Hysteroscopy: Procedure, Risks & Recovery

When ultrasound and other noninvasive procedures fail to detect a problem in the uterus, fallopian tubes, and other parts of the pelvis, a hysteroscopy might be needed. It’s a minimally invasive procedure performed with a thin tube with a camera attached to the end called a hysteroscope. 

The tool is inserted into your uterus through the vagina and is used to visually examine your reproductive organs. Hysteroscopy is mostly recommended for women who report excessive bleeding, post-menopausal bleeding, or infertility. Your healthcare provider will collect samples of the tissues in your uterus or the surrounding areas if the hysteroscopy detects anything unusual.

The biggest advantage of hysteroscopy is the accurate diagnosis and immediate treatment of fibroids, polyps, and adhesions. It’s minimally invasive, so it has fewer side effects and a minimal risk of complications compared to open surgery.

Types of Hysteroscopy

Hysteroscopy is classified into two main types:

Diagnostic Hysteroscopy

It helps your gynecologist identify the underlying issue of the abnormal uterine bleeding or infertility. Diagnostic hysteroscopy is mostly performed in an outpatient setting with local anesthesia. You can expect to go back home the same day after the procedure.

Hysteroscopy can diagnose endometrial cancer, infertility (due to uterine anomalies), uterine fibroids, polyps, and adhesions.

Operative Hysteroscopy

Operative hysteroscopy is used to treat uterine conditions. It can be performed as an immediate surgical procedure to remove fibroid, polyps, uterine septum, and adhesion. An operative hysteroscopy is sometimes carried out as an unplanned operation for conditions that remained undetected in other pelvic tests. The surgeon passes special instruments through the hysteroscope into your uterus to correct the abnormality or remove a mass or other non-cancerous growth.

When is a Hysteroscopy Recommended?

Hysteroscopy is mostly performed in women with abnormal bleeding, bleeding between periods, or periods that last longer than usual. Your doctor might recommend it for other conditions as well.

Here’s when a hysteroscopy is required:

• Pap smear or other pelvic tests had an abnormal result
• You experience postmenopausal bleeding
• You didn’t conceive after trying unprotected sexual intercourse for a year, for six months in women aged 35 and above.
• Your healthcare provider wants to collect a tissue sample of your uterus for further testing.
• You have experienced multiple miscarriages in the past
• You are diagnosed with uterine fibroids, polyps, and adhesions
• The content of the placenta is left inside the uterus after birth
• You experience extreme pelvic pain during and in between periods

How is Hysteroscopy Performed?

Hysteroscopy might be performed with local or general anesthesia. If your doctor recommends general anesthesia, avoid eating anything for 6-10 hours before the procedure. You can relax knowing you won’t feel any discomfort during the procedure. 

The procedure starts with cervical dilatation followed by the insertion of the hysteroscope into your uterus through the vagina and cervix. They will insert a saline solution or gas into the uterus to expand it for better visualization. The pictures of your uterus and the surrounding organs will appear on the monitor.

If a surgical intervention is required, your doctor will insert tools to remove the polyps, fibroids, and adhesions. Hysteroscopy can last 30 minutes or longer if it’s an operative procedure. Diagnostic hysteroscopy takes 5-10 minutes. 

Hysteroscopy isn’t performed on pregnant women, so you must take a pregnancy test before the procedure. If your doctor conducts hysteroscopy for fibroid removal, they might prescribe medication to shrink the size of this non-cancerous growth beforehand. Conditions that make you unfit for hysteroscopy include endometrial or uterine cancer, pregnancy, pelvic infection, and herpes.

Risks and Complications of Hysteroscopy

Light bleeding, spotting, or cramping after hysteroscopy are considered normal and should resolve within a few days. You might also experience gas, which may last for 24 hours. Some rare complications of hysteroscopy include:

• Excessive bleeding
• Damage to the uterus and other pelvic organs
• Infection
• Dizziness due to anesthesia

Any unusual symptom, such as heavy bleeding after the procedure, unbearable stomach pain, or fever, must be reported immediately. Fluid absorption is also a possible complication of hysteroscopy. It’s more common in cases where hypotonic solutions are used instead of normal saline.

It’s advisable to select your healthcare provider and medical facility wisely to minimize the risk of complications.

Recovery After Hysteroscopy

As mentioned earlier, hysteroscopy is an outpatient procedure, and the patient can go home and resume normal activities on the same day. However, if you had an operative hysteroscopy with general anesthesia, you must plan a hospital stay until the effect of the anesthesia wears off. 

Your healthcare provider will closely monitor your vitals. You can request painkillers for cramping. You must avoid sexual intercourse for 1-2 weeks or until the bleeding stops completely. Avoid using tampons, douching, and insertion of any product into your vagina for the first few days or until your doctor gives you a green light. 

If the bleeding is heavy and won’t stop in two weeks, contact your healthcare provider immediately. Rest is crucial for quick recovery, especially in patients undergoing an operative hysteroscopy. So, take some time off from work and rest as much as possible.

Preparing for a Hysteroscopy

Here’s how you can prepare for hysteroscopy:

• Share Your Medical History: Tell your doctor about any allergies, medical conditions, current medication, or a history of invasive medical procedures.
• Take Medication: Your doctor might recommend antibiotics, painkillers, and other medication to prepare you for hysteroscopy. 
• Preparation for the Day: Avoid tampons, sexual intercourse, and douching before hysteroscopy. 

If you get your period, ask your doctor to reschedule the procedure. The best time to have a hysteroscopy is the week after your menstruation (before ovulation begins). So, try to have the procedure around this time. It gives your doctor a better view of your uterine cavity.

Conclusion

Hysteroscopy is a minimally invasive diagnostic procedure for women struggling with heavy bleeding and all kinds of menstrual problems. Since it gives your doctor a clear picture of your pelvic organs, they can recommend the most suitable treatment based on the severity of the problem. The procedure is safe and short. 

At the Australian Concept Infertility Medical Center (ACIMC), we take pride in our team of qualified and experienced gynecologists. They are well-equipped to perform both diagnostic and operative hysteroscopy if required. Our center is fully equipped to perform immediate surgery during hysteroscopy, ensuring the best possible treatment for menstrual problems, infertility, and other reproductive health issues in women. You can rest assured that you are in safe hands.

If you have any doubts or questions, we encourage you to book a free consultation at the Australian Concept Infertility Medical Center. We are here to support you.