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DIAGNOSTIC
HYSTEROSCOPY |
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What is a Diagnostic Hysteroscopy?
Hysteroscopy is a procedure that allows a gynecologist to
look inside your uterus. The hysteroscope is a long tube,
about the size of a straw, which has a built-in viewing
device. It is inserted through the vagina and cervix into
the cavity of the uterus (endometrial cavity). The uterine
cavity is then distended with fluid and visualized.
Hysteroscopy is useful for diagnosing and treating some
problems that cause infertility, miscarriages, and abnormal
menstrual bleeding. Sometimes other procedures, such as
laparoscopy, are done at the same time as hysteroscopy.
What is the purpose of Diagnostic
Hysteroscopy?
Problems that occur with a woman's reproductive organs sometimes
cannot be found by a physical examination alone. Laboratory
tests, ultrasounds and x-rays may still leave some uncertainty.
Frequently, problems, which cannot be discovered by routine
investigations, can be discovered by laparoscopy, or hysteroscopy,
two procedures that provide a direct look at the pelvic
organs.
Hysteroscopy may be either diagnostic or operative.
Diagnostic hysteroscopy is used to examine the inside of
the uterus, also known as the uterine cavity and may also
be used to confirm the results of other tests such as hysterosalpingography(HSG).
This procedure is helpful in diagnosing abnormal uterine
conditions such as polyps, internal fibroids, scarring,
and developmental abnormalities.
Operative hysterocopy may be used, instead of open abdominal
surgery, to both diagnose and treat certain conditions such
as uterine adhesions, septums, or fibroids which can often
be removed through the hysteroscope.
What are the benefits of Diagnostic Hysteroscopy?
- Hysteroscopy is a commonly performed and generally safe
procedure.
- Gives a clear diagnosis.
- Helps in the diagnosis of conditions such as septum,
fibroids, polyps and adhesions.
- Treatment, if required, is quick and effective.
How do I prepare for Diagnostic Hysteroscopy?
- The procedure can be done at any time of the cycle,
but is usually avoided during the menses.
- Do not eat or drink anything after midnight or the morning
before the procedure. Do not even drink coffee, tea, or
water.
- You will need to shave your private parts prior to the
procedure.
- You need to be accompanied by your spouse or another
relative to help you in your post-op recovery period.
- Tell the doctor ahead of time if you have ever had an
allergic reaction to lidocaine or the numbing medicine
used at the dentist's office.
What kind of anesthesia is used for Diagnostic Hysteroscopy?
Diagnostic hysteroscopy is usually conducted on an out patient
basis with either general or local anesthesia.
How is Diagnostic Hysteroscopy performed?
Hysteroscopy is performed as a day case, with no overnight
stay. The procedure usually takes around 15-20 minutes.
You lie on your back on an examination table, with your knees
bent and your feet in footrests, as you would for a pelvic
examination. Your vaginal area is cleaned with an antibacterial
soap.
The first step of diagnostic hysteroscopy involves slightly
stretching the canal of the cervix with a series of dilatators.
Once the cervix is dilated, the hysteroscope, a narrow lighted
viewing instrument similar to but smaller than the laparoscope,
is inserted through the cervix and into the lower end of the
uterus. The scope is then attached to a camera, allowing the
doctor to see a clear image on a video screen. Special clear
solutions (normal saline) are then injected into the uterus
through the hysteroscope sheath. This distends the uterine
cavity, clears blood and mucus away, and enables the doctor
to directly view the internal structure of the uterus- the
walls and the openings of the fallopian tubes.
If surgery is to be done, small instruments will be inserted
through the hysteroscope.
After the examination, the hysteroscope is removed quickly
and easily.
What happens after Diagnostic Hysteroscopy?
After hysteroscopy, the patient is allowed to rest for 2–4
hours to recover from the anesthesia. As the anaesthetic wears
off, there may be some abdominal pain, and painkillers may
be required. You are allowed liquids after 4 hours and soft
diet in the evening.
Since the operation has been planned as a day case, you will
be able to go home once you have recovered from the anaesthetic.
A general anaesthetic can temporarily affect co-ordination
and reasoning skills, so people are advised to avoid driving,
drinking alcohol or signing legal documents for 24 hours afterwards.
Before leaving the hospital, the doctor will explain the findings
of the hysteroscopy. If a biopsy has been done, it will take
5 to 7 days before the results are available.
Once home, further painkillers may be taken if needed. It's
important to take it easy for the rest of the day. Some women
feel ready to resume normal activities and work the day after
the procedure.
What are the risks associated with Diagnostic Hysteroscopy?
Most patients do not have any problems and can even go back
to work the same day. Some patients may feel weak and have
cramps that last several hours afterward. Spotting and light
bleeding like a period can occur for several days afterward
and are considered normal. Complications of hysteroscopy are
rare, and seldom serious. These include
- Bleeding
- Infection
- Perforation (hole) of the uterus with the hysteroscope–
the hole usually heals on its own
- Allergic reaction to the anesthetic
When should I call the doctor?
You should call the doctor is you develop
- A fever above 101
- Severe lower abdominal pain
- Abnormal discharge
- Heavy bleeding
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