Hysteroscopy

What is Hysteroscopy?

Hysteroscopy is the procedure used to examine the inside of the uterus and the part of the fallopian tubes that open into the uterus, using an optical camera. It is a procedure that allows both diagnostic and surgical interventions.

How is Hysteroscopy Performed?

Hysteroscopy is performed by entering the uterus through the cervical canal vaginally, using specialized instruments. The procedure is monitored on a screen. The tubular instrument, consisting of a camera or lens system inserted into the uterus, is called a hysteroscope. There are three main anesthesia methods used during hysteroscopy, which include:

• Local Anesthesia
• General Anesthesia in the Operating Room
• Spinal Anesthesia in the Operating Room

Before surgery, the cervix is dilated using one of two methods, either with medication administered orally or vaginally. In cases where it is difficult for the cervix to dilate enough to allow the hysteroscope to pass, long, thin rods called spark plugs are used to expand it. Once the cervix is dilated, the hysteroscope is gently inserted into the uterus, and the images are projected onto a monitor for viewing. During this time, fluid is introduced into the uterus to expand it further, allowing a clear view of the uterine cavity. If necessary, instruments at the end of the hysteroscope, such as a cutter or burner, can be used for surgical procedures. There are two types of hysteroscopy: diagnostic, also known as office hysteroscopy, and surgical or operative hysteroscopy.

When Should Hysteroscopy Be Performed?

Hysteroscopy is usually performed about one week after menstruation ends. At this time, there is no blood in the uterine cavity, which provides a clear view, and the uterine lining is thin, making it easier to detect polyps or fibroids. Additionally, hysteroscopy may sometimes be necessary in patients experiencing heavy uterine bleeding. However, in general, performing hysteroscopy one week after menstruation provides the best visibility for diagnosis and treatment.

What Should Be Considered After the Procedure?

After the procedure, patients can usually be discharged from the hospital the same day, with a rapid recovery period. Since there is no incision, there is no need for recovery related to scarring. Mild pain after hysteroscopy is normal, but this is not a cause for concern, as the healing process is quick. However, if symptoms such as excessive vaginal bleeding, severe abdominal pain, fever, foul-smelling discharge, or excessive vaginal discharge occur, a doctor should be consulted. After the procedure, mild vaginal discharge and cramping for a few days are normal. Over-the-counter pain relievers can be used to manage discomfort. It is advisable to avoid sexual intercourse for a few days after the procedure or until the next menstrual period.

What Conditions Can Be Treated with Hysteroscopy?

Hysteroscopy is an important diagnostic tool used to investigate the causes of infertility, recurrent miscarriages, abnormal menstrual bleeding, and intrauterine pathologies, as well as to guide treatment. Some conditions treated with hysteroscopy include:

• Polyps or fibroids causing heavy bleeding
• Congenital uterine abnormalities (such as septum, bicornuate uterus, arcuate uterus, or hypoplasia)
• Investigating repeated IVF failure
• Uterine adhesions (Asherman’s syndrome)
• Recurrent miscarriages
• Removal of intrauterine devices (IUDs) when the strings are not visible or have migrated into the uterus
• Diagnosing early-stage uterine cancers (endometrial cancers) by taking a biopsy from suspicious areas under direct visualization
• Confirming abnormal hysterosalpingography (HSG) or ultrasound findings

What Are the Advantages of Hysteroscopy?

Hysteroscopy offers several benefits, including:

• Most procedures are performed with minimal pain and without incisions.
• Pain is minimal during and after the procedure.
• Early mobilization of the patient, allowing them to get up and move shortly after the procedure.
• As a same-day procedure, hospitalization is usually not required.
• Patients can resume their routine activities quickly after resting for just 1-2 hours following the procedure.