How is Hysteroscopy Performed?
Some drugs may be given to relax the patient before diagnostic hysteroscopy. If surgical hysteroscopy will be performed, local or general anesthesia is administered. When general anesthesia is administered, the patient sleeps.
If the case is not complicated, hysteroscopy can be performed under office conditions, and if the case is complicated and difficult, it can be performed under operating room conditions. It is usually performed immediately after the end of menstruation. Some drugs can be administered before the procedure to expand the cervix.
The cervical canal is dilated using the instruments, called dilator to be able to insert the hysteroscope during the procedure.
First, the vagina is opened using ecarteur or speculums to expose the cervix. The hysteroscope is placed inside the opened uterus. Usually, fluid is given to the uterus to inflate the inside of the uterus and visualize it more clearly. However, it is necessary to follow how much of this fluid remains in the patient. If the liquid is too much, it may cause adverse effects on the patient. If biopsy is needed, a biopsy instrument or resectoscope is introduced through inside of hysteroscope.
When should hysteroscopy be performed?
If it is decided to perform hysteroscopy, the most suitable days to perform it are immediately after menstruation. However, if the causes of excessive menstrual bleeding will be examined, hysteroscopy can also be performed during menstruation. In the presence of a severe infection side the uterus and in the case of pregnancy, it is not appropriate to perform hysteroscopy. Moreover, If uterine cancer or a large uterus is present, hysteroscopy is also not recommended to be carried out.
What should be done before hysteroscopy?
If the patient will undergo hysteroscopy in the office, short-term fasting is sufficient. Surgical procedures require at least 6-8 hours of fasting.
Does hysteroscopy have risks?
A life-threatening condition almost never arises in diagnostic hysteroscopy. Because it is not a very complicated procedure. Operative hysteroscopy requires a little bit more experience. Uterine perforation may occur during this procedure. However, the resulting perforation usually heals spontaneously. In some cases, operative hysteroscopy can be performed in combination with laparoscopy. The outside of the uterus can be visualized with laparoscopy. The process in this procedure is more complex than the other. And this depends on the doctor’s experience. Although rare, other complications that may occur are;
- Allergic reactions
- Blood clotting
- Pulmonary edema
- Shortness of breath
- Drop in body temperature
An experienced doctor can prevent the occurrence of these risks by extending the operative time too much and controlling the amount of fluid inside.
An increase in the amount of vaginal secretion and muscle cramps are normal after hysteroscopy. Pain can be reduced with simple painkillers. After hysteroscopy, sexual intercourse should be avoided, but all other activities can be done.
If general anesthesia is administered during hysteroscopy, it is necessary to wait 1-2 hours for the patient to recover. In the meantime, the patient should be kept under observation. It is not recommended to drive car immediately after being discharged. Because driving car is an activity that requires attention. If the surgery took long, blood electrolytes can be controlled and the patient may need to be hospitalized.
What is the success of treatment?
The procedure is almost always successful in patients undergone hysteroscopy, since it is carried under direct visualization. These conditions are polypectomy, myomectomy and removal of uterine septum. If it is performed for too many intrauterine adhesions, multiple hysteroscopy procedures may be performed in such a case. If the uterine cavity could be opened completely or adequately, the conception rate of the patient increases. If the uterine cavity is opened adequately, but the tube outputs cannot be seen, a woman should undergo IVF to conceive.