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Overview

Hysteroscopy - Treatment, Procedure And Side Effects

What is the treatment?

Hysteroscopy can be defined as an inspection of the cavity in the uterus with the help of endoscopy. It is accessed through the cervix. It is done for the diagnosis of the intrauterine pathology and serves as a way of surgical intervention as well. It is executed through the endoscope which carries light and optical fibres. The hysteroscope is introduced like a sheath providing an inflow as well as outflow channel to insufflate the uterine cavity. Sometimes, operative channels are also used for introducing necessary equipment like scissors, biopsy tools and graspers. The method of hysteroscopic resectoscope works like transurethral resectoscope and allows access to the electric hook for shaving off unwanted tissue such as fibroids inside the uterus. The diagnostic hysteroscopy is the most accepted and the most preferred way of diagnosing the problems present in the uterus. It is often used in close conjunction with other procedures including dilation and curettage or laparoscopy. There are two variants of hysteroscopy, namely, the diagnostic hysteroscopy and the operative hysteroscopy. Operative hysteroscopy is used for treating the problems of the uterus.

How is the treatment done?

There are two variants of hysteroscopy- one is operative, and the other is diagnostic. In the case of diagnostic hysteroscopy, the gynaecologist inserts a slender tube with a fitted camera into the abdomen for viewing the uterine cavity. It is also performed for ensuring the results of other tests including HSG (hysterosalpingogram). If the gynaecologist finds any abnormalities while performing the diagnostic hysteroscopy, he may proceed to correct it through operational hysteroscopy. In this method, miniature tools are used for correcting the condition. The anaesthesia used for the process comes in three forms: local, regional and general anaesthesia. In the case of the local anaesthesia, a small part of the body is numbed for a short time while regional anaesthesia helps in numbing the body for hours together. The process of hysteroscopy does not involve any cuts or sutures in the abdomen or any other region, and it doesn’t take much time to complete it. But you may have to be in the operation theatre for some hours for recovery. The expert may also choose to opt for general anaesthesia if other processes are performed along with the hysteroscopy where the patient must not feel anything for the whole procedure.

Who is eligible for the treatment? (When is the treatment done?)

Your doctor may consider you eligible candidate for the hysteroscopy treatment if you have fibroids and polyps in the uterus, adhesions, septums and abnormal bleeding. The hysteroscopy can be used for the removal of a non-cancerous growth in the uterus. In some instances, the doctor may also choose to remove it through operational hysteroscopy. Hysteroscopy can help the doctor to determine if there are any adhesions in the uterus and remove them. These adhesions are a group of scar tissue which forms in the uterus and paves the way for abnormal menstrual flow and infertility.

Who is not eligible for the treatment?

Even though there are several benefits of the hysteroscopy treatment, it may not be for all. There are several factors that play a role in determining whether the treatment would be suitable for a particular patient or not. Thus, it is always recommended to consult with a reputed gynaecologist who can evaluate your condition and determine whether the hysteroscopy treatment is right for your or whether you must look for some other alternatives.

Are there any side effects?

If the regional or general anaesthesia is given during the process, then the patient would be observed for several hours before releasing from the healthcare facility. It is common to have slight cramping and even vaginal bleeding after the process is completed and it can last for up to 2 days. If gas was used during the process, then you may also experience some pain in your shoulder. Some patients also feel fatigued and sick after undergoing hysteroscopy, and it is normal. But you must immediately call your doctor if you see symptoms like fever, unbearable pain in the abdomen and heavy vaginal discharge.

What are the post-treatment guidelines?

Hysteroscopy is a relatively safe procedure, but there is always a probability of certain complications. That is why it is always important to stick to the guidelines instructed by the gynaecologist. You will have to stay in the hospital for at least 4 hours after the treatment. You can start taking meals and drinks right after the treatment and take shower the same day of the treatment. But it is important to avoid having sex for a week or so or until the vaginal bleeding stops. Your doctor would tell you the results of the treatment if they have found anything unusual while diagnosing.

How long does it take to recover?

It is always recommended to take rest whenever you can. The side effects including cramps and vaginal discharge are normal, but you should seek your doctor’s attention immediately if they become unbearable. It is important to consult with the doctor if you feel shortness of breath, nausea, severe pain in the pelvic region. Most women report that they can return to their normal activities the day following hysteroscopy treatment. But you may need to take rest for a few days if you have undergone removal of fibroids.

