Diagnostic Hysteroscopy

Overview

Diagnostic hysteroscopy is a minimally invasive procedure that allows a healthcare provider to view the inside of the uterus using a thin, lighted tube called a hysteroscope. This procedure is typically performed to investigate abnormal uterine bleeding, evaluate the shape of the uterus, check for uterine polyps or fibroids, and assess other uterine conditions.

Specialty

Diagnostic hysteroscopy is typically performed by gynecologists, particularly those specializing in reproductive endocrinology, fertility, and women’s health.

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How is Diagnostic Hysteroscopy Done?

  • Pre-Procedure Consultation: Discuss the procedure with a healthcare provider, including medical history and any medications.
  • Physical Examination: A pelvic examination may be performed prior to the procedure.
  • Medications: Patients may be advised to stop blood thinners or certain medications a few days before the procedure.
  • Timing: The procedure is usually performed in the first half of the menstrual cycle (after menstruation and before ovulation) to ensure the uterus is not thickened by hormonal changes.
  • Fasting: Patients may be advised to fast for several hours before the procedure.

  • Anesthesia: Local anesthesia may be administered to numb the cervix. In some cases, sedation may be provided.
  • Positioning: The patient is positioned on an examination table, similar to a pelvic exam.
  • Hysteroscope Insertion: The hysteroscope is gently inserted through the vagina and cervix into the uterus.
  • Visualization: The hysteroscope provides a clear view of the uterine cavity, allowing the doctor to examine its interior.
  • Fluid Distension: Sterile fluid is infused into the uterus to expand the cavity, providing a better view.
  • Assessment: The doctor assesses for any abnormalities, such as polyps, fibroids, or uterine abnormalities.

While diagnostic hysteroscopy is generally safe, potential complications can include:
  • Infection: Introduction of bacteria into the uterus.
  • Bleeding: Light bleeding is common, but heavy bleeding can occur.
  • Uterine Perforation: Rarely, the hysteroscope may perforate the uterine wall.
  • Fluid Overload: Excess fluid absorption can lead to fluid overload, although this is rare.
  • Adverse Reactions to Anesthesia: Possible allergic reactions or side effects.
What are the Benefits of Diagnostic Hysteroscopy ?
  • Minimally Invasive: Lower risk compared to open surgeries.
  • Diagnostic Accuracy: Provides direct visualization of uterine abnormalities.
  • Simultaneous Treatment: In some cases, therapeutic procedures (e.g., removal of polyps) can be performed during the same session.
  • Short Recovery Time: Most patients can return home the same day and resume normal activities quickly.

Infrastructure and Facility Requirements

  • Ambulatory Surgical Centers: Often performed in outpatient settings equipped for minor surgical procedures.
  • Hospital Facilities: Can be performed in a hospital setting, particularly for cases requiring more comprehensive care.
  • Specialized Equipment: Requires advanced imaging technology, such as hysteroscopes, surgical instruments, and monitoring devices.

FAQs

Mild discomfort is expected, but local anesthesia and sedation can minimize pain during the procedure.

The procedure usually takes about 15-30 minutes.

Light bleeding or spotting may occur. Patients are usually advised to avoid tampons, douches, and sexual intercourse for a few days.

If sedation was used, it’s advised to arrange for someone else to drive you home.

Most patients can return to normal activities within a day, but strenuous activities should be avoided for a short period.

Ultrasound or MRI may be used for imaging, but they do not provide the direct visualization and potential for intervention that hysteroscopy does.

Delaying diagnosis can lead to untreated conditions that may worsen, such as fibroids or polyps, affecting fertility or leading to other complications.

Always consult with a healthcare provider for personalized information regarding diagnostic hysteroscopy.

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