hysteroscopy

What is hysteroscopy?

This procedure is a minimally invasive surgical procedure for viewing the inside of the uterus. Hysteroscopy is performed by inserting a visualizing scope through the vagina and into the cervical opening. Hysteroscopy allows visualization of the inside of the uterus, including the openings to the Fallopian tubes, as well as direct examination of the cervix, cervical canal, and vagina.

Why is hysteroscopy done?

Hysteroscopy can be performed for both diagnosis or also for treatment (therapeutic). Hysteroscopy is one of several procedures that your doctor may recommend to evaluate or treat abnormalities of the uterus or cervix. Since hysteroscopy examines the lining and interior of the uterus, it is not suitable for evaluating problems within the muscular wall or on the outer surface of the uterus.

Hysteroscopy may be recommended as one step in the evaluation of a number of gynecological problems, including:

  • Abnormal vaginal bleeding
  • Retained placenta or products of conception after a birth or miscarriage
  • Congenital (inborn) anatomical abnormalities of the female genital tract
  • Scarring, or adhesions, from previous uterine surgery or instrumentation such as dilation and curettage (D&C)
  • Polyps or fibroid tumors inside the cervical canal or inside the uterine cavity

How is hysteroscopy performed?

There are a number of different sizes and types of hysteroscopes available, depending upon the type of procedure that is required. Some hysteroscopes are combined with instruments that allow surgical manipulation and removal of tissues if necessary.

Hysteroscopy may be performed in an outpatient surgery center or a hospital operating room, or a physician's office. A number of different methods for anesthesia and pain control may be used, depending upon the individual situation. Sometimes, hysteroscopy using narrow-diameter hysteroscopes that do not require dilation of the cervical opening can be performed without anesthesia. In other cases, a local anesthetic can be applied topically or given by injection. In certain cases, a regional or general anesthetic may be recommended.

A vaginal speculum is often inserted prior to the procedure to facilitate insertion of the hysteroscope through the uterine cavity. Depending upon the exact type of hysteroscope that is used, dilation of the cervical opening with surgical instruments may be necessary. After insertion of the hysteroscope, fluid or gas is injected to distend the uterine cavity and allow for better visualization.

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