What is hysteroscopy?

Hysteroscopy is a procedure of looking inside the womb (uterine cavity) with a thin, lighted tube called a hysteroscope that is inserted through the vagina. It offers an excellent visual access to the inner side of the cervix and uterus and helps us to diagnose and treat any abnormal conditions within the cervix and uterine cavity. It is also very valuable in determining and treating certain causes of infertility.

Treatment types

There are two uses for hysteroscopy:

• Diagnostic— In this, hysteroscope is used to look at the interior of the cervix and the uterine cavity to diagnose the causes of infertility, abnormal PAP test, abnormal uterine bleeding, post-menopausal bleeding, recurrent miscarriages, displaced intrauterine devices (IUDs). This can be performed as a day-care procedure with or without anesthesia.
• Therapeutic— In this, hysteroscopy is used to treat uterine and cervical problems like uterine septum, polyps, fibroids, intrauterine adhesions. Visually directed endometrial biopsy can be taken in cases of abnormal bleeding. Endometrial ablation can be performed.

Risks

Risks and side effects of hysteroscopy could include:

• Infection
• Bleeding
• Tearing of uterus or damage to the cervix (rarely)
• Slight vaginal bleeding
• Cramps after procedure
• Watery discharge

How to prepare

Before your procedure, gather as much information as you can. Talk to professionals to clear your queries. Stay relaxed. Have your partner or relative accompany you to the procedure.

What to expect after treatment

After a hysteroscopy, you can expect light bleeding, potential discharge and cramping. You will be kept under observation for a few hours before sending home.

Contact the doctor if you have any of the following:

• Heavy vaginal bleeding
• Severe pain that gets worsened
• Fever

DIAGNOSTIC HYSTEROSCOPY:

Diagnostic hysteroscopy helps to visualise the interior of cervix and uterine cavity. It is helpful in diagnosing the causes of infertility, abnormal uterine bleeding, recurrent miscarriages, post-menopausal bleeding.

HYSTEROSCOPIC POLYPECTOMY:

Polyps are usually benign out-growths arising from the cervix or uterine cavity. Sometimes, they may cause heavy bleeding, pain and infertility. Hysteroscopy is useful for identifying and removing such polyps.

HYSTEROSCOPIC SEPTAL RESECTION:

Uterine septum is a common cause of infertility and recurrent miscarriages. It is a congenital malformation in which a fibrous septum of variable thickness and length is seen within the womb. Hysteroscopy helps in diagnosing and treating the septum in the same procedure. A scissors or electrocoagulation device is used to cut the septum and to restore the normal uterine cavity

HYSTEROSCOPIC MYOMECTOMY:

Fibroids or myomas are benign growths arising from the uterine wall. Fibroids projecting into the uterine cavity and causing heavy menstrual bleeding, pain in the abdomen, infertility or recurrent miscarriages can be treated by hysteroscopic resection.

HYSTEROSCOPIC ADHESIOLYSIS:

Repeated uterine curettages or infections can sometimes lead to damage to the inner lining od uterus(endometrium) and cause intra-uterine adhesions. The woman may have reduced menstrual bleeding, absence of regular menses, difficulty conceiving or sometimes, miscarriages. These intra-uterine adhesions are best diagnosed and treated by hysteroscopy. But, this pathology is notorious for recurrence in short duration.