A hysteroscopy is a procedure that allows a doctor to examine the inside of the uterus using a thin, lighted tube called a hysteroscope. It is often used to diagnose and treat various uterine conditions, including polyps, fibroids, and abnormal bleeding. During the same procedure, treatments like polypectomy, myomectomy, and endometrial ablation can be performed.
Reasons for Hysteroscopy
- Abnormal uterine bleeding.
- Uterine polyps or fibroids.
- Repeated miscarriages.
- Retained placenta or tissue after miscarriage or childbirth.
- Evaluation of infertility.
Types of Procedures During Hysteroscopy
- Polypectomy:
- Removal of uterine polyps (benign growths) using surgical instruments through the hysteroscope.
- Often performed to treat abnormal bleeding and improve fertility.
- Myomectomy:
- Removal of fibroids (non-cancerous growths) from the uterine wall.
- Can improve heavy bleeding, pelvic pressure, and fertility issues.
- Endometrial Ablation:
- Destruction of the lining of the uterus to reduce or stop heavy menstrual bleeding.
- Performed using heat, cold, or electrical energy.
- Not recommended for women who want to have children in the future.
Procedure Overview
- Preparation:
- Avoid eating or drinking for 8 hours before the procedure.
- A sedative or general anesthesia may be given for comfort.
- A dilator may be used to gently widen the cervix before the hysteroscope is inserted.
- Procedure:
- The hysteroscope is inserted through the cervix into the uterus.
- The uterus is inflated with a sterile fluid for better visibility.
- Polyps or fibroids are removed using surgical instruments through the hysteroscope.
- The endometrial lining is destroyed using energy (if an ablation is performed).
- The procedure typically lasts 15 to 45 minutes.
- Aftercare:
- Mild cramping and spotting for a few days.
- Avoid heavy lifting, swimming, and sexual activity for about one week.
- Pain relief medication may be prescribed if needed.
Possible Risks and Complications
- Infection or bleeding.
- Perforation of the uterus (rare).
- Scar tissue formation (Asherman’s syndrome).
- Incomplete removal of polyps or fibroids.
- Fluid overload (from the distension fluid used).
Frequently Asked Questions
1. Is a hysteroscopy painful?
You may feel mild cramping during and after the procedure, but general anesthesia or sedation is often used to minimize discomfort.
2. How long does it take to recover from a hysteroscopy?
Most women recover within a few days, but you should avoid strenuous activity for about a week.
3. Can I get pregnant after a hysteroscopy?
Yes, pregnancy is possible after hysteroscopy unless you’ve had an endometrial ablation.
4. What are the benefits of a hysteroscopy?
It’s a minimally invasive procedure with a short recovery time and effective treatment for uterine polyps, fibroids, and bleeding.
5. Are there alternatives to a hysteroscopy?
Alternatives include medications, dilation and curettage (D&C), or hormonal therapy.
6. How soon can I resume normal activities?
You can usually return to light activities within a day or two, but avoid heavy exercise for about a week.
7. Will my periods stop after an endometrial ablation?
Periods may stop completely or become much lighter after ablation, but it’s not guaranteed.