What is a hysteroscopy?
A hysteroscopy is a diagnostic procedure where a lighted scope,
called a hysteroscope, is inserted
through the cervix into the uterus that lets a doctor view the
inside of the uterus. If growths, scar tissue, or other problems
are found during the procedure, the doctor can use the information
that was gathered during the hysteroscopy, and develop a treatment
plan. The tools that a doctor may use during a hysteroscopy may
not be limited to a hysteroscope.
A speculum, which is the same instrument
used during a pap smear, gently widens
the vagina, and sometimes the cervix as well. The doctor may use
carbon dioxide gas or a liquid that flows through a tube in the
hysteroscope, and then into the
uterus. This would be used to hold the walls of the uterus apart.
Other specially designed surgical instruments can be inserted
through the hysteroscope to take
samples of the uterine lining, or to remove growths.
Before, During, and After
Before the procedure, be sure to ask your doctor whether you can
take medications like ibuprofen, up to an hour before the hysteroscopy
begins. A pain reliever may help lessen the uterine cramps that
sometimes occur during a hysteroscopy. After filling out a few
forms, you will change into a gown and lie down on an examination
table, in the lithotomy position,
with your feet in stirrups. During the procedure, to lessen discomfort,
the doctor might numb your cervix with local anesthesia. If the
hysteroscopy is performed in a hospital, your body might be numbed
below the waist, using regional anesthesia. You could also be
put totally asleep, using general anesthesia. After the anesthesia,
your cervix may be gently widened, after which a hysteroscope
is inserted. If a video camera is attached, you may be able to
view the procedure on the nearby video monitor. After the procedure,
menstrual-type cramps and bleeding are common for around 24 hours,
so wear an absorbent pad. Avoid tampons and sexual intercourse
for a brief period of time after the hysteroscopy is performed.
Be sure to ask your doctor how long the time period is. If carbon
dioxide gas was used to expand the uterus, some gas may have escaped
into your abdomen, which is harmless, but may cause some aching
in your shoulders for up to a day or so.
Risks and Complications
Complications from hysteroscopies are rare. The risks involved
include problems with anesthesia, infection, or perforation of
the uterine wall. Be sure to call you doctor if any symptoms occur
after the procedure, such as heavy bleeding, a fever over 100.4F,
and increased abdominal pain.
What your Doctor Looks for During a Hysteroscopy
During a hysteroscopy, your doctor looks inside your uterus for
anything out of the ordinary. Fibroids,
adhesions, and polyps
are common problems possibly found during the procedure. Fibriods
are round knots of uterine muscle. Fibroids
usually grow slowly, but can become rather large over time. They
might cause abnormal bleeding, cramping, or even fertility problems.
Polyps are single or multiple "fingers"
of soft uterine tissue that dangle from the uterine wall. Polyps
can cause abnormal bleeding. Adhesions
are bands of scar tissue that bind together differrent parts of
the uterine wall. Hyperplasia, which
is an overgrowth of the uterine lining, along with uterine cancer,
are not common, but may be found during the procedure. A small
sample, called a biopsy, may be taken
of the uterine lining for further laboratory testing and evaluation.
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