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What is a hysteroscopy?
Hysteroscopy is a procedure that can be used to both diagnose and treat causes of abnormal bleeding. The procedure allows your doctor to look inside your uterus with a tool called a hysteroscope. This is a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus. Hysteroscopy can be a part of the diagnosis process or an operative procedure.
What is diagnostic hysteroscopy?
Diagnostic hysteroscopy is used to diagnose problems of the uterus. Diagnostic hysteroscopy is also used to confirm results of other tests, such as hysterosalpingography (HSG). HSG is an X-ray dye test used to check the uterus and fallopian tubes. Diagnostic hysteroscopy can often be done in an office setting.
Additionally, hysteroscopy can be used with other procedures, such as laparoscopy, or before procedures such as dilation and curettage (D&C). In laparoscopy, your doctor will insert an endoscope (a slender tube fitted with a fiber optic camera) into your abdomen to view the outside of your uterus, ovaries and fallopian tubes. The endoscope is inserted through an incision made through or below your navel.
What is operative hysteroscopy?
Operative hysteroscopy is used to correct an abnormal condition that has been detected during a diagnostic hysteroscopy. If an abnormal condition was detected during the diagnostic hysteroscopy, an operative hysteroscopy can be performed at the same time, avoiding the need for a second surgery. During operative hysteroscopy, small instruments used to correct the condition are inserted through the hysteroscope.
When is operative hysteroscopy used?
Doctor may perform hysteroscopy to correct the following uterine conditions:
Polyps and fibroids: Hysteroscopy is used to remove these non-cancerous growths found in the uterus.
Adhesions: Also known as Asherman’s Syndrome, uterine adhesions are bands of scar tissue that can form in the uterus and may lead to changes in menstrual flow as well as infertility. Hysteroscopy can help your doctor locate and remove the adhesions.
Septum: Hysteroscopy can help determine whether you have a uterine septum, a malformation (defect) of the uterus that is present from birth.
Abnormal bleeding: Hysteroscopy can help identify the cause of heavy or lengthy menstrual flow, as well as bleeding between periods or after menopause. Endometrial ablation is one procedure in which the hysteroscope, along with other instruments, is used to destroy the uterine lining in order to treat some causes of heavy bleeding.
How is hysteroscopy performed?
Prior to the procedure, Doctor may prescribe a sedative to help you relax. You will then be prepared for anaesthesia. The procedure itself takes place in the following order:
The doctor will dilate (widen) your cervix to allow the hysteroscope to be inserted.
The hysteroscope is inserted through your vagina and cervix into the uterus.
Carbon dioxide gas or a liquid solution is then inserted into the uterus, through the hysteroscope, to expand it and to clear away any blood or mucus.
Next, a light shone through the hysteroscope allows your doctor to see your uterus and the openings of the fallopian tubes into the uterine cavity.
Finally, if surgery needs to be performed, small instruments are inserted into the uterus through the hysteroscope.
The time it takes to perform hysteroscopy can range from less than five minutes to more than an hour. The length of the procedure depends on whether it is diagnostic or operative and whether an additional procedure, such as laparoscopy, is done at the same time. In general, however, diagnostic hysteroscopy takes less time than operative.
What are the benefits of hysteroscopy?
Compared with other, more invasive procedures, hysteroscopy may provide the following advantages:
- Shorter hospital stays.
- Shorter recovery time.
- Less pain medication needed after surgery.
- Avoidance of hysterectomy.
- Possible avoidance of “open” abdominal surgery.