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Hysteroscopy

What is hysteroscopy?
Hysteroscopy is a procedure that can be used to diagnose and treat the cause of abnormal bleeding. This procedure allows your doctor to view the inside of your uterus using an instrument called a hysteroscope. This is a thin, luminous tube that is inserted into the vagina to examine the cervix and the inside of the uterus. Hysteroscopy can be part of the diagnostic process or surgery.


What is diagnostic hysteroscopy?


Diagnostic hysteroscopy is used to diagnose uterine problems. Diagnostic hysteroscopy is also used to confirm the results of other tests, such as hysterosalpingography (HSG). HSG is a color X-ray examination used to examine the uterus and fallopian tubes. Diagnostic hysteroscopy can usually be performed in an office environment.
In addition, hysteroscopy can be combined with other procedures (such as laparoscopy) or before surgery such as dilation and curettage (D&C). With laparoscopy, your doctor inserts an endoscope (a thin tube with a fiber optic camera) into your abdomen to view the outside of your uterus, ovaries, and fallopian tubes. The endoscope is inserted through the navel or an incision below the navel.


What is hysteroscopic surgery?


Surgical hysteroscopy is used to correct abnormalities detected during diagnostic hysteroscopy. If abnormalities are found during diagnostic hysteroscopy, hysteroscopic surgery can be performed at the same time to avoid secondary operations. In surgical hysteroscopy, small instruments are inserted through the hysteroscope to correct the condition.


When to use hysteroscopic surgery?


Your doctor may perform hysteroscopy to correct the following uterine diseases:
Polyps and fibroids: Hysteroscopy is used to remove these benign growths in the uterus.
Adhesion: Uterine adhesion, also known as Asherman syndrome, is a band of scar tissue that can form in the uterus and cause changes in menstrual flow and infertility. Hysteroscopy can help your doctor locate and remove adhesions.


Diaphragm: Hysteroscopy can help determine if you have a uterine diaphragm, which is a uterine deformity (defect) that exists from birth.


Abnormal bleeding: Hysteroscopy can help determine the cause of excessive menstrual flow or prolonged periods, as well as the cause of bleeding between or after menopause.

Endometrial ablation is an operation that uses hysteroscope and other instruments to destroy the endometrium to treat certain causes of excessive bleeding.


When should hysteroscopy be performed?


Your doctor may recommend that you schedule a hysteroscopy in the first week after menstruation. This time provides the doctor with the best view of the inside of the uterus. Hysteroscopy is also performed to determine the cause of unexplained bleeding or spots in postmenopausal women. Chapter


Who is suitable for hysteroscope?


Although hysteroscopy has many advantages, it may not be suitable for some patients. A doctor who specializes in this procedure will consult with your family doctor to determine if it is right for you.


How to perform hysteroscopy?


Before the operation, your doctor may prescribe a sedative to help you relax. Then, you will be prepared for anesthesia. The operation itself is performed in the following order:
The doctor will dilate (widen) your cervix so that you can insert the hysteroscope.


The hysteroscope is inserted into your uterus through your vagina and cervix.
Then through hysteroscope, carbon dioxide gas or liquid solution is introduced into the uterus to expand and remove blood or mucus.


Next, through the hysteroscope, your doctor can see your uterus and the lights on the fallopian tubes that lead to the uterine cavity.


Finally, when surgery is needed, a small instrument is inserted into the uterus through a hysteroscope.


Hysteroscopy may take less than five minutes to more than an hour to complete. The duration of the operation depends on whether it is a diagnostic operation or a surgical operation, and whether additional operations such as laparoscopy are performed at the same time. However, in general, the time required for diagnostic hysteroscopy is shorter than the operation time.


What are the benefits of hysteroscopy?


Compared with other more invasive procedures, hysteroscopy has the following advantages:
The hospital stay is shorter.
Shorter recovery time. There is a minimum of
times pain after surgery. However, as with any type of surgery, complications are possible.

Complications of hysteroscopy in less than 1% of cases may include:

  • risks associated with anesthesia.

  • infection.
  • Heavy bleeding.
  • Injury to the cervix, uterus, intestines, or bladder.
  • Intrauterine scar.
  • Response to substances that expand the uterus.


How safe is the hysteroscopy?


Hysteroscopy is a relatively safe operation. However, as with any type of surgery, complications are possible. Complications of hysteroscopy in less than 1% of cases may include:

  • risks associated with anesthesia.
  • infection.
  • Heavy bleeding.
  • Injury to the cervix, uterus, intestines, or bladder.
  • Intrauterine scar.
  • Response to substances that expand the uterus.


What can I expect after the hysteroscopy?


If you used local or general anesthesia during your hysteroscopy, you may need to observe for several hours before going home. After the operation, you may experience cramps or slight vaginal bleeding within a day or two. In addition, if you use gas during hysteroscopy, you may experience shoulder pain. It is not uncommon to feel weak or sick. However, if you experience any of the following symptoms, be sure to tell your doctor:

  • Fever.
  • Severe abdominal pain.
  • A lot of vaginal bleeding or discharge.

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