Hysteroscopy Explained: Procedure, Benefits, and Recovery

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Hysteroscopy Explained Procedure, Benefits, and
Recovery

• By Dr. Valeria Simone MD
• (Southlake General Surgery, Texas, USA)

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Overview

• If youre researching hysteroscopy, youre
  likely seeking information on this medical
  procedure used to examine the inside of the
  uterus. Hysteroscopy can identify and sometimes
  treat causes of abnormal bleeding, assist with
  infertility evaluations, or detect and remove
  growths like polyps and fibroids.
• This article explains the hysteroscopy procedure,
  its applications, and what you can expect during
  recovery, ensuring you have the facts you need
  for informed healthcare decisions.

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Key Takeaways

• Hysteroscopy is a minimally invasive
  diagnostic and therapeutic procedure performed
  with a hysteroscope to diagnose and treat uterine
  conditions, such as abnormal bleeding, fibroids,
  polyps, adhesions, and infertility.
• While diagnostic hysteroscopy is used for
  visually examining the uterus, operative
  hysteroscopy involves treating identified issues
  with specialized tools, often without the need
  for an overnight hospital stay.
• Though generally safe, hysteroscopy carries risks
  such as bleeding, infection, and uterine
  perforation, and recovery may include mild
  discomfort and cramping, but most patients can
  resume normal activities quickly, with specific
  post-procedural precautions advised to prevent
  complications.

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Understanding Hysteroscopy
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• Hysteroscopy is a procedure enabling a healthcare
  provider to examine the uterus to diagnose and
  treat causes of abnormal bleeding. The procedure
  is performed using something called a
  hysteroscope, a thin, lighted tube that is
  inserted into the vagina to examine the cervix
  and inside of the uterus.
• A hysteroscope is a long, slender telescope that
  is attached to a light source to provide
  illumination for visualization. It is inserted
  through the vagina as part of the procedure to
  diagnose and treat various conditions, including
• Cervical or endometrial cancer
• Uterine fibroids
• Polyps
• Adhesions
• Abnormal uterine bleeding
• Infertility
• Operative hysteroscopy can address abnormal
  conditions identified during a diagnostic
  hysteroscopy. It can perform procedures such as
  polypectomy, myomectomy, and endometrial
  ablation, which help diagnose and treat uterine
  fibroids.
• The procedure is helpful for treating
  intrauterine adhesions in many ways, including
  visually guided lysis and the use of different
  methods such as cutting, excision with a blunt or
  sharp instrument, electrocautery, or laser.
• This can help remove scar tissue and other
  adhesions within the uterus, making it a
  preferred method for the treatment of
  intrauterine adhesions.

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Defining the Procedure

• Hysteroscopy involves inserting a slender,
  flexible thin tube with a camera through the
  vagina to examine the cervix and uterus, aiding
  in the accurate diagnosis and treatment of
  uterine conditions.
• This minimally invasive procedure is recommended
  for patients experiencing abnormal uterine
  bleeding, especially when periods are longer or
  heavier than normal, or if there is bleeding
  between periods. It can help diagnose and treat
  abnormal growths within the uterus, thus proving
  to be a very safe procedure for treating uterine
  conditions.
• The distending media in a hysteroscopy procedure
  serves the purpose of expanding the uterus for
  improved visualization. This is particularly
  essential when dealing with uterine conditions
  such as polyps and fibroids, which are
  frequently indicated for a hysteroscopy,
  especially when they cause symptoms such as
  abnormal bleeding or heavy vaginal bleeding.
• This makes the hysteroscopy procedure not only a
  diagnostic tool but also a therapeutic
  intervention for a range of uterine conditions.

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Diagnostic and Operative Hysteroscopy

• While both diagnostic and operative hysteroscopy
  procedures are used to inspect the inside of the
  uterus, their applications differ.
• Diagnostic hysteroscopy is utilized to identify
  abnormalities within the uterus. However, when
  conditions are identified that require
  intervention, an operative hysteroscopy procedure
  is executed.
• This procedure involves the use of specialized
  tools to address the conditions once they have
  been identified. Contrary to what may be assumed,
  an operative hysteroscopy is not categorized as a
  major surgical procedure.
• Despite the procedures ability to treat
  conditions, it generally does not necessitate an
  overnight hospital stay, thus making it a
  convenient option for many women.
• Be aware that the type of anesthesia used during
  a hysteroscopy can range from local to regional
  or general, depending on the procedures specific
  needs.

