Hysteroscopy is a diagnostic tool usually used in the investigation of infertility, repeated miscarriage problems, intrauterine pathologies. Hysteroscopy is also a procedure performed by filling the uterus with fluid with the help of an optic with a cold light source to view the intrauterine layer and interference with small instruments.
Usually, it is filled with water by expanding the uterus under regional anesthesia or general anesthesia and passes it into the uterus with the help of a hysteroscope that looks like a thin telescope. In this way, the uterine layer is examined. Hysteroscopy can be used for diagnostic purposes as well as for therapeutic purposes.
As with laparoscopy, hysteroscopy is divided into two parts on its own.
Diagnostic Hysteroscopy (Office Hysteroscopy )
Surgical (Operative) Hysteroscopy
1.Diagnostic Hysteroscopy (Office Hysteroscopy )
Diagnostic hysteroscopy, popularly known as office hysteroscopy, is a method used to examine and monitor the inside of the uterus. Dec. The office has been named hysteroscopy because it can be applied to the patient during the examination. Office hysteroscopy also uses a light-optical telescope system like laparoscopy; however, the diameter of this telescope is thinner. The hysteroscope used for diagnostic purposes has a diameter of 5 mm. Before the cervical dilation procedure is performed, the patient is placed in a gynecological position and thus the expansion of the uterus becomes even easier.
It is entered into the uterus by giving CO2 or special fluids from the cervix using a hysteroscope. Thus, it is ensured that the uterine wall is separated from one another. Thanks to this, direct examination is provided by hysteroscopy in the uterus where the expansion is performed. Office hysteroscopy is also a method that usually does not need anesthesia or can be performed without hospitalization with regional anesthesia. In order to make it easier to examine the inside of the uterus, it is usually recommended to apply it a few days after the end of menstruation. With office hysteroscopy, it is possible to directly see pathologies such as polyps, fibroids, adhesions in the uterus. Diagnosis will be made and appropriate preparations for treatment will be started if necessary.
How is Surgical (Operative)Hysteroscopy Performed?
Abnormal conditions detected during diagnostic hysteroscopy can be treated with surgical hysteroscopy method. In particular, polyps, septums, adhesions and fibroids found in the uterus can be removed by surgical methods.
The channels inside the hysteroscope are designed to allow the passage of scissors, capture forceps, biopsy forceps, laser fiber and electro-surgical tools to be used in the operation. Adhesions, fibroids and polyps seen in the uterus can be removed. The formation, which is a congenital abnormality and completely or partially divides the uterus into two, can be corrected hysteroscopically.
After the operative procedure, a spiral or thin urinary probe may be inserted into the uterus to prevent the uterine walls from sticking together. Antibiotics and hormonal drugs can be used to prevent inflammation and speed up the healing of the inner lining of the uterus.Hysteroscopic surgery based on the principle of destruction of the inner lining of the uterus, known as endometrial ablation in medical parlance, can be performed in the treatment of excessive bleeding in the uterus, in cases where removal of the uterus (hysterectomy) is not appropriate.
In addition, hysteroscopy is a very useful method for finding and removing intrauterine spirals.
What are the Risks of Hysteroscopy?
Diagnostic hysteroscopy also rarely sees undesirable conditions and is rarely life-threatening.
Perforation of the uterus during hysteroscopy is one of the undesirable situations. But these holes that form usually heal on their own without the need for another surgical procedure.
When an operative hysteroscopy is performed, laparoscopy is often performed to see the external structure of the uterus at the same time. Surgical hysteroscopy also 1 – 2 / 100 an undesirable situation(complication) occurs at the rate. Although it is rarely seen during the surgical procedure, the most common one is again a uterine puncture. Some other undesirable conditions also occur due to the fluids used to dilate the uterus.
Serious allergic reactions, Deceleration of body temperature, clotting problems, breathing difficulties, fluid accumulation in the lungs are among the complications that occur. During the surgical hysteroscopy procedure, on the other hand, the intra-abdominal organs may rarely be injured and bleeding may occur. Although it is a serious and potentially life-threatening undesirable condition, they are rare.
Care After Hysteroscopy
After hysteroscopy, it is normal to feel some vaginal discharge and cramps in the few days following hysteroscopy. For this, simple pain relieving drugs can be used to relieve the pain. Definitely, sexual intercourse should be avoided for a few days or Decoupled until the next period at the longest. It is usually possible to return to normal activities within a day or two. If the probe is inserted, it will be removed in a short time. Hormonal therapy may need to be applied for several months after the surgical procedure.
Instruments used in hysteroscopic procedure (Hysteroscope)
In some women undergoing infertility treatment, Surgical (Operative) or Office (Diagnostic) Laparoscopy operations can sometimes be performed in the same session as surgical hysteroscopy.