What is a hysteroscopy?
A hysteroscopy is a procedure that involves examining the interior of a woman's uterus by inserting a slender tube equipped with a tiny camera. This examination is typically carried out to assess the uterine cavity, which is the space where fetal development occurs during pregnancy. Individuals who possess a uterus are eligible for a hysteroscopy, provided that they are not currently pregnant.
1.
Why would I need a hysteroscopy?
Hysteroscopy is a valuable procedure used by doctors to both diagnose and treat various uterine conditions that can lead to abnormal uterine bleeding, heavy menstrual bleeding, spotting between periods, and postmenopausal bleeding.
This minimally invasive technique allows for the identification and removal of structural abnormalities such as polyps and fibroids through procedures known as hysteroscopy polypectomy and hysteroscopy myomectomy, respectively. Additionally, hysteroscopy can effectively address issues like uterine adhesions (Asherman's syndrome) which may impact menstrual flow and fertility. It can also be utilized to assess the presence of a uterine septum or investigate causes of recurrent miscarriages and infertility.
Furthermore, hysteroscopy aids in locating intrauterine devices (IUDs) and removing placental tissue post-delivery.
2.
Who is a candidate for hysteroscopy?
Before performing a hysteroscopy, your surgeon will carefully examine your medical background and assess your present well-being to ascertain its suitability. While hysteroscopy offers numerous advantages, it may not be suitable for all individuals. Specifically, if you are pregnant or currently dealing with a pelvic infection, undergoing a hysteroscopy is not recommended.
3.
When should hysteroscopy be performed?
For optimal visualization of your uterus during a hysteroscopy, it is advisable to schedule the procedure within the first week after your menstrual cycle ends, provided that your periods are regular. In case of irregular cycles, coordination with your surgeon is necessary to determine the most suitable timing. Post-menopausal individuals can undergo a hysteroscopy at any time.
What happens before a hysteroscopy?
Your surgeon will evaluate your suitability for a hysteroscopy, guide you through the process, and address any inquiries you may have. Detailed instructions will be provided to ensure you are well-prepared for the procedure. Your healthcare provider may: Review your medical history and inquire about your current medications, including vitamins and supplements. Prior to the procedure, discontinuation of blood-thinning medications (such as aspirin) may be necessary. Conduct a physical examination, pelvic assessment, and pregnancy test. Additional diagnostic tests or blood work may be required based on the specific requirements of your hysteroscopy. Provide guidance on preparation, including attire recommendations for the procedure, fasting instructions, and arrangements for transportation post-procedure if needed.
What happens during a hysteroscopy?
During the hysteroscopy procedure, you will need to empty your bladder and change into a hospital gown. Aneasthesia or a sedative may be administered to help you relax, depending on whether the procedure is taking place in a hospital or your surgeon's office, and if other procedures are happening at the same time. You will be positioned on the exam table with your legs in stirrups. The surgeon will conduct a pelvic exam, dilate your cervix to insert the hysteroscope into your uterus through your vagina and cervix. A liquid solution will be sent through the hysteroscope to expand and clear your uterus for better visibility. The surgeon will inspect your uterine cavity, fallopian tube openings using the light from the hysteroscope. Surgical instruments may be used to remove any irregularities if necessary. The duration of a hysteroscopy can range from five minutes to over an hour, depending on whether it is diagnostic or operative and if additional procedures like laparoscopy are performed simultaneously.
What can I expect after a hysteroscopy?
After undergoing a hysteroscopy with anaesthesia, you may need to be monitored in the recovery area for a few hours. It is common to experience mild cramping and light bleeding for a couple of days afterward. Feeling faint or nauseous right after the procedure is also typical.
Will I have to stay in hospital overnight after a hysteroscopy?
Hysteroscopy is typically classified as a minor procedure that generally does not necessitate an overnight hospital stay. However, in cases where your healthcare provider has apprehensions regarding your response to anesthesia, an overnight stay may be recommended.
What are the benefits of hysteroscopy?
