Examining for endometrial cancer
  • Using heated instruments for removing the problem areas in the uterine lining (endometrial ablation)
  • Placing a sterilization coil in the Fallopian Tubes opening as a procedure of everlasting sterilization, like Essure.

How to Prepare for Hysteroscopy

Inform your doctor:

  • In case you happen to be pregnant, or, there is a possibility of carrying your pregnancy.
  • In case you have been taking any kind of medication.
  • In case you happen to be allergic to some kind of medications.
  • If you have experienced bleeding issues or taking blood-thinning medicines such as warfarin (Coumadin) or aspirin.
  • In case you have lately been treated for pelvic, vaginal or cervical infection during the last six weeks.
  • In case you have lungs or heart related issues.

The hysteroscopy is performed after your menstrual periods. In case there is a possibility of your being pregnant, the procedure is performed before you happen to ovulate.  This is done to ensure that you are not pregnant.

You are advised not to use vaginal medications, tampons and douching for nearly 24 hours before performing the procedure.

You may either be given sedatives or local, general or regional anesthesia for relaxing you for the examination. Your doctor may like to discuss this with you.

If you have opted for general anesthesia, you will probably be required to stop drinking and eating before the procedure. You should be following the doctor’s instructions precisely when to stop drinking and eating, else your hysteroscopy procedure may be put off to another date.

In case your doctor has prescribed you to take certain medicines on the day of your surgery, you are required to take them only with a mouthful of water.

Since you will be given sedatives, you may have to arrange someone for driving you back home on the day of your examination.

You will perhaps be asked to fill in and sign an authority form saying that you understand the procedural risks and tend to agree to having the surgery done.

You should be talking to your doctor in case you happen to have to some concerns about the potential risks or how the procedure will be performed in mind.

The support staff at the Clinic may provide you the instructions on how to be ready for your hysteroscopy surgery.  Or, someone may call you to provide you the instructions before the surgery.

How is the Hysteroscopy performed?

  • Hysteroscopy is generally performed by a Clinic surgeon at the Clinic in the Operation Theatre. Mostly women are allowed to get back home on the same day.
  • You are given anesthesia to help you get relaxed and numbing the pelvic region or putting you to sleep.
  • You will be asked to change into a Clinic gown. You will also be asked to visit the Clinic’s cloakroom for emptying your bladder before performing the procedure. Afterwards, you will be asked to lie down on the examination table with your feet raised, supported by footrests.
  • Your doctor will place a lubricated device, known as a speculum, in your vagina. The speculum softly widens apart the walls of your vagina and enables the doctor to see within your vagina and cervix of the uterus. The vagina will be cleansed using a special soap.
  • The hysteroscope is inserted through the entrance of your vagina and softly moved through the cervix into your uterus. A liquid or gas will be inserted through the hysteroscope in your uterus, which will help the doctor look at the uterine lining closely and clearly.

The hysteroscope gives a magnified scrutiny of the uterine lining to your doctor. Your doctor will also be able to see the openings of the Fallopian Tubes into your uterus on a computer screen.

  • In case some other procedure or a biopsy is to be taken, your doctor may use small instruments passing through the hysteroscope. A hysteroscopy can be performed in just 30 minutes unless some other procedures are also to be performed.

How will you feel during Hysteroscopy

  • In case you are given regional or local anesthesia or sedatives, you may feel abdominal cramping during the procedure. After the examination, you may experience a tickling, hoarseness in your voice, dry or sore throat mildly. You may experience these symptoms for several days. Throat-soothing lozenges and gargles with lukewarm salty water greatly help in relieving the symptoms relating to your throat.
  • Some females experience dizziness or sickness in their stomachs. This is known as vasovagal reaction. These normally go away within a few minutes.
  • You are advised to avoid playing sports, using tampons or copulating for quite some time after the hysteroscopy procedure.
  • Consult your doctor about when you can resume your routine activities.

Potential risks of Hysteroscopy

  • In case general anesthesia is given to you, there is a possibility, although little, of developing the anesthesia-related problems.
  • If case fluid is used during the procedure for helping the doctor monitor the uterine lining unmistakably, you are likely to absorb some fluid. It may also increase the sodium levels in your blood and you may experience bloating.
  • In case gas is used, you may run a risk for air embolism (air bubble) in your blood vessels. But, this happens in very rare cases.
  • Your uterus of the cervix may get injured during the hysteroscopy procedure and may develop bleeding or an infection. In certain rare cases, your bowel, bladder or the uterus may get punctured during the procedure that may require repair with a surgery.

After the procedure

Immediately after the procedure, you will be carried to the recovery room in the care of qualified nurses to observe your condition.

If all seems well, you are kept in the recovery room for nearly 2 to 4 hours before allowing you to go home. As you are moving home with an attendant accompanying you, you will be given a set of instructions and information about whom to call in case of later problems arising out of the procedure.

It is quite usual to experience a small quantity of vaginal bleeding during the day after the hysteroscopy procedure. You may also experience mild abdominal pain in case a gas was filled in the uterus during the procedure. This normally goes away within 24 hours.  You may take Tylenol (acetaminophen) for getting relief in the pain.

Follow your doctor’s instructions diligently. Call him or her in case you experience:

  • Intense vaginal discharge or bleeding (more than your usual menstruation/periods)
  • Fever
  • Problems while urinating
  • Severe pain/cramping in the abdominal or pelvic region
  • Throwing-ups
  • Breathing problems

Outcomes

The hysteroscopy is a method for your doctor to scrutinize your uterine lining. The doctor uses a slender instrument, known as hysteroscope, for inspecting the lining. Your doctor may discuss with you what he or she observes in the hysteroscopy procedure.

Hysteroscopy Results
Normal: The uterus from within looks normal in its shape and size.
No abnormal growths, fibroids or polyps are found to be present.
The Fallopian Tube openings seem to be normal.
Abnormal: The uterus shape or size within seems to be abnormal.
There are traces of scar tissues in the uterus.
The presence of uterine fibroids, polyps or other growths.
A lost intrauterine device (IUD) is located, but removed.
The openings of the uterus towards one or both the Fallopian Tubes are found to be closed.

What may affect the procedure?

The reasons why hysteroscopy cannot be performed or, if performed, you may get blurred outcomes because:

  • You have your periods and the doctor may not be able to see the uterine lining observably.
  • If you happen to be pregnant and the hysteroscopy procedure cannot be performed. If done, there is a potential risk of the procedure to the fetus (developing baby).
  • A cervical or vaginal infection is found.

If you are sexually inactive, the procedure can be performed any time. But it is not in your interest to go through the procedure when you are having your periods.

In case you have attained menopause, the procedure can be performed any time.

Points to Ponder

  • Women having abnormal bleeding and suffering from uterine fibroids may choose to go in for hysteroscopy for removal of the fibroids instead of opting for hysterectomy.
  • Hysteroscopy is not suggested to women having a pelvic inflammatory infection or cervical cancer.
  1. October 28, 2016

    Geez, that’s unebbievalle. Kudos and such.

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