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Indications for Hysteroscopy
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• Hysteroscopy is required in various scenarios. It
  serves to diagnose and treat
• abnormal uterine bleeding
• uterine fibroids
• polyps
• adhesions
• uterine septum
• endometrial cancer
• The procedure can be performed in a hospital
  setting, at a doctors office, or an outpatient
  surgery center, depending on the preference of
  the healthcare provider and the specifics of the
  procedure required.
• Local anesthesia, regional anesthesia, or general
  anesthesia may be administered to patients
  undergoing a hysteroscopy procedure depending on
  the requirements of the procedure, thus making it
  a versatile procedure that can be adjusted
  according to patient needs.
• Moreover, hysteroscopy also plays a significant
  role in assessing infertility. It is a valuable
  tool in the evaluation and treatment of
  conditions that may impact fertility, and health
  problems such as issues related to the fallopian
  tubes.
• Therefore, a patient should seek medical
  attention following a hysteroscopy if they
  encounter abnormal bleeding, severe abdominal
  pain, or any other worrisome symptoms.

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Abnormal Uterine Bleeding and Uterine Conditions

• Hysteroscopy has been established as a useful
  tool in diagnosing and treating abnormal uterine
  bleeding. Patients undergoing hysteroscopy under
  local or general anesthesia are advised to empty
  their bladder and have their vaginal area
  cleansed with an antiseptic solution.
• Additionally, they may be administered medication
  to aid in relaxation. The procedure performed in
  hysteroscopy often involves endometrial ablation,
  which is used to treat abnormal bleeding,
  especially in cases where other treatments have
  not been successful.
• This procedure has demonstrated high diagnostic
  precision for endometrial cancer, with an overall
  sensitivity of 86.4 and a specificity of 99.2.
  Diagnostic hysteroscopy, when combined with
  sonohysterography, has been demonstrated to be up
  to 88 effective in identifying polyps and
  submucosal fibroids. This combination can provide
  valuable diagnostic information for such
  conditions.

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Infertility and Reproductive Concerns

• Hysteroscopy also plays a significant role in
  assessing and treating infertility and
  reproductive issues. Müllerian anomalies, for
  instance, refer to abnormalities in the
  reproductive tract that affect approximately 1-2
  of all women, 4 of infertile women, and 10-15
  of patients with recurrent miscarriage.
• Hysteroscopy is considered the gold standard
  for diagnosing a septate uterus when conducted
  alongside laparoscopy, and it is commonly used
  for
• Diagnosing and treating uterine polyps
• Removing intrauterine adhesions
• Treating uterine fibroids
• Evaluating and treating endometrial hyperplasia
• Diagnosing and treating uterine septum
• The hysteroscopic removal of lesions has been
  found to not have a negative impact on IVF
  cycles.
• In fact, hysteroscopic polypectomy prior to IUI
  has been associated with increased odds of
  pregnancy, with a relative risk of 2.1. However,
  it is important to keep in mind that myomas only
  affect a small percentage (1.22.4) of women who
  are infertile and do not have any other problems.
• Also, there are not many controlled studies that
  show how well hysteroscopic treatment for
  proximal tubal obstruction works in treating
  infertility.

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The Hysteroscopy Experience
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• The hysteroscopy process can be divided into
  three stages pre-procedure, during the
  procedure, and post-procedure. Each stage has its
  own set of expectations and requirements that are
  important for patients to understand.
• In preparation for a hysteroscopy, it is
  advisable to
• Schedule the procedure at a non-menstrual time
• Refrain from inserting any vaginal medications,
  douches, or tampons for 24 hours prior
• Follow any pre-procedure medication or testing
  instructions given by your physician.
• During the procedure of office hysteroscopy,
  patients may receive local, regional, or general
  anesthesia, depending on the specific
  requirements of the procedure.
• Pain perception during hysteroscopy can be
  influenced by factors including the duration of
  the procedure, parity of the patient, and the
  patients level of anxiety.
• The procedure can be performed in a hospital
  setting or at a doctors office, depending on the
  preference of the healthcare provider and the
  specifics of the procedure required.

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Before the Procedure

• Ahead of the procedure, patients can undertake
  several preparatory steps. For instance, patients
  are advised to
• Fast for 6-12 hours before the hysteroscopy if
  they will be receiving general anesthesia.
• Refrain from using douches, tampons, or vaginal
  medicines for 24 hours before the procedure.
• Schedule the procedure for a time when they are
  not menstruating.
• Note that the use of prophylactic antibiotics is
  not indicated for hysteroscopy.
• Further, patients undergoing hysteroscopy under
  general anesthesia are advised to empty their
  bladder and have their vaginal area cleansed with
  an antiseptic. Additionally, they may be
  administered medication to assist in relaxation.

