What is a hysteroscopy?
In this procedure, a hysteroscope, which is a narrow telescope with a light camera at the end, is used. It is inserted through the vagina and cervix. The images of the womb are reflected in the monitor for the doctor to check for any problems.
Why would I need the procedure?
There are two types of hysteroscopies. One is diagnostic hysteroscopy and the other one is operative hysteroscopy.
Diagnostic hysteroscopy
Diagnostic hysteroscopy is used to investigate any symptoms or problems of the reproductive area. It is recommended: -
- In cases of heavy periods, unusual vaginal bleeding, postmenopausal bleeding, or repeated miscarriages.
- It helps in diagnosing conditions such as fibroids, polyps, or scarring of the uterus.
- It even checks whether you have blocked fallopian tubes.
- It investigates the reason behind pelvic pain experienced by women.
Operative Hysteroscopy
Operative hysteroscopy is commonly used to treat the problem that was found out during the diagnostic hysteroscopy. It is used: -
- To remove fibroids, polyps displaced intrauterine devices (IUDs) and intrauterine adhesions.
- To perform a sterilization procedure.
- To take a biopsy of tissue for further investigation.
These are the reasons you might need a hysteroscopy. Before any procedure, especially an invasive one, you need to be prepared. We will discuss certain preparation that you need to do before undergoing the procedure.
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How do I prepare for the procedure?
Your doctor will first ask you about your medical history. It will include the medication you take or the procedures that you might have undergone. The doctor may ask you to stop taking medications before the procedure that prevents blood clotting.
To ensure that you are in good health for the procedure some blood and diagnostic tests will be suggested. Once it is cleared then you need to give consent for the procedure. You may be asked to fast if you are given local or general anaesthesia.
Further, you are required to inform in case you are pregnant. The surgery will be scheduled after your period and before ovulation. Any other required directions and precautions will be conveyed by your doctor.
What happens during a hysteroscopy?
Hysteroscopy surgery is generally done on an outpatient basis. It is not a major surgery. Sometimes local anaesthesia that numbs your cervix is used. They will also use medication or tools to dilate your cervix.
You will be first required to change into a hospital gown and empty your bladder before the procedure. Then you will lie down on the examination table with legs stirrups.
- Firstly, your cervix will be dilatated.
- After that, a speculum will be inserted into the vagina.
- The hysteroscope will then be inserted through the cervix and into the uterus.
- Gas or liquid solution is then inserted through the tool to remove any blood or mucus. It is also done to expand the uterus and get a clear view of the womb.
- The doctor inspects the wall of the uterus and the opening of the fallopian tube through the tool. Photographs, videos or even tissue samples can be taken using it.
- In case any problem is detected and surgery is needed, another tool may be inserted to remove the abnormality.
The total process of hysteroscopy can be between 5 minutes to 30 minutes or more. The length of the procedure depends on whether it is operative or diagnostic. The latter usually takes less time than the former.
What to do after hysteroscopy?
After the hysteroscopy procedure, you will be kept in an observation room. The doctor checks whether the effect of the anaesthesia has worn off before sending you home.
Hysteroscopy recovery happens almost immediately. Most of them return to their normal activities the following day. Even some women start working the same day. If a general anaesthetic is used then it is advised to take rest for at least one to two days.
You can straight away go to your normal diet. They might be some mild cramping or bleeding, like periods. Some pain medications might be given to help ease the pain. It is advised to avoid sex for at least two weeks after the procedure or until the bleeding has stopped. This is recommended to reduce the risk of infection. But is there any major risk involved in the procedure?
What are the hysteroscopy risks?
Hysteroscopy risk is very minimal. Less than 1% of cases see any complications. It is generally a safe procedure. Complications can be more seen in operative hysteroscopy.
Some of the rare possible complications could be: -
- Damage to the womb- There can be an accidental puncture in your uterus. This can be easily treated with antibiotics. In the rarest of rare cases, it will require another operation to repair it.
- Damage to the cervix- It is very rare. However, even if this happens, it can be easily repaired.
- Excessive bleeding during or after surgery- It can occur when the procedure is done in general anaesthesia. This can be treated easily with medication or other procedures. Hysterectomy or removal of the womb is rarely required.
- Womb infections- this can be indicated by fever, odorous discharge, and heavy bleeding, after the procedure. It can usually be treated with medication.
- Feeling faint or dizzy- After the procedure, you might feel faint or dizzy because of the anaesthesia. It is very common.
It is quite rare that hysteroscopy can be life-threatening. Contact your doctor immediately if you have a fever, severe abdominal pain, or heavy bleeding post-procedure. Only if the risks outweigh the benefits the doctor will recommend hysteroscopy. Let us now know the breakup of the entire hysteroscopy cost.
What is the cost of a hysteroscopy?
The hysteroscopy cost varies with the additional procedures that doctors need to do. It usually ranges from 5,000 to 50,000. The cost depends on the quality of the service, the requirement for anaesthesia, etc. Further, diagnostic hysteroscopy will cost less than operative one.
Conclusion
Hysteroscopy is a procedure by which the inside of the womb is examined. It is also used as a treatment to remove fibroids, polyps, or any other problem found during diagnosis. The procedure is very simple and minimally invasive.
The procedure as well as the recovery period is short. There can be possibilities of some risk. The main risk involves damaging the reproductive capacity of the woman. In the worst-case scenario, it might even require the removal of the womb as well. In that case, it will make it difficult for you to conceive naturally.
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Frequently Asked Questions
How painful is a hysteroscopy?
Hysteroscopy is generally painless or causes mild pelvic discomfort. However, this may vary from patient to patient. Minor discomfort will be there during the procedure. Some may even face severe pain in the pelvic region after the procedure.
Is hysteroscopy a major surgery?
Hysteroscopy is a minor surgery as it is minimally invasive. It can be performed as an outpatient or day-case procedure. It does not even require an overnight stay in the hospital unless the doctor is concerned about your reaction to the anaesthesia.
What happens during a hysteroscopy?
The procedure is started by giving general or local anaesthesia. After this, the tube with a camera at the end is inserted into the uterus. It descends into the uterus and gives the complete visual of the uterine cavity. Gas or liquid-like saline is inserted to expand the uterus.
How long does hysteroscopy surgery take?
It is a very short procedure. It might take 5 to 30 mins or at maximum one hour. After the surgery, the patient might be asked to stay in the hospital till the effect of the anaesthesia stays. the procedure usually takes place on an outpatient or day-care basis.
References
1. https://europepmc.org/article/med/6193274.
2.https://journals.lww.com/coobgyn/Abstract/2002/08000/Complications_in_hysteroscopy__prevention,.8.aspx.
3. https://www.sciencedirect.com/science/article/abs/pii/S0029784400008656.
4. https://europepmc.org/article/med/17482613.