What is hysteroscopy?

When Is a Hysteroscopy Suggested?

Clinical examination can detect defects in the female external genitalia and vagina. However, the cervical canal and the uterine cavity are not visible externally. A hysteroscope serves the purpose of examining the inner uterine lining.

Finding and treating uterine problems is important. These problems can include birth defects, heavy periods, foreign objects in the womb, and fertility issues.

Treating these issues can help improve overall health and well-being. Some of the indications of hysteroscopy are:

• Irregular menstrual cycles.
• Heavy bleeding during period.
• Suspected lesions in the uterus like polyps and fibroids.
• Infertility.
• Repeated miscarriages.
• Removal and adjustment of foreign bodies like intrauterine devices (IUD).
• Mullerian congenital anomaly (uterine and vaginal septum).
• Bleeding after menopause.
• Abnormal thickening of endometrial lining.

When Is Hysteroscopy Not Preferred?

There aren’t many absolute contraindications for hysteroscopy. A few of the generally considered contraindications are:

• Active or prodromal genital herpes.
• Active pelvic infection.
• Cervical or endometrial cancers.
• Pregnant women cannot undergo hysteroscopy. However, the removal of IUDs and other conception devices in pregnant women requires a hysteroscopy.
• People with medical conditions like coronary heart disease and bleeding diathesis.
• Abnormal vaginal bleeding is not an absolute contraindication. Copious irrigation during the procedure can enhance visibility.

How to Prepare Yourself for a Hysteroscopy Procedure?

Hysteroscopy is a relatively painless and minimally invasive procedure. However, it can lead to apprehension. Follow the instructions below for an easy experience.

• Engage in a conversation with your doctor. They will explain why you need it and its benefits, risks, and alternatives.
• You can read and sign the consent form from the healthcare provider. 
• The physician performs a complete physical examination to rule out other medical conditions before the procedure.
• Blood tests and diagnostic tests help determine any contraindications.
• Inform your doctor about your complete medical history. Never miss out on information about any bleeding disorders or blood-thinning medications you take.
• If you are in the child-bearing age group, do a pregnancy test. It will do less harm to an undetected pregnancy and allow for a better view of the womb.
• Inform your doctor if you are allergic to medications, anesthetics, latex, or other surgical amenities.
• For premenopausal women, it is best to perform the procedure after your menstruation and before ovulation. There is a less chance of negatively impacting undetected pregnancy and allows a better view of the uterus.
• If you are too anxious, you can ask for sedation. Your doctor will use sedatives in the presence of a bystander who can take care of you after the procedure.
• Choose comfortable clothing on the day of the procedure. Prefer outfits that will help the practitioner easily access the area.
• Follow all the instructions your health care provider gives you before the procedure.

How does a hysteroscopy procedure work?

Like any other gynaecological examination, hysteroscopy requires proper patient positioning. Dorsal lithotomy is the preferred position.

Once everything is ready, the doctor will insert a narrow tube into the vaginal canal. The tube has a camera at its tip.

The tube then passes through the cervix and reaches the uterus. The doctor passes the distending medium, usually saline solution, through the tube into the uterus. The solution helps increase the visibility of the uterus.

The camera at the tip of the hysteroscope will record the womb’s inner lining . The doctor can see the real-time images of the uterus on a screen connected to the hysteroscope. Using the visuals, the doctor can detect and interpret any defects in the uterine lining.

Hysteroscopy is not a painful procedure. However, if pain occurs, you can ask the doctor to stop in between. The doctor can then continue with a local anesthetic.

It takes longer for hysteroscopy surgery to remove lesions from the womb. However, normal hysteroscopy lasts for 10 to 15 minutes. After the procedure, you can return home after resting for a while.

You need hospital admission for hysteroscopy under general anesthesia. Doctors usually administer general anesthesia or sedatives only when a bystander is present.

Recovering From Hysteroscopy

The recovery after hysteroscopy depends on several factors. If you are on sedation or general anesthesia, the healthcare provider will monitor you until you are stable. You might have pain for a few days after a hysteroscopy.

Period cramp medications or paracetamol can help. Faint bleeding or spotting is also common after the procedure.

Pick sanitary pads over tampons to avoid any risk of infection. Abstain from physical activities or sex until you recover from bleeding and pain. 

What Are the Complications Associated With Hysteroscopy?

Hysteroscopy, a minimally invasive procedure, has few to no complications. However, we cannot overlook those few complications.

• Like any other surgical procedure, there is a chance of infection.
• Chances of uterine wall perforation during the procedure. If there is no vascular damage, surgeons do not need to perform laparoscopy to manage the perforation. Conservative management is enough.
• Fluid overload may result from excess absorption of the fluid used as a distending medium. It leads to cerebral edema, nausea, dizziness, vomiting, and headache. Isotonic fluid, like normal saline, has a lesser risk of fluid overload.
• If carbon dioxide is the distending medium, air embolism is likely. It can lead to cardiac failure and death. Using a liquid-distending medium can reduce the risk of air embolism.

Cost of Hysteroscopy in India

The cost of hysteroscopy depends on various attributes. Whether diagnostic or surgical, using sedatives, local or general anesthesia, and the health care facility determines the price. It may range from INR 5000 to INR 50,000. You can also get insurance coverage for the hysteroscopy procedure. 

Here Are Some Questions to Ask Before You Get a Hysteroscopy Done

Now that you know the what, why, and how of hysteroscopy, you can make informed decisions about your reproductive health! Here are some questions to consider if you need a hysteroscopy:

1. What is the procedure called?
2. What are the indications for undergoing the procedure?
3. What are the benefits and risks of the procedure?
4. What are the complications?
5. Is it an absolute necessity?
6. Who will do the procedure, and what are their credentials?
7. What is the cost of performing the procedure?
8. How long will the procedure take, and will I need hospital admission?
9. How long will it take to recover from the procedure?

To sum up, hysteroscopy is a gold standard for diagnosing and treating various uterine abnormalities. Hysteroscopy has several advantages, from diagnosing malignancies to treating fertility issues. If you want to learn more about hysteroscopy, contact Motherhood Fertility & IVF Centre at 08067238900 or book an appointment with us.