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During the Hysteroscopy Procedure

• During the hysteroscopy procedure, the following
  steps are typically what happens during a
  hysteroscopy
• The type of anesthesia local, regional, or
  general is determined based on the specific
  procedure requirements.
• The hysteroscope is carefully inserted through
  the cervix into the uterus.
• The uterus is then expanded with liquid or gas to
  improve visualization.
• The uterine wall is examined for abnormalities.
• The average duration of a hysteroscopy procedure
  can vary from 5 minutes to more than an hour,
  depending on the specific nature of the
  procedure. During the procedure, the patient is
  typically positioned in a dorsal lithotomy
  position, with her legs placed in adjustable
  stirrups.

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After the Hysteroscopy Procedure

• After a hysteroscopy, patients can typically
  expect the following symptoms
• Mild discomfort
• Mild cramping
• Light bleeding
• Feeling faint or sick
• Mild fever
• Bleeding usually has mild pain that lasts for a
  few days. It is important to rest and take care
  of yourself during the recovery period.
• Following a hysteroscopy, patients are advised to
  refrain from douching, sexual intercourse, or
  inserting any vaginal objects, such as tampons,
  to facilitate healing and prevent infection.
• A patient should seek medical attention following
  a hysteroscopy if they encounter abnormal
  bleeding, severe abdominal pain, or any other
  worrisome symptoms.

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Potential Risks and Complications
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• Though hysteroscopy is generally deemed safe, it
  carries some risk. Potential risks and
  complications may include
• Bleeding
• Infection
• Uterine perforation
• Abnormal placentation
• Uterine perforation occurs in approximately
  1-1.61 of cases.
• Indications of complications subsequent to a
  hysteroscopy may encompass
• Profuse bleeding
• Intense pain unresponsive to standard pain relief
  medication
• Indications of infection such as elevated body
  temperature, shivering, and malodorous vaginal
  discharge
• Manifestations of uterine perforation

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Managing Complications

• When complications occur, their management
  usually depends on their severity and unique
  circumstances. For example, minor complications
  such as minor bleeding can be managed by applying
  pressure or using medications to promote blood
  clotting. On the other hand, severe complications
  such as uterine perforations might necessitate
  surgical intervention.
• In the event of excessive bleeding after a
  hysteroscopy, it is crucial to promptly seek
  assessment from the healthcare unit or surgeon.
  They will evaluate the situation and recommend
  appropriate treatment and interventions to manage
  the bleeding, potentially including operative
  measures for significant bleeding.
• Similarly, in the event of a uterine perforation
  during hysteroscopy, the standard management
  protocol may involve
• laparoscopy or laparotomy to address the injury.
• careful observation for symptoms of infection or
  other problems.
• potential antibiotic treatment.
• in severe cases, an emergent hysterectomy might
  be necessary.
• It is important to follow the guidance of your
  healthcare provider in these situations.

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Recovery and Post-Procedure Care
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• Post-procedure, patients often feel mild
  discomfort and need a brief rest period. During
  the recovery from a hysteroscopy, most patients
  can resume their daily activities within a brief
  timeframe, typically within a few hours or days
  after the procedure.
• Following a hysteroscopy, patients are advised to
  refrain from douching, sexual intercourse, or
  inserting any vaginal objects, such as tampons,
  to facilitate the healing of pelvic infection,
  and prevent infection.
• Patients should also be aware of potential
  sources of discomfort that they may encounter
  after undergoing hysteroscopy. For example,
  following a hysteroscopy, a patient can encounter
  cramping and mild pelvic pain. To address this
  discomfort, management strategies may involve the
  use of over-the-counter pain medication and
  adequate rest.
• It is also not advisable for patients to drive
  immediately after a hysteroscopy procedure. They
  should arrange for someone else to drive them
  home, as they may be recovering from anesthesia
  or experiencing some discomfort.

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Returning to Daily Life

• After a hysteroscopy, patients should be vigilant
  for typical indicators of potential
  complications.
• These include heavy bleeding, infection,
  intrauterine scarring, reaction to anesthesia,
  and injury to the cervix, uterus, bowel, or
  bladder.
• Lets explore more Hysteroscopy Explained
  Procedure, Benefits, and Recovery - Southlake
  General Surgery

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Make an Appointment

• We understand that health concerns can be a
  source of anxiety, and were here to help. If
  youre experiencing any symptoms or have concerns
  about your reproductive health, dont hesitate to
  make an appointment with us.
• If you require assistance or direction, our team
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  possible, from the moment you walk in the door to
  the time you leave.
• Contact us today to schedule your appointment at
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  your health by starting now.

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• Medically Reviewed By Dr. Valeria Simone MD
• Board-certified General Surgeon at Southlake
  General Surgery, Texas, USA.
• Follow us on Facebook and YouTube.
• Source Hysteroscopy Explained Procedure,
  Benefits, and Recovery - Southlake General
  Surgery

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76092
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