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Diagnostic Hysteroscopy Tips

Diagnostic Hysteroscopy - How Can It Be Of Help?

Dr. Pragnesh Shah 87% (121 ratings)
MD, MBBS
Gynaecologist, Ahmedabad
Diagnostic Hysteroscopy - How Can It Be Of Help?

Indications:

  1. Primary Infertility
  2. Secondary Infertility
  3. Investigating & treating a case of B.O.H.
  4. Investigating & treating Abnormal bleeding P/V
  5. Investigating & treating case of mass inside the uterine cavity

Objective:

Hysteroscopy is the commonest type of work up in the entire Infertility patient along with Diagnostic Laparoscopy. Only diagnostic hysteroscopy is the commonest work up recommended before IVF. We record Hysteroscopy diagnostic & operative procedure for future important record in Infertility patient, for second opinion & for deciding future treatment protocol. 

Benefits of Hysteroscopy Surgery:

  1. Shorter Hospital stay.
  2. Earlier return to your routine work.
  3. Cosmetically no scar on abdomen.
  4. Less pain after operation.
  5. Best fertility enhancement & Fertility results following hysteroscopy
  6. Video-live operative file available in CD/DVD for future reference (Transparency about surgical procedure).
  7. Patient discharged within 2-4 hours after procedure.
  8. Patient can resume to her normal routine work within 12-24 hours after the procedure.

Pre-operative Check Lists:

  1. Lab. Investigation for Surgery (Urine complete & Blood complete, HbsAg, HIV, R.B.S.Etc.); Pelvic Trance vaginal USG report.
  2. Specific Investigations for Infertility (Endocrine, Blood, Genetic, Husband’s Semen report etc. If The couple is infertile)
  3. Operation planned from 4th to 10th day of Menstrual Cycle.
  4. Preparation of local parts.
  5. No. Of Cuts on Abdomen: Nil 

Average Stay in Hospital:
2 to 4 hours. (DAY CARE SURGERY)

Average Duration of Surgery:
2 to 10 minutes

Average Blood loss during Surgery:
Negligible

Average time after operation to resume normal activities/work:
Within 12-24 hours.

Anesthesia:

General Anesthesia (Patient will not feel any pain in Operation Theatre during surgery)Procedure:Patient is given general anesthesia. Patient is put on lithotomy position. Local parts cleaning & paintings with antiseptic solution & draping are done. After P/V examination cervix is checked with uterine sound. For Diagnostic hysteroscopy after removing the air, hysteroscopy (varsascope/1.9 mm/ 2.9 mm Hysteroscopy along with irrigation of Normal saline is introduced inside the cavity. Systemically both corneal openings, cavity, both lateral walls and anterior & posterior wall of the uterine wall is noticed for any lesions or normalcy. For operative/therapeutic hysteroscopy cervix is dilated up to 7mm / 10 mm for introduction of Operating hysteroscopic sheath or resectoscope for operative hysteroscopy. Hysteroscopy requires dilatation of the uterine cavity to create working space inside the uterine cavity and flushes both fallopian tubes with high pressure fluid helps in achieving very good fertility enhancing results following Hysteroscopy in infertility patients. Addressing all the infertility related lesions like broad septum from the fundus, intra-uterine adhesions, polyps or tubal cannulation helps us in treating infertility patients in the same sitting
                        
Post-operative Course:

Patient remains drowsy/sedated for 1-2 hours after hysteroscopy but conscious & pain free. Patient can take fluids 1-2 hours after hysteroscopy & light food after 2-4 hours. She may feel little discomfort after hysteroscopy for 6-8 hours but it can be relieved with pain killer tabs. Most of the patients can walk normally without support and can take normal diet 6-8 hours after the hysteroscopy. She can be discharged on the same day of the operation. Few patients may feel nausea & vomiting after hysteroscopy, which can be very well controlled with injection in post-operative room. Patient can do her normal activity within 12-24 hours after hysteroscopy. Patient is advised to take antibiotics & analgesic tabs for 5 days following hysteroscopy. Patient is advised to report to doctor for severe pain or bleeding or fever in postoperative period (Day-1 to Day-5) immediately. Patient is advised to come for follow up 7 days after the next period or on the day for IVF protocol & preparation for IVF. In case you have a concern or query you can always consult an expert & get answers to your questions!

3819 people found this helpful

Diagnostic Tests Females

Dr. Richika Sahay Shukla 92% (827 ratings)
DNB (Obstetrics and Gynecology), MBBS
IVF Specialist, Delhi
Diagnostic Tests Females

Diagnostic Tests Females

We provide testing for fertility by all modalities ranging from reproductive hormones to diagnostic ultrasound to ascertain the cause. It is advisable that we make you undergo these tests before your final treatment/ plan of management is started.