What is the price of the treatment in India?

The exact cost of the diagnosing hysteroscopy cannot be assessed as it depends on several factors. But it is fairly affordable and costs about Rs. 20,000. However, it can vary according to the quality of the treatment offered at the healthcare facility, your individual health condition, and other factors. For more information, your doctor would be able to guide you better.

Are the results of the treatment permanent?

What are the alternatives to the treatment?

Like all other treatments, hysteroscopy also has some alternatives. For instance, your doctor can take a small sample of the lining of the uterus to find out if there are any abnormalities. Also, ultrasound scans help in offering an insight to the uterus of the patient. But you should note that there are certain conditions which can only be diagnosed and cured through hysteroscopy and thus, you must consider it.

Safety: Medium Effectiveness: High Timeliness: Medium Relative Risk: Medium Side Effects: Medium Recovery Time: Medium Price Range: RS. 20,000

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Diagnostic Tests Females

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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.

11 Most Common Types of Endoscopy!

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11 Most Common Types of Endoscopy!
A cut on your skin can be seen by the naked eye, but injuries and infections to internal organs are not so easily visible to the eye. The procedure to view and operate on the body s internal organs is known as an endoscopy. An endoscopy is performed using a flexible tube with a camera attached at one end known as an endoscope. This is inserted into the body though a natural opening in the body such as the mouth or through a small incision on the body. While the camera gives the doctor a view of the internal organs, forceps or a pair of scissors can be used to operate or remove tissue that needs to be biopsied. Since an endoscopy is performed without making large incisions, it negates the development of scarring. Types of Endoscopies Endoscopies can be used for both diagnostic and therapeutic purposes. It is also one of the means for early detection of cancer. There are 11 main types of endoscopies which include: Arthroscopy: This is used to get a closer look at joints. In such cases, the endoscope is inserted into a small incision near the joint being examined. Upper gastrointestinal endoscopy: Examining the esophagus and upper intestinal tract by inserting a scope through the mouth is known as an upper gastrointestinal endoscopy. Colonoscopy: In this procedure, a scope is inserted through the anus to get a view of the colon. Bronchoscopy: This procedure is used to examine a patient s lungs. It involves the insertion of a scope into the nose or mouth to give a view of the lungs. Cystoscopy: When the bladder needs to be examined closely, an endoscope is inserted through the urethra. This is known as a cystoscopy. Enteroscopy: This is a procedure where the scope is inserted through the mouth or anus to get a look at the small intestines. Hysteroscopy: Here a scope is inserted through the vagina to get a look at the inside of the uterus. Laparoscopy: It is an endoscopy to examine the abdominal area is known as a laparoscopy. This scope is inserted through an incision in the abdomen. Laryngoscopy: This type of endoscopy involves inserting a scope through the mouth or nose to examine the voice box. Mediastinoscopy: By inserting a scope into an incision above the breastbone, doctors can get a look at the area between the lungs. This is known as a mediastinoscopy. Ureteroscopy: This procedure is used to examine the patient s ureter by inserting a scope through the urethra.
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Abnormal Uterine Bleeding - How Hysteroscopic Treatment Can Help?

Dr. Vaishali Sharma 92% (167 ratings)
MD - Obstetrtics & Gynaecology, MBBS
Gynaecologist, Delhi
Abnormal Uterine Bleeding - How Hysteroscopic Treatment Can 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: Hormonal imbalance Cancer Uterine polyps Uterine fibroids 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.
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Know Everything About Fibroid

