Hysteroscopy

When is operative hysteroscopy used?
Your doctor may perform hysteroscopy to correct the following uterine conditions:
. Polyps and fibroids: Hysteroscopy is used to remove these non-cancerous growths found in the uterus.
. Adhesions: Also known as Asherman's Syndrome, uterine adhesions are bands of scar tissue that can form in the uterus and may lead to changes in menstrual flow as well as infertility. Hysteroscopy can help your doctor locate and remove the adhesions.
. Septums: Hysteroscopy can help determine whether you have a uterine septum, a malformation (defect) of the uterus that is present from birth.
. Abnormal bleeding: Hysteroscopy can help identify the cause of heavy or lengthy menstrual flow, as well as bleeding between periods or after menopause. Endometrial ablation is one procedure in which the hysteroscope, along with other instruments, is used to destroy the uterine lining in order to treat some causes of heavy bleeding.

How is hysteroscopy performed?
Prior to the procedure, your doctor may prescribe a sedative to help you relax. You will then be prepared for anesthesia. The procedure itself takes place in the following order:
. The doctor will dilate (widen) your cervix to allow the hysteroscope to be inserted.
. The hysteroscope is inserted through your vagina and cervix into the uterus.
. Carbon dioxide gas or a liquid solution is then inserted into the uterus, through the hysteroscope, to expand it and to clear away any blood or mucus.
. Next, a light shone through the hysteroscope allows your doctor to see your uterus and the openings of the fallopian tubes into the uterine cavity.
. Finally, if surgery needs to be performed, small instruments are inserted into the uterus through the hysteroscope.
The time it takes to perform hysteroscopy can range from less than five minutes to more than an hour. The length of the procedure depends on whether it is diagnostic or operative and whether an additional procedure, such as laparoscopy, is done at the same time. In general, however, diagnostic hysteroscopy takes less time than operative

How safe is hysteroscopy?
Hysteroscopy is a relatively safe procedure. However, as with any type of surgery, complications are possible. With hysteroscopy, complications occur in less than 1% of cases and can include:
. Risks associated with anesthesia
. Infection
. Heavy bleeding
. Injury to the cervix, uterus, bowel or bladder
. Intrauterine scarring
. Reaction to the substance used to expand the uterus

What Are the Risks?

Just like any medical procedure, you could have some complications from a hysteroscopy, including:
. Problems from the anesthesia
. Infection
. Tearing or damage to your cervix, though this is rare
. Problems with gas or fluid from the uterus
. Damage to nearby organs like the bladder, bowel, or ovaries
. Pelvic inflammatory disease