  • Blood tests: These include a whole array of blood investigation ranging from CBC , Urine routine microscopy, RBS, TSH,PROLACTIN,VDRL,HIV,HBSAG,HCV,AMH. And any other test depending on the history of the couple.
  • Transvaginal ultrasound: A complete ultrasound of the uterus and adnexa is done to diagnose any anatomical disorder.
  • Specific tests: In cases of recurrent implantation failure and recurrent pregnancy loss or if required other tests are also advised.
  • Diagnostic Laparoscopy and Hysteroscopy: For many, this test is an important part of a fertility evaluation .Laparoscopy takes place under general anaesthesia with small incisions made at or just below the navel and the pubic hairline. A laparoscope (a small-diameter telescope) is passed through the incision, which enables one to view the ovaries, fallopian tubes, uterus and pelvic cavity for abnormalities. We can check that the tubes are open (tubal patency) by injecting dye through the uterus and observing it spill or not through the ends of the fallopian tubes.
  • Hysteroscopy: uses another small-diameter telescope called a hysteroscope. This enables to assess the uterine cavity for abnormalities such as polyps, adhesions or fibroids.

Diagnostic Tests- Females

Dr. Richika Sahay Shukla 92% (827 ratings)
DNB (Obstetrics and Gynecology), MBBS
IVF Specialist, Delhi
Diagnostic Tests- Females

Diagnostic tests- Females

We provide testing for fertility by all modalities ranging from reproductive hormones to diagnostic ultrasound to ascertain the cause. It is advisable that we make you undergo these tests before your final treatment/ plan of management is started.

  • Blood tests – These include a whole array of blood investigation ranging from CBC , Urine routine microscopy, RBS, TSH, PROLACTIN, VDRL, HIV, HBSAG, HCV, AMH. And any other test depending on the history of the couple.
  • Transvaginal ultrasound- A complete ultrasound of the uterus an adenexa is done to diagnose any anatomical disorder.
  • Specific tests – In cases of recurrent implantation failure and recurrent pregnancy loss or if required other tests are also advised.
  • Diagnostic Laparoscopy and Hysteroscopy – For many, this test is an important part of a fertility evaluation .Laparoscopy takes place under general anaesthesia with small incisions made at or just below the navel and the pubic hairline. A laparoscope (a small-diameter telescope) is passed through the incision, which enables one to view the ovaries, fallopian tubes, uterus and pelvic cavity for abnormalities. We can check that the tubes are open (tubal patency) by injecting dye through the uterus and observing it spill or not through the ends of the fallopian tubes.

Hysteroscopy uses another small-diameter telescope called a hysteroscope. This enables to assess the uterine cavity for abnormalities such as polyps, adhesions or fibroids.

1 person found this helpful

Diagnostic tests- Females

Dr. Richika Sahay Shukla 92% (827 ratings)
DNB (Obstetrics and Gynecology), MBBS
IVF Specialist, Delhi
Diagnostic tests- Females

Diagnostic tests- Females

We provide testing for fertility by all modalities ranging from reproductive hormones to diagnostic ultrasound to ascertain the cause. It is advisable that we make you undergo these tests before your final treatment/ plan of management is started.

  • Blood tests – These include a whole array of blood investigation ranging from CBC , Urine routine microscopy, RBS, TSH, PROLACTIN, VDRL, HIV, HBSAG, HCV, AMH. And any other test depending on the history of the couple.
  • Transvaginal ultrasound- A complete ultrasound of the uterus an adenexa is done to diagnose any anatomical disorder.
  • Specific tests – In cases of recurrent implantation failure and recurrent pregnancy loss or if required other tests are also advised.
  • Diagnostic Laparoscopy and Hysteroscopy – For many, this test is an important part of a fertility evaluation .Laparoscopy takes place under general anaesthesia with small incisions made at or just below the navel and the pubic hairline. A laparoscope (a small-diameter telescope) is passed through the incision, which enables one to view the ovaries, fallopian tubes, uterus and pelvic cavity for abnormalities. We can check that the tubes are open (tubal patency) by injecting dye through the uterus and observing it spill or not through the ends of the fallopian tubes.

Hysteroscopy uses another small-diameter telescope called a hysteroscope. This enables to assess the uterine cavity for abnormalities such as polyps, adhesions or fibroids.

