Hysteroscopy is a procedure that allows a physician to look through the vagina and neck of the uterus (cervix) to inspect the cavity of the uterus. A telescope-like instrument called a hysteroscope is used. Hysteroscopy is used as both a diagnostic and a treatment too.
A hysteroscopy may be done to:
Find the cause of abnormal bleeding. Your doctor can pass heated tools through the hysteroscope to stop the bleeding.
Find the cause of bleeding after menopause.
See whether a problem in the shape or size of the uterus or if scar tissue in the uterus is the cause of infertility.
Look at the uterine openings to the fallopian tubes. If the tubes are blocked, your doctor may be able to open the tubes with special tools passed through the hysteroscope.
Find the possible cause of repeated miscarriages. Other tests may also be done.
Find and reposition a misplaced intrauterine device (IUD).
Find and remove small fibroids or polyps.
Use heated tools to remove problem areas in the lining of the uterus (endometrial ablation).
Place a contraceptive implant (Essure) into the opening of the fallopian tubes as a method of permanent sterilization.
Diagnostic hysteroscopy is usually conducted on an out patient basis with either general or local anesthesia. The procedure usually takes around 15-20 minutes.
Generally, a hysteroscopy follows this process:
An intravenous (IV) line may be inserted in your arm or hand. You will be positioned on an operating table, lying on your back with your feet in stirrups. The vaginal area will be cleansed with an antiseptic solution. The cervix may be dilated prior to the insertion of the hysteroscope.The hysteroscope will be inserted into the vagina, through the cervix, and into the uterus. A liquid or gas will be injected through the hysteroscope to expand the uterus, allowing for better visualization. The wall of the uterus will be examined for abnormalities. Photographs or video documentation may be made. Biopsy specimens may be taken. If a procedure such as fibroid removal is to be performed, instruments will be inserted through the hysteroscope.For more detailed or complicated procedures, a laparoscope (a type of endoscope inserted through the abdomen) may be used to view the outside of the uterus simultaneously.When the procedure is completed, the hysteroscope will be removed.
After hysteroscopy, the patient is allowed to rest for 2-4 hours to recover from the anesthesia. As the anesthetic wears off, there may be some abdominal pain, and painkillers may be required. You are allowed liquids after 4 hours and soft diet in the evening.
Complications of hysteroscopy are rare, and seldom serious. These include:
Perforation (hole) of the uterus with the hysteroscope- the hole usually heals on its own
Allergic reaction to the anesthetic.
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