Hysteroscopy is a minimally invasive procedure in which a thin telescope is inserted inside the uterus through the cervix to examine the uterine lining for any pathology. It is a very safe simple procedure, used as a Diagnostic as well as therapeutic procedure also called Diagnostic Hysteroscopy and Operative Hysteroscopy.
What is Diagnostic Hysteroscopy?
It is usually conducted on a day-care basis with either general or local anesthesia and takes about ten minutes to perform. However, these days we can do it in OPD as well without Anesthesia which is also called Office Hysteroscopy.
The first step of hysteroscopy involves cervical dilatation – stretching and opening the canal of the cervix with a series of dilators. Then the hysteroscope, a narrow lighted telescope, is passed through the cervix and into the lower end of the uterus. The doctor systematically examines the lining of the cervical canal; the lining of the uterine cavity; and looks for the internal openings of the fallopian tubes where they enter the uterine cavity – the tubal ostia.
If required, hysteroscopy guided biopsy and curettage (a surgical scraping of the inside of the uterine cavity) is performed after the hysteroscopy and endometrial tissue is sent for pathological examination.
Many conditions that can be diagnosed on Hysteroscopy are Sub mucous Fibroids , Uterine polyps, Adhesions or scarring of uterus, Uterine septum or other Congenital malformations, Misplaced Copper T, Tubal ( ostia ) blockage etc. IN almost all cases of IVF, Diagnostic Hysteroscopy is needed to evaluate the Uterine Cavity.
What is Operative Hysteroscopy?
It can treat many of the abnormalities found during diagnostic hysteroscopy at the time of diagnosis. The procedure is very similar to diagnostic hysteroscopy except that operating instruments can be placed into the uterine cavity through a channel in the operative hysteroscope.
Operative Hysteroscopy helps to remove uterine polys, helps in resecting the adhesions/scarring of the uterine lining. Misplaced Copper T can be removed easily. Large Sub mucous Fibroids can be resected safely as a day care procedure without any incision by Operative Hysteroscopy. Endometrial ablation hysteroscopically helps to treat Endometrial Hyperplasia in many women with Abnormal Uterine Bleeding. Infertility caused because of tubal/ostia blockage can be treated by passing stents during hysteroscopy.
When do you require Hysteroscopy?
You may need to undergo Hysteroscopy if you are suffering from abnormal uterine bleeding, postmenopausal bleeding or not having periods for a prolonged time after an abortion. In case of recurrent abortions, infertility or misplaced copper T, you may need to undergo Hysteroscopy.