Hysteroscopy

Hysteroscopy is the inspection of the uterine cavity by endoscopy with access through the cervix.

It allows for the diagnosis of intrauterine pathology and serves as a method for surgical intervention (operative hysteroscopy).It is best carried out when the endometrium is relatively thin, that is after a menstruation. Both diagnostic and simple operative hysteroscopy can be carried out in an office or clinic setting on suitably selected patients.

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Preparation

Local anesthesia can be used. Analgesics are not always necessary. A paracervical block may be achieved using a Lidocaine injection in the upper part of the cervix. Hysteroscopic intervention can also be done under general anesthesia (endotracheal or laryngeal mask) or Monitored Anesthesia Care (MAC). Prophylactic antibiotics are not necessary. The patient is in a lithotomy position during the procedure.

Procedure

If abnormalities are found, an operative hysteroscope with a channel to allow specialized instruments to enter the cavity is used to perform the surgery. Typical procedures include endometrial ablation, submucosal fibroid resection, and endometrial polypectomy.

Post-procedure

After procedure we should monitor for vitals and vaginal bleeding.

What are the benefits & risks of Hysteroscopy?

The outcomes of Hysteroscopy depend on several factors and conditions suffered by the patient in the past.

The benefits & risks of Hysteroscopy include

A possible problem is uterine perforation when either the hysteroscope itself or one of its operative instruments breaches the wall of the uterus. This can lead to bleeding and damage to other organs. If other organs such as bowel are injured during a perforation, the resulting peritonitis can be fatal. Furthermore, cervical laceration, intrauterine infection (especially in prolonged procedures), electrical and laser injuries, and complications caused by the distention media can be encountered.

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