Hysteroscopy; It is the process of observing the inner layer of the uterus with a special optical instrument with a cold light source and performing intrauterine interventions using small hand tools.
What is Hysteroscopy?
General anesthesia or regional (epidural/peridural) After dilating the cervix under anesthesia, the uterus is filled with fluid and a thin telescope-like optical device (hysteroscope) is advanced into the uterus. With the hysteroscope, the image of the inner layer of the uterus is transmitted to the screen. In this way, the doctor observes the uterus (uterine cavity). Hysteroscopy can be used for diagnostic purposes as well as for therapeutic purposes.
Diagnostic Hysteroscopy: In diagnostic hysteroscopy, the cervix is first widened to a width that the hysteroscope can pass through. Then, the hysteroscope connected to the light source is advanced into the uterus/intrauterine cavity (uterine cavity) through the cervical canal. During the procedure, carbon dioxide gas or special liquids are injected into the uterus to separate the walls of the uterus (uterus) from each other and to expel the blood and mucus in the environment. Congenital uterine anomalies can be diagnosed. It is a very important method in infertility research, recurrent pregnancy loss and abnormal uterine bleeding cases. In addition, samples can be taken to diagnose uterine wall (endometrial) pathologies by hysteroscopy. It can be applied when diagnostic hysteroscopy is performed or it can be planned later. In operative hysteroscopy, unlike diagnostic hysteroscopy, scissors, biopsy forceps, cautery or holding instruments are sent through the hysteroscope. With these surgical instruments, determined pathologies can be corrected.
With operative hysteroscopy, myomas and polyps can be removed, and if there are intrauterine adhesions, they can be treated by cutting them. Intrauterine devices that are placed in the uterus with hysteroscopy and cannot be removed by other methods can also be easily removed. After surgical interventions, intrauterine device (spiral) or Foley catheter can be placed in the uterus to prevent re-adhesion of the uterine walls. In addition, hormonal therapy can be applied to support the healing of the uterus after the procedure.
When is Hysteroscopy Performed?
Hysteroscopy is a day surgery procedure and does not require overnight stay in the hospital. It is usually performed on the days following the end of menstrual bleeding. In this way, both the inside of the uterus can be seen more clearly and the risk of harming a possible pregnancy is eliminated.
What are the Advantages of Hysteroscopy?
Since hysteroscopy is an outpatient surgical procedure, it does not require hospitalization. After the procedure, the patient can return to his normal life after resting for 1-2 hours. Since possible problems in the uterine cavity (uterine cavity) can be observed directly, its diagnostic power is higher than other methods. It can also provide effective treatment in cases such as endometrial polyp and submucous fibroids.
What are the Conditions That Should Not Be Performed Hysteroscopy?
Hysteroscopy should not be performed in case of pregnancy, in the presence of vaginal or urinary tract infections or in known cases of uterine cancer.
There is no risk-free surgical procedure. Although there are some risks of surgical intervention specific to hysteroscopy, their incidence is very low and they are rarely life-threatening. The incidence of complications is 1-2 per 100 operative hysteroscopy.
The most common complication is perforation of the uterus with a hysteroscope. Such a condition usually heals on its own without the need for additional surgical intervention. Some complications may also occur due to the fluids used to expand the intrauterine cavity. Among them; pulmonary edema, difficulty in breathing, blood coagulation disorders, decrease in body temperature and allergic reactions. It should be noted?
It is normal to have mild cramps and a small amount of bloody discharge for a few days after the procedure. When the bleeding has stopped and you feel better, return to normal physical activities and sexual life.
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