A hysteroscopy is a procedure that allows your doctor to look inside your uterus to check your uterine lining (endometrium) for abnormalities and bleeding. The causes of abnormal bleeding are easier to diagnose and treat with a hysteroscopy. Using a hysteroscope (a thin tube with a camera light one end), your doctor will be able to see the inside of you.
Hysteroscopy has many uses. Depending on what your symptoms and concerns are, your doctor can perform a hysteroscopy to check the cause of abnormal bleeding, investigate bleeding after menopause, examine possible reasons for infertility, remove growths, and collect sample tissues for a biopsy. The full range of situations that would necessitate a hysteroscopy are:
- Endometrial Ablation: Using heated tools, your doctor can find and remove problem areas in the lining of your uterus.
- Endometrial Cancer Screening: Tumors and cancerous growths are much more easily spotted during a hysteroscopy.
- Fallopian Tube Examination: Your doctor may check your uterine openings to your fallopian tubes. If these tubes are blocked, he or she may be able to open your fallopian tubes with special tools passed through the hysteroscope.
- Fibroids and Polyps: Your doctor can pass special instruments through the hysteroscope and remove small growths with relative ease during a hysteroscopy.
- Implant: Certain contraception implants (such as Essure) are placed in the opening of your fallopian tubes. This type of implant is a method of permanent sterilization.
- Infertility Causes: A hysteroscopy helps your doctor to determine whether the cause of your infertility is a problem with the size or shape of your uterus or by scar tissue in your uterus
- IUD: Hysteroscopies help doctors find an intrauterine device that may have been misplaced (not lost, but installed incorrectly) by your previous doctor.
- Repeated Miscarriages: Performing a hysteroscopy will help your doctor find possible causes for miscarriages.
- Severe Cramping: Your doctor can locate the cause and begin immediately treating you for severe cramps or excessive bleeding. Heated tools passed through the hysteroscope can stop the bleeding.
Preparing For Your Hysteroscopy
Besides general hygiene and planning to get to the hospital on time, no real preparation is needed unless you are having a hysteroscopy done while you are “put under” a general anesthetic. If this is your situation you may or may not need to prepare for hysteroscopy in the following ways:
- Blood Tests: Having your blood work done about a week before the procedure is the norm.
- Fasting: Do not eat or drink anything (not even water) after midnight the night before your procedure.
- Hygiene: Shower or bathe either the night before or the morning of the operation.
First, you will be given an anaesthetic medication to block the pain, a general anaesthetic to make you unconscious, and a tube or breathing mask to help you breathe. Either a local anaesthetic (applied to your skin) or a regional anaesthetic (given by injection) will be given to you depending on your medical situation and the type of operation you are having along with the hysterectomy.
Your doctor may use another instrument to widen your cervix enough to where the hysteroscope will fit through your cervix and up into your uterus. Once the hysteroscope is inside your uterus, gas or liquid is inserted to expand it like a balloon, making it easier for the doctor to see. Then your doctor will look at the inside of your uterus and search for the source of your problem. If he or she finds anything abnormal, they will remove a small sample for further testing and examination.
If surgery is needed to treat a problem, your doctor will pass small instruments through the hysteroscope. Through the hysteroscope, your doctor can repair your septum, remove fibroids and polyps, and destroy the overgrown lining of your womb if needed.
When the operation is over your doctor will remove the instruments and the gas or liquid.
Risks Involved With A Hysteroscopy
Hysteroscopies are very safe, but there are some small risks. The likelihood of these complications is not high, especially since your doctor will monitor you and take special safety measures throughout the operation to reduce your risks. The potential risks involved in a hysteroscopy are:
- Anaesthesia and Medication Issues
- Bloodstream Infiltrated by Gas/Liquid
- Organ Damage
- Torn Cervix
You may be allowed to leave directly after the procedure is over, but most of the time you are required to stay in the hospital for up to four hours until you recover. If you have been given anaesthetic, you should have a friend or family member drive you home. Usually, when you have been put under like that, you will feel sore, drained and drowsy. You may also experience nausea, shoulder pain, cramps, spotting or light bleeding, and a sore throat after your procedure. These symptoms are all normal and part of the process. They will go away after a few days.
Symptoms that are not normal and require an immediate call to your doctor and possibly return to the hospital include excessive bleeding, heavy vaginal discharge, severe pain in your abdomen, and fever.
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