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What is hysteroscopy?

Doctor gynecologist pointing model of female reproductive system

Introduction: A hysteroscopy can be an invaluable procedure for identifying, diagnosing, or treating various issues within the uterus. This minimally invasive approach uses a specialized instrument called a hysteroscope—a thin, flexible tube equipped with a camera and light. Whether you’re facing unexplained symptoms, or your doctor has recommended further investigation, understanding what to expect can ease your concerns. In this article, we delve into the details of what a hysteroscopy involves, why it might be suggested, and what you can anticipate before, during, and after the procedure, along with the potential risks and next steps if fertility issues are identified.

Understanding Hysteroscopy

Hysteroscopy is a common procedure used to identify, diagnose, or treat several issues in the woman’s uterus. The procedure is conducted using a piece of equipment known as a hysteroscope, a thin and flexible tube fitted with a camera and a light. It is a similar instrument to the ones used in keyhole surgery and other investigative procedures. Although it is natural to be nervous before undergoing a hysteroscopy, it is not something you should unduly worry about.

A hysteroscopy can be performed in a hospital, although some fertility clinics in Bangkok also perform the procedure. It is important that when your doctor has advised you that you need a hysteroscopy, that you choose the right hospital or clinic to conduct the operation as those with modern equipment will give a far more accurate diagnosis. It is covered by many health insurance policies, so you should speak to your provider or broker before undergoing any treatment.

Preparation for Hysteroscopy

Once it has been decided that you require a hysteroscopy, your doctor will advise what, if any, medication you need to take beforehand. Some people may be given a sedative, a tablet that will help them remain calm; others may have a local anesthetic where the vagina and lower abdomen will be numbed, usually by an injection.

Hysteroscopy pic from Wikipedia.

Hysteroscopy pic from Wikipedia.

In some cases, although it is becoming increasingly rare, they may be given a general anesthetic, which will mean that you will be asleep during the operation. Your doctor will talk to you about which is most appropriate for you.

The Hysteroscopy Procedure

A hysteroscope is used to inspect the uterine cavity and will enter via the cervix. It is frequently used to diagnose intrauterine pathology and would be classed as a surgical procedure. After you have been given one of the medications outlined above, the doctor will insert a speculum (a medical tool that looks similar to the bill of a duck) into the vagina, thus allowing easy access to the cervix and finally the uterus.

Once the hysteroscope is in place, the uterus will be filled with a harmless gas called carbon dioxide, or a fluid such as saline solution (salt water) and this is done via the hysteroscope. The purpose of this is to expand the uterus, which will make it easier for the doctors to view the uterus’ lining and the entrance to the fallopian tubes. The amount of gas or fluid in the uterus will be monitored throughout the procedure. The hysteroscope can be used to pass small tools into the uterus, allowing the doctor to perform a biopsy or other surgical procedures.

Reasons for Suggesting a Hysteroscopy

Your doctor may suggest a hysteroscopy if you have been experiencing problems such as heavy menstrual cycles, cramping, or having problems conceiving. In our experience, it may be a combination of these problems that leads the doctor to believe that it needs further investigation.

However, a hysteroscopy may be suggested for various other complaints, including:

  • Bleeding between cycles
  • Experiencing bleeding after you have been through menopause
  • Checking for the presence of polyps, fibroids, or scarring in or on the uterus

Reasons for Hysteroscopy

In some cases, a hysteroscopy may be a follow-up procedure such as returning abnormal results from a Pap test, taking a biopsy (a small amount of tissue) from the uterus for further analysis, to investigate fertility issues or why the female has experienced more than one miscarriage. Sometimes a hysteroscopy may be suggested if contraceptive devices such as an IUD or coil have become misplaced or are causing discomfort.

If the lady decides that she wishes to undergo permanent birth control, the doctor may suggest that the sterilization procedure be conducted using a hysteroscope.

Post-Hysteroscopy Expectations

In most cases, you will be allowed to go home a few hours after the procedure once the doctors are satisfied that you have suffered no adverse reaction. If a sedative has been used, you will be allowed to go home once it has worn off, but if a local anesthetic were used, you would need to make arrangements for someone to collect you. In most cases where a general anesthetic is used, you will be required to stay overnight at the hospital or clinic and again be collected the following day.

Mild cramping and minor bleeding are to be expected for up to a week after undergoing the procedure, and gas or fluids may be involuntarily released for 24 hours. Your doctor will likely issue you with medication to help with pain relief. You should avoid vaginal intercourse for a minimum of two weeks following a hysteroscopy. You will be advised on a more personal level of what you may expect and how you should look after yourself by a member of the medical team when you are discharged.

