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What is hysteroscopy?

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What is hysteroscopy?

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Written by: Kathryn Danzey

There are two types of hysteroscopy. Diagnostic hysteroscopy refers to the examination of the inside of the uterus (womb) using a telescope. If an abnormal condition is detected during the diagnostic procedure, operative hysteroscopy may then be performed to correct it at the same time, avoiding the need for a second surgery.

Do I need any anesthetics?

Diagnostic hysteroscopy may sometimes be carried out as an outpatient procedure with or without local anesthetics. However, operative hysteroscopy often requires a general anesthetic. If it is likely that an abnormal condition is present, it is better to arrange the procedure to be carried out under general anesthetic to avoid the need for a second hysteroscopy later on.

How is it done?

The first step of diagnostic hysteroscopy involves slightly stretching the canal of the cervix with dilators. Once the cervix is dilated, the hysteroscope, a narrow lighted viewing instrument is inserted through the cervix into the cavity of the uterus. Carbon dioxide gas or a special clear solution is then introduced into the cavity to distend it, to facilitate inspection. Additional instruments may be introduced into the cavity if surgery is required.

Who needs it?

Hysteroscopy provides important diagnostic information on the cavity of the uterus. Women with the following conditions may benefit from hysteroscopy:

• heavy/irregular periods
• bleeding after menopause
• miscarriage especially recurrent miscarriage

Operative hysteroscopy

Operative hysteroscopy may treat many of the abnormalities found during diagnostic hysteroscopy, for example:

• fibroids
• polyps
• scar tissue (adhesion)
• congenital abnormalities such as septum

Endometrial ablation/resection

This is a form of hysteroscopic surgery used to treat heavy periods. The basic principle is to remove (ablate) the lining of the uterus (endometrium) using some forms of energy e.g. diathermy, laser and thermal energy. It is often considered as an alternative to removing the whole uterus in women who do not have fibroids or other significant abnormalities in the pelvis.

Preparation for hysteroscopic surgery

Sometimes it is helpful to make the lining of the uterus (endometrium) as thin as possible, to facilitate the surgery. If this is considered necessary, you may be asked to take hormone medication, either in the form of tablets, nasal spray or monthly implants for about two months prior to the surgery – until you come into hospital for the operation.

How long do I need to stay in the hospital?

In most cases you can go home within 8 hours of the procedure. In operative hysteroscopy, sometimes it may be necessary for you to stay overnight.

Risks of hysteroscopy

Diagnostic hysteroscopy – complications are rare. Perforation of the uterus is the most common complication, but the hole usually heals on its own without the need for additional surgery.

Operative hysteroscopy – complications occur in one or two out of every 100 operative hysteroscopy procedures, including:

• Uterine perforation: most common complication
• Absorption of fluid used to distend the uterine cavity into the circulation: this may lead to fluid in the lung (pulmonary oedema), breathing difficulties, which often settle within 24 hours
• Damage to bowel or bladder: this rarefy occurs and may follow if there is perforation of the uterus

After the operation

Following hysteroscopy, some vaginal bleeding or discharge and cramping may be experienced for a few days.

Sexual intercourse should be avoided for several days or for as long as bleeding occurs.

Normal activities may usually be resumed within one or two days in the case of diagnostic hysteroscopy, or three to four days in the case of operative hysteroscopy.

After operative hysteroscopy, it is common to continue bleeding for up to two weeks. It is better to use pads, not tampons, during this time.

When should I be concerned?

You should contact your sugeon or your GP if you experience:

• severe abdominal pain
• heavy vaginal bleeding
• offensive vaginal discharge

Prof T C Li
Consultant Gynaecologist
7 Williamson Road
Sheffield S119AR
Tel: 0114 2550365
March 2007

About the Author

Kathryn Danzey
I have a passion to bring to you what really works in the beauty industry, from a moisturiser to the latest advanced treatment for anti ageing. After almost 4 decades in the industry I'm packed with info to share but never tire of looking for new things and would love you to share your experiences with us too. We're here to help you find that treatment or product that will make a change for you. Can't do without My Collagen Shots and H3O Night Repair. Love a great serum and UV protection

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