Hysteroscopy

What is Hysteroscopy?

Hysteroscopy is the direct visualization of the uterine cavity and the cervical canal through a telescope-like instrument called the hysteroscope. Visualization of the uterine cavity will note the presence of any masses (polyps), bands (adhesions), uterine deformities (septum) and nature of the uterine lining or endometrium. The opening of the fallopian tubes (ostia) into the uterine cavity can also be visualized.

Hysteroscopy can serve as an aid to diagnosis as well as treatment for certain conditions. The former is termed as a diagnostic hysteroscopy, while the latter is referred to as an operative hysteroscopy.

What are the indications for a Hysteroscopy?

• Infertility
• Abnormal uterine bleeding
• Abnormal hysterosalpingography (X-ray of the uterus) findings.

When is it performed?

Hysteroscopy is an outpatient or day-care procedure performed between the 7th & 10th day of the menstrual cycle. Prior to the procedure, it is important to ensure that the patient is in good health by a clinical examination and certain laboratory investigations such as routine blood and urine tests.

Hysteroscopy should not be performed in the presence of

• Uterine bleeding
• Pelvic infection
• Cancer of the cervix or uterus.

Procedure

• The procedure is performed in the operation theater under intravenous sedation and/or local anesthesia.
• The woman should report on the morning of the procedure on an empty stomach after an overnight fast.
• The patient is placed on the examination table in a specific yet comfortable position.
• Initially a pelvic or vaginal examination is done to assess the position and size of the uterus.
• The hysteroscope is introduced into the uterus via the vagina and cervix after the cervix has been adequately opened or dilated by instruments called dilators.
• The uterine cavity and the opening of the fallopian tubes are visualized completely.
• The procedure is short and lasts between 2-7 minutes.

After-care

• The woman can usually leave after 1-2 hours.
• Antibiotics are given to prevent infection and analgesics are prescribed to relieve pain.
• In some patients there may be mild cramping pain in the abdomen for a few hours after the procedure.
• Uterine bleeding (mild to moderate) may occur for a few days after the procedure.
• The woman may resume work the next day.
• In case of any discomfort, sexual intercourse may be avoided for 48 hours.

Complications

Complications of diagnostic hysteroscopy are rare and seldom life-threatening.

They include perforation of the uterus (a hole punctured in the uterus), cervical trauma, infection etc.

Operative Hysteroscopy

This is a procedure which involves introducing accessory instruments such as scissors, biopsy forceps, electrosurgical or laser instruments, through channels in the hysteroscope. These instruments are used to cut or burn tissues. Operative procedures are generally day-care procedures performed under general anesthesia. Treatment may be performed at the same sitting as a diagnostic hysteroscopy or at a later date.

This is some background information about the procedure. If you have any further queries, please approach the front desk to schedule an appointment with one of our doctors. We would be happy to be of assistance.