Risks Involved in Hysteroscopy

Unfortunately, all medical procedures carry an element of risk, but all efforts are made to minimize them.

Some relatively common complications reported include:

  • A reaction to the anesthesia, although this is usually only when the patient has undergone a general anesthetic
  • Infection of wounds

Other rare complications include:

  • Pelvic inflammatory disease
  • Physical damage to organs located close to the uterus such as the bladder, bowel, or ovaries
  • Tears or other damage to the cervix

It is vital that if you experience heavy bleeding, a fever (meaning a temperature of above 37.5 degrees Celsius), or severe abdominal pain that you seek immediate medical attention. Any of these problems could signify a problem that will need to be investigated by a medical professional and treated appropriately.

Addressing Fertility Issues After Hysteroscopy

If you have been diagnosed with a fertility problem, don’t worry; it doesn’t necessarily mean that you can’t have children. As the leading fertility clinic in Bangkok, we will be able to discuss the available options.

It may include:

  • In-vitro fertilization (IVF)
  • A series of other treatments that we can offer

A member of our team will talk you through each procedure, allowing you to make an informed choice on how you will proceed.

Conclusion: A hysteroscopy is a valuable diagnostic and therapeutic tool for addressing various uterine issues. While the idea of the procedure may seem daunting, understanding the process and what to expect can alleviate much of the anxiety associated with it. By choosing a reputable medical facility and following the post-procedure guidelines, you can ensure a smoother recovery. If any complications or fertility issues arise, expert advice and modern treatments are available to support and guide you on your path to well-being.

FAQs: Frequently Asked Questions

1. What Is Hysteroscopy?

Hysteroscopy is a medical procedure used to examine, diagnose, or treat issues within the uterus using a thin, flexible tube with a camera and light called a hysteroscope. It is commonly performed to investigate problems such as heavy menstrual cycles, cramping, fertility issues, and abnormal bleeding.

2. Where Can I Have a Hysteroscopy?

Hysteroscopies can be performed in hospitals and some fertility clinics. It is important to choose a facility with modern equipment for accurate diagnostics. Many health insurance policies cover this procedure, so check with your provider before undergoing treatment.

3. What Preparations Are Needed Before a Hysteroscopy?

Your doctor may recommend certain medications beforehand, such as sedatives or anesthetics (local or general). The type of medication will depend on your specific case and will be determined in consultation with your healthcare provider.

4. How Is a Hysteroscopy Performed?

After administering the appropriate medication, the doctor will insert a speculum to gain access to the cervix. A hysteroscope is then introduced, and the uterus will be filled with carbon dioxide gas or saline solution to expand it. This allows the doctor to inspect the uterine lining and perform any necessary procedures.

5. Why Would a Doctor Recommend a Hysteroscopy?

A doctor may suggest a hysteroscopy for several reasons, including diagnosing the causes of heavy menstrual cycles, cramping, fertility issues, abnormal bleeding, polyps, fibroids, scarring, or other uterine abnormalities. It may also be used to retrieve misplaced contraceptive devices or for sterilization procedures.

6. What Should I Expect After a Hysteroscopy?

You can generally go home a few hours after the procedure. There may be mild cramping, minor bleeding, and release of gas or fluids for up to a week. If a general anesthetic was used, an overnight stay might be required. Avoid vaginal intercourse for at least two weeks post-procedure.

7. Are There Any Risks Involved in Hysteroscopy?

While hysteroscopy is generally safe, risks include reactions to anesthesia, infections, pelvic inflammatory disease, and potential damage to organs near the uterus. Seek immediate medical attention if you experience heavy bleeding, fever, or severe abdominal pain after the procedure.

8. What Options Are Available If Hysteroscopy Reveals a Fertility Issue?

If a fertility issue is diagnosed, various treatment options, including in-vitro fertilization (IVF), could be explored. A fertility specialist will discuss these options with you in detail to help you make an informed decision about your next steps.

  • Published on : Tuesday July 6, 2021
  • Last updated : Thursday July 4, 2024
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About the author

Michelle Tan is an IVF Consultant with 12 years of experience in fertility consulting. Having personally undergone IVF and surrogacy, she brings firsthand insight and empathy to her work. Based in Singapore, Michelle frequently travels to clinics in Bangkok, Phnom Penh, and Bishkek, sharing her expertise and supporting patients on their fertility journeys.