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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

Popular Health Tips

Abnormal Uterine Bleeding - How Hysteroscopic Treatment Can Help?

MD - Obstetrtics & Gynaecology, MBBS, Diploma In Specialised Advanced Gynaecological Endoscopy
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: 

  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. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

3799 people found this helpful

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:

  1. HysterectomyHysterectomies involve the surgical removal of the entire uterus.

  2. 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.

  3. 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.

  4. 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.

  5. Uterine artery embolizationAlso 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.

  6. Anti-inflammatory painkillers. This type of drug is often effective for women who experience occasional pelvic pain or discomfort. In case you have a concern or query you can always consult an expert & get answers to your questions!

2407 people found this helpful

Infertility: Causes And Symptoms!

MS - Obstetrics and Gynaecology, MBBS
IVF Specialist, Dibrugarh
Infertility: Causes And Symptoms!

Infertility is a condition where a couple, trying to conceive in a natural way is not able to do so even after one year of trying. It is also a matter of worry for patients who are over the age of 35 years and those who are not able to conceive naturally even after 12 months of trying constantly.

Causes: There are many causes of infertility. It may be down to a condition present in one or both partners. Ovulation and fertilisation are the main elements of the conception process and any condition in the female or male can upset either function, which can make it difficult to conceive.

While abnormal sperm production and transport may be a common condition that leads to infertility in males, other factors like side effects of cancer treatments and too much exposure to toxins and chemicals can also play an important role in this regard. For females, the causes of infertility may range from ovulation disorders, uterine and fibroid tumours, uterine and cervical anomalies, damage to or blockage of the fallopian tubes, endometriosis, primary ovarian insufficiency and pelvic adhesions.

Infertility Symptoms in Women

In women, changes in the menstrual cycle and ovulation may be a symptom of a disease related to infertility. Symptoms include:

Treatment: Female patients can turn to medication that will stimulate ovulation, intrauterine insemination, and surgical processes to correct a uterine septum and remove endometrial polyps, or even a hysteroscopy surgery. Male patients can go through a treatment for any existing infections, hormonal injections and medication, surgical options like vasectomy reversal and art or assistive reproductive technology.

If these methods fail, the patient or the couple can always turn to methods like in vitro fertilisation. For other mild reasons, lifestyle changes along with a stress free environment can help in increasing the chances of conception. If you wish to discuss about any specific problem, you can consult a gynaecologist.

2371 people found this helpful

Complete Infertility Investigation - Why is It Important?

MBBS, DNB - Obstetrics and Gynecology, DGO
Gynaecologist, Delhi
Complete Infertility Investigation - Why is It Important?

While some couples conceive with ease, conceiving a child can be extremely difficult for others. In cases where a woman is not able to get pregnant despite having regular intercourse in tune with her biological cycle, infertility tests may be suggested to investigate the reason behind this. In most cases, these tests are suggested if a year has gone by without intercourse resulting in a pregnancy. Women may also be said to be infertile, if they cannot carry a foetus to full term.

Infertility can affect both men and women and can be triggered by a number of different reasons. In some cases, it is treatable while in others, alternative ways of having a family may need to be discussed. Hence, it is very important to understand the different types and triggers for infertility and to undergo complete infertility investigations. Some of the common types of infertility investigations are as given below.

  1. Blood tests: A blood test of both partners is used to assess the general health of the couple and to identify any health factors that may be impeding fertility.
  2. Tests for women: 
    1. Hysterosalpingogram: This is an X ray that can identify if a blockage or any other issue in the fallopian tubes are the cause for infertility.
    2. Pelvic ultrasound: This is used to have a look at the anatomy of the female reproductive system and to check for fibroids.
    3. Laparoscopy / hysteroscopyThis is used to get a clearer picture of the ovaries, uterus and other parts of the reproductive system.
    4. Tracking cycle: Ovulation and the thickness of the uterus lining may also affect infertility, This can be diagnosed by tracking and assessing the menstrual cycle.
  3. Tests for men
    1. Semen analysis:This test is used to get an idea of sperm concentration, motility and the appearance of sperm in a man’s semen. In some cases, the semen may not include any sperm cells. In such cases, a follow up investigation may be required to assess if sperm cells are being created in the testicles. This is known as testicular sperm aspiration or a testicular biopsy.
    2. Sperm DNA: The DNA in sperm also plays an important role in fertility. This test is used to assess the sperm DNA integrity and to see how it may affect embryo development and chances of an on-going pregnancy.