Diagnostic Tests Females

Dr. Richika Sahay Shukla 92% (827 ratings)
DNB (Obstetrics and Gynecology), MBBS
IVF Specialist, Delhi
Diagnostic Tests Females

Diagnostic Tests Females

We provide testing for fertility by all modalities ranging from reproductive hormones to diagnostic ultrasound to ascertain the cause. It is advisable that we make you undergo these tests before your final treatment/ plan of management is started.

  • Blood tests: These include a whole array of blood investigation ranging from CBC , Urine routine microscopy, RBS, TSH, PROLACTIN, VDRL, HIV, HBSAG, HCV, AMH. And any other test depending on the history of the couple.
  • Transvaginal ultrasound: A complete ultrasound of the uterus and adnexa is done to diagnose any anatomical disorder.
  • Specific tests: In cases of recurrent implantation failure and recurrent pregnancy loss or if required other tests are also advised.
  • Diagnostic Laparoscopy and Hysteroscopy: For many, this test is an important part of a fertility evaluation. Laparoscopy takes place under general anaesthesia with small incisions made at or just below the navel and the pubic hairline. A laparoscope (a small-diameter telescope) is passed through the incision, which enables one to view the ovaries, fallopian tubes, uterus and pelvic cavity for abnormalities. We can check that the tubes are open (tubal patency) by injecting dye through the uterus and observing it spill or not through the ends of the fallopian tubes.
  • Hysteroscopy: uses another small-diameter telescope called a hysteroscope. This enables to assess the uterine cavity for abnormalities such as polyps, adhesions or fibroids.
1 person found this helpful

Does Hysteroscopy Improves Chance Of IVF Success?

Dr. Arun Muthuvel 85% (10 ratings)
MCH - Reproductive Medicine & Surgery, MS - Obstetrics & Gynaecology
IVF Specialist, Chennai
Does Hysteroscopy Improves Chance Of IVF Success?

IVF is one of the most common ways to treat infertility. This procedure can be described as one where the woman’s eggs and the man’s sperm are harvested and combined in a laboratory to form an embryo. Two or more embryos are then inserted into the woman’s womb where they will develop during the pregnancy. IVF has a high success rate but there are a number of factors that could interfere with this. Issues with the woman’s uterus such as the presence of scar tissue or polyps could be one such factor. Thankfully, this issue can be identified and treated before undergoing IVF so as to increase the chances of its success.

  1. A hysteroscopy is a procedure through which the doctor can take a look inside the woman’s uterus. This is an invasive procedure that is performed while the woman is under general anesthesia. It involves inserting a narrow tube with a telescope at one end into the uterine cavity.
  2. The cavity may or may not be filled with a gas or a fluid. The telescope then captures and transmits images of the uterus to a screen where it can be viewed by the doctor. Any malformations such as polyps, scar tissue, fibroids etc. will be made visible through this procedure. If any such issues are seen, the doctor will then proceed to remove them. In this case, the procedure is not only diagnostic but operative as well.
  3. The fertilized embryos are then inserted into the woman’s uterus. Since all the scar tissue and uterine abnormalities have been addressed, the embryos then have a higher chance of being successfully implanted. This boosts the chances of a successful IVF pregnancy.
  4. A hysteroscopy may not be very effective for a patient with recurrent IVF failures but for a woman who is undergoing IVF treatment for the first time, this could be quite helpful. It is rare for a hysteroscopy to have side effects. Infection caused by this procedure is very rare. In some cases, women may experience temporary bloating or cramps after the procedure. This does not affect her fertility in any way. A hysteroscopy is not a typical part of the IVF procedure and hence there are additional costs associated with it. However, in the long run, by increasing the chances of having a successful pregnancy, these costs may be offset by negating the need for a second round of IVF treatment. In the end, the choice is a personal one.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2906 people found this helpful

Postmenopausal Bleeding - 5 Diagnostic Methods

Motherhood 88% (259 ratings)
Speciality Birthing Care
Gynaecologist, Bangalore
Postmenopausal Bleeding - 5 Diagnostic Methods

Most women attain menopause between the ages of late 40s and early 60s, the average age being about 51. This is an important milestone in a women-s gynecological history. One major change is altered female hormone levels, and this leads to a lot of physiological changes. From hot flashes to mood swings, there is also increased predisposition to osteoporosis and uterine cancer.


If you have not had your menstrual cycles for close to 12 months, chances are you are into menopause. So, that means absolutely no vaginal bleeding anymore whatsoever. However, if you experience bleeding, even spotting, be on the alert. It is not normal and needs to be examined, and if required, diagnosed and treated.
Postmenopausal bleeding or PMB as it is popularly called can be due to a variety of reasons. While it could be something as trivial as inflammation of the uterine or vaginal lining, it could also be an indication of more severe issues like cancer.


