Hysteroscopy- What are You Missing?

Hysteroscopy- What are You Missing?

You went to your obs-gyn for your regular check-up only to find some underlying problem in your uterus. So, without any further delay, your doctor puts you up for a hysteroscopy, leaving you wondering what exactly is going to happen to you during this procedure.

What is hysteroscopy?

Hysteroscopy is a procedure used to diagnose and cure problems of the womb or the uterus. The process involves the use of a slender, telescope-like camera which makes sit way to the uterus through the vagina. The camera bears a tiny light on its end and is known as a hysteroscope.

A diagnostic hysteroscopy is performed mainly to find out about the abnormal uterine bleeding. Abnormal bleeding indicates frequently occurring menstrual periods with a heavier blood flow that lasts longer than usual. Abnormal bleeding can take place both in prepubescent and postmenopausal females. Bleeding between periods is considered as another kind of abnormality.

Another type of hysteroscopy, known as the operative hysteroscopy, utilizes the hysteroscope as a surgical tool.

Hysteroscopy is contraindicated when a woman is going through her regular menstrual period. It is usually performed in a doctor’s office or a hospital and does not require the patient to stay at the hospital overnight.

Hysteroscopy Facts

  • Women who undergo hysteroscopy must be able to go home shortly after the procedure has taken place
  • Hysteroscopy is generally considered as a safe process with no underlying complications
  • The cost of hysteroscopy in the United States varies from area to area

What are the Indications of Hysteroscopy?

The main indications of performing a hysteroscopy are the problems of the womb or the uterus. Depending upon the case, either of the two types of hysteroscopy can be performed-operative and diagnostic.

A woman exposed to diagnostic hysteroscopy may sometimes require an operative hysteroscopy.

Diagnostic hysteroscopy

In addition to abnormal bleeding, a woman may require diagnostic hysteroscopy for the following reasons:

  • To diagnose certain conditions such as polyps or fibroids, the abnormal growths in the womb, non-cancerous in nature
  • To find out the cause of repeated miscarriages. This usually takes place if a woman goes through two miscarriages one after the other
  • To detect the fertility issues if a woman finds it difficult to conceive
  • To examine the cause of pelvic pain experienced by a woman

Operative Hysteroscopy

Your doctor may suggest operative hysteroscopy for the following reasons:

  • To detect and eliminate an intrauterine device inserted into the uterus for the purpose of birth control
  • To excise fibroids and other abnormal growths
  • To take a sample for tissue biopsy for further investigations
  • To remove adhesions. These adhesions are actually scars that bind the tissues together within the uterus. Tissue adhesions may occur after a surgery or infection and have the tendency to reduce fertility and disturb the normal menstrual cycle
  • To carry out a sterilization process

How Should You Prepare for Hysteroscopy?

If your doctor has suggested hysteroscopy for you, certain protocols need to be followed. You might need to take a pregnancy test seven days before you go through the process of hysteroscopy. You are also advised to use suitable contraception in between. This is because pregnancy can hinder the procedure and its overall efficiency.

If fibroids are to be removed during the procedure, medication to reduce their size may be prescribed beforehand.

How does Hysteroscopy Take Place?

Several steps are followed before, during, and after the process of hysteroscopy.

Before the Procedure

Before carrying out a hysteroscopy, the patient is sometimes given medications, often a certain type of sedative, which helps to relax her. According to the circumstances, general or local anesthesia is also given to alleviate pain.

In some cases, medication is injected by the healthcare team into the cervix to initiate dilation. This makes it easier for the doctors to perform hysteroscopy.

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During the Procedure

After providing the necessary medications, the vagina is opened wide with the help of a tool known as speculum so that the hysteroscope can be inserted.

To make the lining of the uterus more visible, carbon dioxide, either in the form of fluid or gas, is often inserted into the uterus. The amount of carbon dioxide introduced into the uterus is carefully monitored throughout the process.

After the introduction of hysteroscopy in the uterus, it is gently moved to inspect the surroundings and to display the pictures all the tissues and the openings of uterine tubes on a monitor.

During the diagnostic hysteroscopy, doctors are meant to closely look at the images and detect problems, if any. In an operative hysteroscopy, the hysteroscope is used as a surgical tool and is used to excise any abnormal outgrowths, such as uterine fibroids.

If the purpose of hysteroscopy is sterilization, small implants are inserted into the uterine tubes. The hysteroscope is accompanied by a tiny instrument for the extraction of tissue sample if a biopsy is required.

The total procedure requires 5 to 10 minutes if it is meant for diagnosing the problem or investigating the symptoms, but can extend up to half an hour in some cases. Hysteroscopy is not generally painful, however, you might experience cramps while the procedure is being carried out.

After the Procedure

If hysteroscopy involved the use of general anesthetics, you might need to wait for its effects to wear off before getting discharged.

The majority of women continue performing their routine activities the very next day whereas some even return to work the same day. In case the procedure involved a general anesthetic, it is advised to take complete rest for a few days.

Some women tend to experience spotting or bleeding for a few days after the procedure. Sometimes, it can also cause cramping, similar to period pain. It is important to know that experiencing these symptoms is completely normal and there is nothing to worry about it.

It is advised to avoid sex for seven days following a surgery to decrease the risk of infection.

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Does Hysteroscopy Cause any Side Effects?

As mentioned earlier, it is completely normal to feel mild cramping or light bleeding for a few days.

A small risk of complications is associated with hysteroscopy which mainly occurs in women undergoing operative procedures.

The rare complications of hysteroscopy include:

  • Womb infections: These infections can cause fever, odorous discharge, and heavy bleeding. Such infections can be treated with antibiotics.
  • Damage to the womb: In such cases, antibiotics or surgery might be required depending upon the extent of the damage.
  • Damage to the cervix: This type of damage repairs easily.
  • Excessive bleeding following the procedure: Treating it may require medications or an additional procedure.
  • Dizziness: According to the National Health Service (NHS), 1 in every 200 women who undergo hysteroscopy using a local anesthetic or no anesthetic at all are said to suffer from dizziness.

You are required to seek medical attention upon suffering from chills, fever, or heavy bleeding following a hysteroscopy.

What is the Cost?

The price of hysteroscopy varies according to the type of procedure required. It may or may not be covered by insurance, depending upon your plan. Some sources estimate the procedure to cost $1500 while others put the price at around $3000 to $7000.

Additional procedures, for example removing adhesions or fibroids, can cause extra.

Nancy Walker

Nancy holds a Medicine degree and a Masters of Science MS in Infectious Disease and Global Health (MS-IDGH) from Tufts University. She worked as a lecturer for three years before she turned towards medical writing. Her area of interest are infectious diseases; causes, mechanism, diagnosis, treatments and prevention strategies. Most of her writings ensure an easy understanding of uncommon diseases.

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