Infertility treatment depends on the cause identified by the above tests and hence it is important for both partners to undergo complete testing. If you wish to discuss about any specific problem, you can consult a gynaecologist.

3886 people found this helpful

Abnormal Uterine Bleeding - 3 Ways to Treat it!

MD, MBBS
Gynaecologist, Vadodara
Abnormal Uterine Bleeding - 3 Ways to Treat it!

Any kind of bleeding from the uterus, which is not normal, can be termed as abnormal uterine bleeding. This refers to bleeding between periods or before periods, bleeding after having sex, spotting, abnormally heavy bleeding or bleeding after attaining menopause. If you are suffering from any of these issues, you need to consult with the doctor. 

Diagnosis
It is very important to diagnose abnormal uterine bleeding. There are several examinations and tests that have to be carried out, depending on age. For irregular spotting, a pregnancy test can be undertaken in case you think you could be pregnant. If your uterine bleeding is very heavy, a test has to be performed to check blood count. This is done to observe whether you have anemia. An ultrasound test of the pelvic region will also be advised by your doctor to know the cause of the bleeding. Several hormonal tests and thyroid function tests are required as well.

Other diagnostic tests include:

  1. Sonohysterography: When fluid is placed within the uterus and ultrasound images of the uterus are taken. An image of the pelvic organs is obtained.
  2. HysteroscopyIt can be carried out when a device is inserted via the vagina and enables the doctor to examine the uterus internally.
  3. Magnetic resonance imaging: This is also used to get images of the organs.
  4. Endometrial biopsy:  It involves insertion of a catheter to take out a tissue which is microscopically observed. 

Treatment
There are different types of treatment for abnormal uterine bleeding depending upon factors such as the cause of bleeding and the age of the patient.

  1. Medications: Several medicines are used to treat abnormal uterine bleeding. Sometimes hormonal medicines are used. Birth control pills are also used to improve the regularity of periods. Hormonal infections, vaginal creams and an IUD device releasing hormone can be used. Non steroidal anti-inflammatory drugs are also used to control bleeding. Several antibiotics may also be prescribed.
  2. Surgery: In some cases of abnormal uterine bleeding, a woman has to undergo a surgery for the removal of growth such as polyps and fibroids, which results in bleeding. While some fibroids can be removed via hysteroscopy, others require different techniques for treatment.
  3. Endometrial ablation: It can be undertaken to control bleeding. This mode of treatment aims at reducing the bleeding permanently. In case all treatment methods fail, hysterectomy has to be carried out. This is a serious surgery and after it is performed, a woman does not have periods anymore and will not be able to conceive a child.

Abnormal uterine bleeding is a serious health condition, which may lead to severe complications. Immediate diagnosis and appropriate treatment methods should be undertaken in case of any abnormal uterine bleeding.

2639 people found this helpful

Popular Questions & Answers

I am 25 years old. Sometimes when I go to the toilet I feel my vaginal tube is coming outside about half an inch. It is in round shape. But it goes back.

MD - Obstetrtics & Gynaecology, FCPS, DGO, Diploma of the Faculty of Family Planning (DFFP)
Gynaecologist, Mumbai
Most of medical challanges need doctor to listen to detailed medical history in form of questions and answers, examination of patient and sometimes reports so meet concerned doctor.-Gynecologist.
1 person found this helpful

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.

I have undergone laparoscopy and hysteroscopy on 17th August then my menses came on 24th august. But before operation my last menses was on 29th july, now the issue is this month my menses date will be which one? And till now i.e today 25th September I am not having my menses? Please awaiting of a answer. Thank you.