- Atrophic vaginitis - Decreasing hormonal levels lead to increased dryness and therefore inflammation of the vaginal and uterine tissue. This is one of the common causes of bleeding after menopause.
- Endometrial atrophy - Also caused by lower hormone levels, the lining of the body of the uterus gradually thins down and can get inflamed.
- Polyps - Noncancerous growths in the uterus, cervix, vulva, or vagina can also lead to bleeding
- Infections - General infection of any area along the uterine tract could lead to occasional bleeding

- Cancer - Though only 1 in 10 PMB cases turn out to be cancers, the prognosis improves with early diagnosis and intervention.


Diagnosis: As repeated above, reach out to your doctor if you notice postmenopausal bleeding.  Diagnostic methods could include the following:
- Physical Examination
- Transvaginal Ultrasound
- Endometrial Biopsy
- Hysteroscopy
- Dilatation and Curettage
 

Treatment: Needless to say, this would depend on the diagnosis.
For very minor cases with diagnosis like altered hormone levels, no treatment may be required other than modification of the hormone replacement therapy.

For endometrial atrophy and atrophic vaginitis, use of estrogen creams and pessaries would be sufficient.
Polyps would require removal followed by cauterization (application of slight heat) to stop the bleeding.
Cancer - this would depend on the type and location and require a combination of chemotherapy and surgery.  Removal of the uterus also may be required in some cases.
So, if you have had bleeding of any sort after ayear of menopause, do not ignore it. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

6146 people found this helpful

Hysteroscopy - How IT Can Help In Diagnosing Infertility?

Dr. Rita Bakshi 89% (2899 ratings)
MBBS, DGO, MD, Fellowship in Gynae Oncology
Gynaecologist, Delhi
Hysteroscopy - How IT Can Help In Diagnosing Infertility?

Hysteroscopy is considered as a therapeutic modality and a valuable detection in the management or treatment of infertility. It is a process whereby a doctor checks the uterus cavity to treat the cause of abnormal menstrual bleeding which may be impeding chances of conception. It is performed with the help of a hysteroscope (a thin tube) inserted in the uterus to detect and examine the cervix (lower end of the uterus). Its role has changed and modified overtime.

Hysteroscopy is performed to find out certain causes of infertility; which may be:

  1. Problem in the size or shape of the uterus.

  2. Repeated miscarriages.

  3. Endometrial cancer (a cancer of the uterus).

  4. Scar tissue in the uterus.

How and when to prepare for hysteroscopy?

  1. The best time for hysteroscopy to be carried out is when one is not on her menstruating cycle.

  2. Make sure not to insert tampons or use vaginal medicines 24 hours prior to the surgery.

  3. An anesthetic will be given to relax you before hysteroscopy.

How is it performed?

The procedure begins with the administration of anesthesia.

  1. The cervix will be widened (dilated) by the doctor to insert the hysteroscope.

  2. The hysteroscope is then inserted into the uterus through the vaginal tract and the cervix.

  3. The uterine cavity is expanded by the usage of carbon dioxide gas. The blood and mucus is then cleared. This is done once the hysteroscope is put into the uterine cavity.

  4. The hysteroscope light allows the doctor to see and diagnose the problem in the uterine cavity by observing the openings of the fallopian tubes (tubes through which the eggs travel from ovaries to the uterus).

Expectations after the procedure:

  1. You will have to be observed for a few hours before you are allowed to go home.

  2. Post-surgery vaginal bleeding or cramping is also common.

  3. In case carbon dioxide gas is used in the surgery, mild shoulder pain might be another botheration. However, it should subside within a day or two.

  4. It is also completely normal to feel slightly sick or even have a few bouts of fainting.

Certain complications which might require medical attention are:

  1. Heavy vaginal discharge or bleeding

  2. Acute fever

  3. Acute abdominal pain

In case you have a concern or query you can always consult an expert & get answers to your questions!

3734 people found this helpful

Uterine Bleeding - Can Hysteroscopy Help?

Motherhood 88% (259 ratings)
Speciality Birthing Care
Gynaecologist, Bangalore
Uterine Bleeding - Can Hysteroscopy Help?

Abnormal uterine bleeding, also known as AUB, is one of the most common causes requiring gynecologic evaluation. Hysteroscopy is a procedure wherein a thin camera called hysteroscope is introduced into the uterus via the vagina and this light helps in a thorough examination of the uterus. In cases where there are cysts or fibroids or even cancerous growths, this is used to get more details on the lesions. However, hysteroscopy also has a therapeutic use in that it is used to treat conditions like abnormal uterine bleeding. Read on to know more about AUB and how hysteroscopy helps in treatment. 

