Diagnostic Operative Hysteroscopy

What is Hysteroscopy ?

Hysteroscopy is a procedure that allows monitoring endometrium through a special optic device with a cold lighted tube after filling the intrauterine with liquid, and performing intrauterine interventions using small hand tools. After general anesthesia or local (epidural/ peridural) anesthesia, the cervix is expanded to fill the intrauterine with liquid, and a thin optical device (hysteroscope) similar to a telecope is moved along the uterus. The image of endometrium is displayed on the screen with hysteroscope. So, the doctor can monitor the uterine cavity during the process. Hysteroscopy can be either diagnostic or operative.

Diagnostic Hysteroscopy

In diagnostic hysteroscopy, the cervix is expanded enough by means of bougies to allow hysteroscope to enter the uterus. Once the cervical span is ensured, the hysteroscope with an optical light is inserted into the cervical area and uterine cavity.  Carbon dioxide or specific liquids are injected into the cavity during the process to separate the walls of uterus and to discharge the blood and mucus. Diagnostic hysteroscopy is used to diagnose submucous mymoa, intrauterine damages and adhesive, polyps, septum, etc. and cognitive uterus anomalies. It is a very important method in infertility investigations, recurrent pregnancy losses, and abnormal uterus bleeding. A sample can be collected to make a diagnosis in endometrial pathologies.

Operative Hysteroscopy

Intrauterine adhesives, myomas, and abnormal structures (e.g. polyp), if present, can be hysteroscopically intervened when necessary. The treatment can be applied as diagnostic hysteroscopy is being performed, or it can be planned later on. Unlike diagnostic hysteroscopy, operative hysteroscopy is intended to correct pathologies identified by inserting scissors, biopsy forceps, cautery or clamping tools through hysteroscope. Myomas and polyps can be removed; intrauterine adhesives can be cut out and released if applicable. Those that cannot be removed by other methods can easily be removed by hysteroscopy.  

After corrective surgical interventions for uterine cavity, intrauterine devices (spiral) or foley catheter can be inserted the cavity to prevent re-adhesion of walls of the uterus. In addition, a hormonal treatment can be applied to support healing intrauterine after the procedure.

When Is Hysteroscopy Used ?

Hysteroscopy is one-day surgical intervention and needs no hospitalization overnight. It is usually performed on the days after menstrual period is completed. So, both intrauterine can be monitored more clearly and the risk to damage a likelihood pregnancy is eliminated.

Advantages of Hysteroscopy

Since hysteroscopy is a one-day surgical procedure, patients need no hospitalization. The patient can go back to her normal life after a 1-2-hour rest following the procedure. The diagnostic power is higher than other methods because possible problems can directly be monitored in the uterine cavity. It is an effective treatment method for cases such as endometrial polyps and submucous myomas.

When Should The Hysteroscopy Not Be Performed?

Hysteroscopy should not be performed in pregnancy, presence of vaginal or urinary tract infections, or known uterine cancer cases.

How Safe is Hysteroscopy Procedure?

Any surgical procedures are risky. Although there are some surgical intervention risks specific to hysteroscopy, they are highly rare and unlikely to pose a life-threatening risk. Complications occur in less than 1 percent in 100 operative hysteroscopy.

The most common complication is penetration of uterus with hysteroscope, and it is self-healed with no additional surgical intervention. Some complications occur associated with the liquids used to expand the cavity. These include pulmonary edema, difficulty in breathing, blood coagulation disorders, decreased body temperature, and allergic reactions.

Although some complications such as intraabdominal organ injuries, bleeding, and infections can occur associated with the surgical procedure, they are very rare.  

After Being Discharged

It is usual that you have mild cramps and little amount of bloody discharge for a few days after the procedure. When the bleeding is stopped and you feel better, you can return to your usual physical activities and sexual life.

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The information on this website is not intended to replace any medical advice given by physicians with access to your detailed medical history.