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Hysteroscopic procedures

What is hysteroscopy?

Hysteroscopy is a minimally invasive procedure to diagnose and treat problems of the uterus. A hysteroscope is a thin telescope-like device with camera and light source which is inserted in the uterus through the vagina. No cutting or incision is given in vagina or cervix when inserting the thin hysteroscope. The image of your uterus is transmitted onto a video screen and the diagnosis is made. Any problem can also be corrected at the same sitting if required. The procedure can be recorded for future reference.

What is office Hysteroscopy?

In certain advanced setups, hysteroscopy is done in OPD setting without anaesthesia or sedation, using very fine calibre hysteroscopes, hence reducing overall side effects of anaesthesia and overall cost of procedure. In almost all of the cases you may resume your normal activities very soon after the procedure. This procedure is gaining immense popularity in many countries, owing to its low cost and almost nil complications and morbidity following the procedure.

For what conditions hysteroscopy is used?

Hysteroscopy is done when a woman experiences certain set of symptoms and gynecology endoscopic surgeon chooses to examine the uterine cavity to eliminate the possibility of any great risk to the health of the woman or when there is a need to decide for a major surgery.

One of the most common uses of hysteroscopy is to find the cause of abnormal uterine bleeding (AUB) and take the endometrial biopsy under vision. Other conditions where hysteroscopy is used are-

  • Heavy or excessive bleeding
  • Postmenopausal bleeding
  • Diagnose and remove submucous and intramural myoma
  • Endometrial polyps
  • Intrauterine adhesion due to infection or previous surgery
  • To locate and remove IUCD embedded inside the uterus
  • To remove foreign bodies
  • Diagnose a cause of repeated miscarriage
  • To diagnose the cause of difficulty in getting pregnant
  • Opening of fallopian tube
  • Endometrial ablation
  • Diagnose and correct uterine malformations

How is hysteroscopy performed?

A hysteroscopy is performed as an out-patient or day care procedure and you are discharged with in few hours on the same day.

Before starting the procedure, medication is given to help you relax. Local or general anaesthesia may be given depending upon the indication and whether the procedure is performed as an outpatient or in operation theatre.

Usually the hysteroscopy procedure takes 5-30 min and no incisions or cuts into the skin are involved. As the procedure is generally not painful most of the time anaesthesia is not required and any discomfort can be prevented by taking pain killer one hour before the procedure. However, a local anaesthesia can also be given to numb the cervix.

In some cases general anaesthesia is required as in when removing fibroid. When under general anaesthesia you will be asleep during the procedure.

Proper counselling is given before every procedure.

Is hysteroscopy painful ?

The pain felt by a woman can very considerably during the procedure. Some may feel no pain at all, some will have mild pain and some have considerable pain. You can discuss about your anxiety and pain relief with your doctor or nurse before the procedure. Queen’s Gynecology is reputed for hysteroscopic surgery in South Delhi.

Recovery after hysteroscopy

You will be able to go home few hours after the outpatient procedure. If hysteroscopy is performed under general anaesthesia you may have to wait till the effects of anaesthesia are over and you are able to drink, eat, walk and pass urine. In both the cases you will be discharged on the same day.

The recovery is usually quick, it is normal to have minor cramping and minimal bleeding or bloody discharge following the procedure. It might persist for few days and medications may be given to ease the symptoms. Your menses may also come at a different date.

Most women resume their normal activity the following day, however some are back to the work on the same day.

Risks and complications of hysteroscopy

Hysteroscopy is a very safe procedure. Complications during or after the hysteroscopic procedure are uncommon when performed by an expert surgeon. However, like any other surgical procedure there are small risk. Most common among them is accidental uterine perforation or cervical injury. Other complications that may occur are

  • Bleeding
  • Infection
  • Fluid overload
  • Anaesthetic complications

You should not undergo hysteroscopy if you are pregnant as there are chances of miscarriage. Please inform you doctor about your pregnancy.

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