Hysteroscopy: Everything you need to know about it

Have you also had irregular periods? Maybe you bleed a lot for a few days. Or maybe you bleed a little after your period stops. When you go to the doctor with this problem, did he tell you that you need to have a "Hysteroscopy"? When you hear this name, you may feel a little scared, "What do you mean by putting a camera inside?" But this is actually a very advanced, very simple and safe procedure. Today, we will talk about this to dispel all your doubts and fears.

Simply put, what is Hysteroscopy?

Hysteroscopy is, simply put, a test to look inside your uterus. This is done using a very thin tube, a little thicker than a pencil, with a light and a camera on the front. We call this instrument a hysteroscope . It is inserted very carefully through your vagina and passed through your cervix into your uterus. The doctor can then see the images from the camera on a monitor, magnified and clearly.

There are two main types of this:

1. Diagnostic Hysteroscopy: This is done to check for any problems inside the uterus. For example, it can help determine the cause of abnormal bleeding, whether there are any tumors in the uterus, or any other abnormalities. Sometimes it is done after an ultrasound scan to confirm the diagnosis.

2. Hysteroscopy for treatment (Operative Hysteroscopy): This is where the disease is not only detected, but also treated on the spot. Imagine, if something like a polyp is seen during the examination, a small surgical instrument can be inserted through the hysteroscope and the polyp can be removed. This way, both the examination and the surgery can be done at the same time, so there is no need to have another surgery.

When is a hysteroscopy necessary?

Most often, your gynecologist will recommend this test if they suspect a problem with your uterus. Here are some of the situations in which this may occur.

What happens before this test?

Your doctor will examine you carefully before performing this test and decide if it is appropriate for you.

• They will ask about your complete medical history. They will also ask about any medications and vitamins you are taking. They may ask you to stop taking blood thinners (anticoagulants) for a few days.
• A physical exam and pelvic exam will be performed. A test will be done to see if you are pregnant.
• The most important thing is to choose the best time to do this. If your period is on its due date, the doctor will usually give you a day to do this within the first week after your period stops . This is because the inside of the uterus is most clearly visible at that time.

What happens during the test?

Don't be scared when you hear this, the whole process will happen without you feeling any discomfort.

1. Preparation: You will be changed into a hospital gown and lie down on an examination table. Your legs will be placed in a specially designed support.

2. Anesthesia: Most of the time, this is done under general anesthesia, meaning you won't feel anything. For some minor tests, only the lower abdomen may be numbed (regional anesthesia). Your doctor will explain this to you in advance.

3. Examination: The doctor will first examine the vagina. Then, the cervix will be slightly opened (dilated) to allow the hysteroscope to be inserted.

4. Insertion of the hysteroscope: Next, the instrument is carefully inserted into the uterus.

5. Cleaning the uterus: A liquid solution, such as saline, is injected into the uterus to make it slightly swollen and visible. This removes any blood or mucus that may be inside, allowing the doctor to see the walls of the uterus and the openings of the fallopian tubes clearly.

6. Treatment (if necessary): If there is anything like a tumor or adhesion, it is removed with small instruments that pass through the device.

This entire process can take anywhere from as little as 5 minutes to as long as an hour, depending on whether it's just a test or if you're also doing treatment.

What to expect after the test?

After the test, you will be kept in a recovery room for a few hours and then sent to the ward.

• It's normal to have some cramping in your lower abdomen (like during menstruation) and some light bleeding for a few days. Don't worry about it.
• As your doctor says, you should avoid having sex, using tampons, and taking hot baths for about two weeks .

Are there any side effects? When should I see a doctor immediately?

Hysteroscopy is a very safe procedure. Side effects occur in less than 1% of cases. However, as with any medical procedure, it is good to be aware of the very rare cases that can occur. For example, infections, excessive bleeding, and reactions to anesthesia.

However, if you have these symptoms, you should call your doctor immediately or go to the Emergency Department (ETU) of your nearest hospital:

Are Hysteroscopy and D&C the same thing?

No. This is something that many people confuse. In a D&C `(Dilation and Curettage)` procedure, the walls of the uterus are scraped and a tissue sample is taken. In that case , the doctor cannot see inside, and the tissue is taken by guessing. But in Hysteroscopy , a camera can be used to clearly see inside the uterus, identify the exact location of the problem, and remove only that part very delicately. Therefore, Hysteroscopy is a very accurate and precise method.

Hysteroscopy, examination of the uterus, women's diseases, gynecology, irregular menstruation, D&C, uterine cysts