Causes of Abnormal Uterine Bleeding: Vaginal bleeding that occurs more often than 21 days and farther apart than 35 days is known as abnormal uterine bleeding. The bleeding is also abnormal if it lasts longer than 7 days and more than 80 mL of blood is lost during each cycle. 

Some causes include: 

  1. Hormonal imbalance 
  2. Cancer 
  3. Uterine polyps 
  4. Uterine fibroids 
  5. Cervical infections 

Diagnosis/Treatment: 

When a woman has abnormal bleeding, further diagnosis is required to confirm the exact cause of the bleeding. This is where the hysteroscopy comes into the picture. Hysteroscopy, literally translates to viewing the uterus from inside directly through a camera. 

How it is done: 

Hysteroscopy is done as an outpatient procedure and normally takes about 3 to 4 hours. General or spinal anesthesia may be used depending on complexity and overall patient health. The uterus is filled with a fluid like saline or glycerin and a thin lighted instrument called the hysteroscope is inserted through the vagina, up the cervix, and into the uterus. This tube is flexible and so can be moved across the uterus to identify any areas of abnormality. It also has a camera and so can be used to take pictures of suspicious areas. 

Causes for infertility may also be detected using hysteroscopy. Small knives can also be used to remove the lesion like fibroid or polyp. These are often the cause of abnormal bleeding. Samples can also be taken for biopsy to confirm if any cancerous growth is detected.

Hysteroscopy is a safe and effective way to examine the cervical canal and uterine cavity. It is better to accompany D&C with hysteroscopy instead of going for blind dilatation and curettage, especially in women who are peri or premenopausal. Hysteroscopy is a safe procedure if done by a doctor, specialised in gynecological endoscopy and helps in both diagnosis and treatment of abnormal uterine bleeding. In case you have a concern or query you can always consult an expert & get answers to your questions!

5675 people found this helpful

Why Go For Hysteroscopy In Case Of Uterine Bleeding?

Dr. Rashi Sinha 82% (140 ratings)
MBBS, MS, DNB, Rcog London
Gynaecologist, Muzaffarpur
Why Go For Hysteroscopy In Case Of Uterine Bleeding?

Abnormal uterine bleeding, also known as AUB, is one of the most common causes requiring gynecologic evaluation. Hysteroscopy is a procedure wherein a thin camera called hysteroscope is introduced into the uterus via the vagina and this light helps in a thorough examination of the uterus. In cases where there are cysts or fibroids or even cancerous growths, this is used to get more details on the lesions. However, hysteroscopy also has a therapeutic use in that it is used to treat conditions like abnormal uterine bleeding. Read on to know more about AUB and how hysteroscopy helps in treatment. 

Causes of Abnormal Uterine Bleeding: Vaginal bleeding that occurs more often than 21 days and farther apart than 35 days is known as abnormal uterine bleeding. The bleeding is also abnormal if it lasts longer than 7 days and more than 80 mL of blood is lost during each cycle. 

Some causes include: 

  1. Hormonal imbalance 
  2. Cancer 
  3. Uterine polyps 
  4. Uterine fibroids 
  5. Cervical infections 

Diagnosis/Treatment: 

When a woman has abnormal bleeding, further diagnosis is required to confirm the exact cause of the bleeding. This is where the hysteroscopy comes into the picture. Hysteroscopy, literally translates to viewing the uterus from inside directly through a camera. 

How it is done: 

Hysteroscopy is done as an outpatient procedure and normally takes about 3 to 4 hours. General or spinal anesthesia may be used depending on complexity and overall patient health. The uterus is filled with a fluid like saline or glycerin and a thin lighted instrument called the hysteroscope is inserted through the vagina, up the cervix, and into the uterus. This tube is flexible and so can be moved across the uterus to identify any areas of abnormality. It also has a camera and so can be used to take pictures of suspicious areas. 

Causes for infertility may also be detected using hysteroscopy. Small knives can also be used to remove the lesion like fibroid or polyp. These are often the cause of abnormal bleeding. Samples can also be taken for biopsy to confirm if any cancerous growth is detected.

Hysteroscopy is a safe and effective way to examine the cervical canal and uterine cavity. It is better to accompany D&C with hysteroscopy instead of going for blind dilatation and curettage, especially in women who are peri or premenopausal. Hysteroscopy is a safe procedure if done by a doctor, specialised in gynecological endoscopy and helps in both diagnosis and treatment of abnormal uterine bleeding.

5 people found this helpful
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