Hysteroscopy
Hysteroscopy Overview
Hysteroscopy is a medical procedure that utilizes a thin, flexible instrument known as a hysteroscope to examine the internal structures of the uterine cavity. This procedure is commonly employed for both diagnostic and therapeutic purposes related to various uterine conditions.
Primary Applications of Hysteroscopy
Hysteroscopy can be used to diagnose and treat a range of conditions associated with the uterine cavity, including:
- Abnormal Uterine Bleeding: To investigate causes of abnormal bleeding, such as uterine fibroids, polyps, or endometrial hyperplasia.
- Endometrial Abnormalities: To assess lesions of the endometrium, including polyps and hyperplastic changes.
- Intrauterine Foreign Bodies: To identify and remove foreign objects within the uterus, such as retained intrauterine devices (IUDs).
- Uterine Tumors: To evaluate intrauterine tumors, including endometrial polyps and adenomyosis.
Preparation for Hysteroscopy
Before the procedure, patients may be advised to:
- Discontinue certain medications, especially anticoagulants or non-steroidal anti-inflammatory drugs (NSAIDs).
- Inform the doctor of any wounds or sores in the genital area.
- Avoid the examination during menstruation.
- Notify the doctor if they are pregnant or suspect they might be.
- Fasting Instructions: Patients are typically required to fast for 6 hours prior to the procedure, allowing only plain water until 2 hours before the examination.
- Preoperative Medications: Patients should take any prescribed medications as directed.
- Prior to the procedure, the doctor will explain the reasons for the hysteroscopy, the process involved, and any potential complications. After understanding this information, patients will be asked to sign a consent form.
Procedure
- Anesthesia: The examination is conducted under monitored anesthesia and local anesthesia to ensure patient comfort. An anesthesiologist will be present throughout the procedure to ensure safety.
- Hysteroscope Insertion: Once anesthesia takes effect, the doctor will gently insert the hysteroscope through the cervix. The hysteroscope, equipped with a camera, allows the doctor to visualize the uterine cavity.
- Examination: The doctor will advance the hysteroscope into the uterine cavity, examining the internal tissues for any abnormalities or lesions.
- Treatment or Biopsy: If abnormalities are detected, the doctor may use specialized instruments for treatment or sampling, such as removing polyps or abnormal tissue.
Follow-Up and Recovery
After the procedure, patients should:
- Allow time to rest and recover, avoiding vigorous exercise or heavy activities on the day of the examination.
- Expect light vaginal bleeding, which is normal. If bleeding is excessive or prolonged, contact the doctor.
- Manage mild abdominal discomfort with over-the-counter pain relievers, after consulting with a healthcare professional.
- Resume normal dietary habits after the examination.
- Refrain from sexual activity for a few days to reduce the risk of infection.
- Post-procedure symptoms such as headaches, dizziness, nausea, or tenderness at the venipuncture site should resolve within a few days.
- Patients are advised to avoid alcohol, operating heavy machinery, or driving on the day of the procedure. Additionally, it is recommended to refrain from signing any legal documents for 24 hours post-procedure.
- Patients may return home once the effects of anesthesia have worn off, but must be accompanied by an adult.
- Monitor for any unusual or persistent symptoms, such as ongoing bleeding, severe abdominal pain, fever, or abnormal discharge. If any of these symptoms occur, contact your healthcare provider promptly.
References
National Health Service inform. Hysteroscopy. Available at : https://www.nhsinform.scot/tests-and-treatments/non-surgical-procedures/hysteroscopy/
Johns Hopkins Medicine. Hysteroscopy. Available at :
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/hysteroscopy