By utilizing hysteroscopy, your surgeon can both diagnose and treat conditions in a single procedure. This minimally invasive and precise technique enables the identification and removal of abnormalities without harming nearby tissue.
How safe is hysteroscopy?
Hysteroscopy is generally regarded as a safe medical procedure, although like all surgeries, there is a risk of complications. The incidence of complications with hysteroscopy is less than 1%, and these may involve issues such as:
- Infection.
- Heavy bleeding.
- Intrauterine scarring.
- Reaction to the anesthesia.
- Injury to your cervix, uterus, bowel or bladder.
- Reaction to the substance used to expand your uterus.
How long does it take to recover from hysteroscopy?
The duration of your healing process is influenced by the complexity of your procedure, such as if your hysteroscopy involved both diagnosis and treatment. Patients recuperating from a hysterectomy are typically cautioned against engaging in douching, sexual activity, or using vaginal inserts like tampons for a period of two weeks post-surgery. It may also be recommended to refrain from taking baths, swimming, or using hot tubs while you are recovering. It is important to adhere to the advice provided by your surgeon that is tailored to your specific circumstances.
When should I see my doctor?
If you encounter symptoms like fever, severe abdominal pain, or heavy vaginal bleeding, be sure to reach out to your provider immediately. Remember to mention the keyword hysteroscopy during your communication.
How painful is a hysteroscopy?
Individual experiences vary greatly. Research indicates that factors such as the duration of the procedure, prior childbirth history, and pre-surgery anxiety levels can impact pain sensitivity during hysteroscopy. It is advisable to discuss any worries with your surgeon. Inquire about the sensations you may encounter during the hysteroscopy and the type of anesthesia that will be administered to ensure your comfort throughout the process.
Are you awake for a hysteroscopy?
Different types of anaesthesia can be used for hysteroscopy, including local, regional, and general. General anaesthesia induces sleep, while local anesthesia numbs a specific area temporarily. Regional anaesthesia numbs a larger portion of the body for several hours. Under general anesthesia, the entire body is numb throughout the procedure. Prior to a hysteroscopy under general anaesthesia, there may be restrictions on eating and drinking for a specified period.
Is hysteroscopy major surgery?
A hysteroscopy is classified as a minor surgical procedure, typically not necessitating an overnight hospital stay. Unlike more invasive surgeries that involve opening the abdomen to reach internal organs, a hysteroscopy can be conducted through the vaginal canal.
What is diagnostic hysteroscopy?
A diagnostic hysteroscopy can detect any structural abnormalities in the uterus that could be responsible for abnormal bleeding. Additionally, it can validate findings from other tests like ultrasound or hysterosalpingography (HSG), which is an X-ray dye test to assess potential blockages in the fallopian tubes that may hinder fertility.
What is operative hysteroscopy?
Operative hysteroscopy is utilized to address any abnormalities identified during a diagnostic hysteroscopy, potentially eliminating the necessity for a separate surgical procedure. This procedure involves the removal of any detected abnormalities that could be contributing to abnormal uterine bleeding. Endometrial ablation, another method for treating abnormal uterine bleeding, involves the use of a hysteroscope to examine the uterus before destroying the uterine lining with a specialized device.
Is a D&C the same as a hysteroscopy?
Both a hysteroscopy and a D&C procedure serve the purpose of removing tissue from the uterus. During a hysteroscopy, the surgeon can identify and eliminate growths using precise surgical tools, whereas a D&C involves gently scraping larger amounts of tissue from the uterine lining for sampling.
Mr Nader Aziz
Consultant in Gynaecology and IVF
A leading consultant in gynaecology and IVF, a UK-trained specialist with a wealth of experience from renowned institutions. Currently making a difference at The Portland Hospital and Homerton Hospital within the NHS. Providing top-notch care and expertise tailored to your needs to guide you on your journey to reproductive wellness.
Portland Street Hospital
209 Great Portland St, London W1W 5AH
Tel. 02079657484