MD - Obstetrtics & Gynaecology, FMAS, DMAS, Fellowship in Assisted Reproductive technology, MBBS Bachelor of Medicine and Bachelor of Surgery
Gynaecologist, Noida
Hello, Menses can be delayed due to stress induced hormonal imbalances, however its best you rule out pregnancy first with a home pregnancy test.

Table of Content

What is the treatment?
How is the treatment done?
Who is eligible for the treatment? (When is the treatment done?)
Who is not eligible for the treatment?
Are there any side effects?
What are the post-treatment guidelines?
How long does it take to recover?
What is the price of the treatment in India?
Are the results of the treatment permanent?
What are the alternatives to the treatment?
Play video
Laparoscopy and Hysteroscopy
Difference Between Laparoscopy and Hysteroscopy Surgery
Play video
Infertility Treatment
Treatment of Infertility by Laparoscopy and Hysteroscopy

I am Dr. Vishakha Munjal. I am a laparoscopy surgeon and infertility specialist. Today, I am going to talk about the role of laparoscopy and hysteroscopy in treating infertility.

Today, infertility has almost become an epidemic. This is because of multiple reasons like late marriages, late planning of pregnancy, various diseases like tuberculosis and pelvic infections which affect the fallopian tubes and cause their blockages. Then there is a certain disease like Endometriosis and fibroids which are at times the reason for infertility. These days lifestyle changes and an increase in stress level is also one of the reasons for ovulatory dysfunction and decreased sperm count. Couples facing infertility should consult an experienced gynecologist to understand the reason for infertility and how best it can be solved. Laparoscopic and Hysteroscopic surgeries can greatly help in diagnosing as well as many factors of infertility, thus, helping a woman to conceive naturally. Also, certain conditions like fibroids, endometriosis, and tubal factors need to be treated prior to IVF to increase the success rate of IVF else the woman will undergo multiple cycles of IVF and will get no results. So, it is very important to treat disease prior undergoing IVF.

The major Fertility Enhancing Surgery is Fibroid Removal, which is also called Myomectomy. Almost, any size of the fibroid can be taken care of laparoscopically. Compared to an open surgery, Laparoscopic Myomectomy has lesser blood loss and leads to lesser addition formation. It is also less painful for the patients. Patients can return back to work more quickly and they can plan for pregnancy also more quickly. Then, there is Endometriosis which is a chronic painful condition which causes severe pain during periods and during sex along with fertility. It is one of the major reasons for infertility in today s age. It is also associated with cyst formation at times which is called the chocolate cyst. Laparoscopy is a gold standard for treating Endometriosis. After Endometriosis, a woman gets not only relieve her pain but also she is able to conceive quickly. Then there are variances which are a hindrance for conception. Any size of the ovarian cyst can be treated laparoscopically.

First of all, get a histopathological diagnosis to rule out any malignancy in the cist as well as we remove the hindrance which is coming in the way of conception. Then, talking about tubal factors, tubal blockage at any level can be treated laparoscopically and if the blockage is at the starting of the fallopian tube then there are very fine cannulas available along with guide wires available which we used to cannulate the fallopian tubes and this can be done very effectively and it increases the chances of conception naturally. Now, let me talk about hysteroscopy. Well, hysteroscopy is a small telescope which is passed into the uterine cavity to see the cavity from inside for any pathology and to see the opening of the fallopian tube. Certain factors like presence of a fibroid, a polyp, a polyp is a sort of growth inside the uterine cavity, a septum which is like a wall causing a partition inside the uterine cavity. They all can be removed hysteroscopic ally, once this thing is removed hysteroscopic ally, the chances of the conception of a woman in creases greatly. All in all laparoscopy and hysteroscopy are a boon for infertility management. Laparoscopy is technically as much superior procedure than an open surgery. Since it is done through small punctures it is cosmetically very appealing, it causes less pain, less blood loss, less hospital stay, early recovery and early return to work for a patient.

If you wish to contact me for any laparoscopic enhancing surgery or infertility related problems, you can contact me at MediClinic, E16 Lajpat Nagar 3. Thank you.
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