FRCOG (LONDON) (Fellow of Royal College of Obstetricians and Gynaecologists), CCT (Lon), DNB (Obstetrics and Gynecology), MD
Gynaecologist, Mumbai
Know Everything About Fibroid
Fibroids are the most frequently seen tumors of the female reproductive system. Fibroids, also known as uterine myomas, leiomyomas, or fibromas, are firm, compact tumors that are made of smooth muscle cells and fibrous connective tissue that develop in the uterus. It is estimated that between 20 to 50 percent of women of reproductive age have fibroids, although not all are diagnosed. Some estimates state that only about one-third of these fibroids are large enough to be detected by a doctor during a physical examination. In more than 99 percent of fibroid cases, the tumors are benign (non-cancerous). These tumors are not associated with cancer and do not increase a woman's risk for uterine cancer. They may range in size, from the size of a pea to the size of a softball or small grapefruit. Causes: While it is not clearly known what causes fibroids, it is believed that each tumor develops from an aberrant muscle cell in the uterus, which multiplies rapidly because of the influence of estrogen. Risk Factors: Age: Women who are approaching menopause are at the greatest risk for fibroids because of their long exposure to high levels of estrogen. Obesity Race: African-American heritage also seems to be at an increased risk, although the reasons for this are not clearly understood. Parity: Some studies, of small numbers of women, have indicated that women who have had two liveborn children have one-half the risk of developing uterine fibroids compared to women who have had no children. Scientists are not sure whether having children actually protected women from fibroids or whether fibroids were a factor in infertility in women who had no children. Symptoms: Some women who have fibroids have no symptoms, or have only mild symptoms, while other women have more severe, disruptive symptoms. The following are the most common symptoms for uterine fibroids: Heavy or prolonged menstrual periods Abnormal bleeding between menstrual periods Pelvic pain (caused as the tumor presses on pelvic organs) Frequent urination Low back pain Pain during intercourse A firm mass, often located near the middle of the pelvis, which can be felt by the doctor on examination In some cases, the heavy or prolonged menstrual periods, or the abnormal bleeding between periods, can lead to iron-deficiency anemia, which also requires treatment. Diagnosis: Fibroids are most often found during a routine pelvic examination. This, along with an abdominal examination, may indicate a firm, irregular pelvic mass to the physician. In addition to a complete medical history and physical and pelvic and/or abdominal examination, diagnostic procedures for uterine fibroids may include: Transvaginal ultrasound (also called ultrasonography). An ultrasound test using a small instrument called a transducer, that is placed in the vagina. Magnetic resonance imaging (MRI). A non-invasive procedure that produces a two-dimensional view of an internal organ or structure. Hysterosalpingography. X-ray examination of the uterus and fallopian tubes that use dye and is often performed to rule out tubal obstruction. Hysteroscopy. Visual examination of the canal of the cervix and the interior of the uterus using a viewing instrument (hysteroscope) inserted through the vagina. Blood test (to check for iron-deficiency anemia if heavy bleeding is caused by the tumor). Treatment: Since most fibroids stop growing or may even shrink as a woman approaches menopause, the doctor may simply suggest "watchful waiting." With this approach, the doctor monitors the woman's symptoms carefully to ensure that there are no significant changes or developments and that the fibroids are not growing. In women whose fibroids are large or are causing significant symptoms, treatment may be necessary. Treatment will be determined by the doctor based on: Your overall health and medical history Extent of the disease Your tolerance for specific medications, procedures, or therapies Expectations for the course of the disease Your opinion or preference Your desire for pregnancy In general, treatment for fibroids may include: Hysterectomy. Hysterectomies involve the surgical removal of the entire uterus. Conservative surgical therapy. Conservative surgical therapy uses a procedure called a myomectomy. With this approach, physicians will remove the fibroids, but leave the uterus intact to enable a future pregnancy. Gonadotropin-releasing hormone agonists (GnRH agonists). This approach lowers levels of estrogen and triggers a "medical menopause." Sometimes GnRH agonists are used to shrink the fibroid, making surgical treatment easier. Anti-hormonal agents. Certain drugs oppose estrogen (such as progestin and Danazol), and appear effective in treating fibroids. Anti-progestins, which block the action of progesterone, are also sometimes used. Uterine artery embolization. Also called uterine fibroid embolization, uterine artery embolization (UAE) is a newer minimally-invasive (without a large abdominal incision) technique. The arteries supplying blood to the fibroids are identified, then embolized (blocked off). The embolization cuts off the blood supply to the fibroids, thus shrinking them. Health care providers continue to evaluate the long-term implications of this procedure on fertility and regrowth of the fibroid tissue. Anti-inflammatory painkillers. This type of drug is often effective for women who experience occasional pelvic pain or discomfort.
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Popular Questions & Answers

I had positive pregnancy test and then periods which I took to be miscarriage. Doctors at aiims have asked me to prepare for hysteroscopy. How painful is hysteroscopy. Is there any option.

B.H.M.S
Homeopath, Mehsana
Pls. Remove it and than do the torch profile, usg abdomen, cbc and urine r m blood report its viral and bactarial infection inthe body that will also disturb next preg also. Repeat the same thing.

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