Table of contents:
- Hysteroscopy Indication
- Hysteroscopy Alert
- Before Hysteroscopy
- Hysteroscopy Procedure
- After Hysteroscopy
- Hysteroscopy Complications
Hysteroscopy is a procedure to examine the condition of the neck and the inside of the uterus. This procedure can be used to diagnose diseases or causes of infertility and help treat abnormalities in the uterus
Hysteroscopy is performed using a hysteroscope, which is a thin, flexible tube with a camera at the end. The device is inserted into the uterus through the vagina, so the doctor can check the condition of the inside of the uterus through the monitor screen.
There are two types of hysteroscopy methods, namely diagnostic hysteroscopy and operative hysteroscopy. Diagnostic hysteroscopy is used to see the condition of the uterus. However, if an abnormality is found on examination that can be corrected immediately, this procedure becomes an operative hysteroscopy.
Doctors can perform hysteroscopy with the aim of:
- Find out the cause of abnormal vaginal bleeding, such as continuous menstruation or bleeding after menopause
- Investigating the causes of repeated miscarriages (at least 2 times in a row) or the causes of women having difficulty conceiving after 1 year of being pregnant
- Detects abnormal uterine tissue, such as scar tissue, fibroids, and uterine polyps
- Detect uterine or fallopian tube deformities
- Take a sample of suspected abnormal tissue (biopsy) for analysis in the laboratory
- Removing abnormal tissue in small uterus
- Repairing abnormalities at the end of the fallopian tube
- Removing an intrauterine device (IUD) that is difficult to remove manually
- Assisting with sterilization procedures, namely permanent contraception for women by closing the fallopian tubes
Patients with the following conditions are not allowed to undergo hysteroscopy:
- I'm pregnant, because it can trigger a miscarriage
- Suffering from cervicitis
- Suffering from cervical cancer
- Has a wide uterine cavity or a uterus length of more than 10 cm
- Experiencing very heavy bleeding in the uterus
- Suffering from pelvic inflammation
Before undergoing hysteroscopy, there are several things that patients need to pay attention to, namely:
- Ask the doctor whether fasting is necessary before the procedure.
- Avoid using douches, tampons, or medications that are inserted into the vagina.
- Inform your doctor if you are menstruating or if the hysteroscopy schedule coincides with your expected period.
- Tell your doctor about any medications, supplements, or herbal products you are currently taking.
- Invite relatives or family to drop off, pick up, and accompany you during and after the procedure.
- Take painkillers, such as ibuprofen or paracetamol, 1 hour before the procedure, if you are worried that the procedure will cause discomfort. However, consult your doctor first.
Before the procedure begins, the patient will be asked to remove all lower clothing. Next, the doctor will perform a hysteroscopy with the following steps:
- The patient will be asked to lie on his back with his knees bent and wide apart.
- The doctor may administer local anesthesia (the patient remains awake) or general anesthesia (the patient is asleep), depending on the patient's condition and how complicated the procedure is.
- The doctor will clean the patient's vagina with an antiseptic solution.
- The doctor will insert a speculum into the vagina to support the vaginal wall to keep it open.
- The doctor will slowly insert the hysteroscope through the vagina, then into the cervix, and finally into the uterine cavity. At this stage, the patient may experience discomfort or cramping as if he was menstruating.
- The doctor will insert sterile gas or liquid into the uterus, so that the uterus expands and the camera captures a clearer picture of the uterine cavity.
- The doctor will see and analyze the condition of the inside of the uterus through a monitor that is connected to the camera on the hysteroscope.
- If there is tissue that needs to be removed, either for surgery or a biopsy, the doctor will insert a special instrument through the hysteroscope to remove the tissue.
Hysteroscopy can take 15–60 minutes. The length of this procedure depends on what type of action was performed.
After the procedure is complete, the patient can go home immediately. However, the patient is advised to rest first in the treatment room for a few hours, until the effect of the anesthetic wears off.
For a few days after the procedure, the patient may experience mild cramping and bleeding. The doctor will give you painkillers to relieve the cramps you feel.
The results of the operative hysteroscopy and some diagnostic hysteroscopy can be immediately informed to the patient after the procedure is complete. However, for diagnostic hysteroscopy that requires a biopsy, the results are usually not available for 2-3 weeks after the procedure.
The following are some of the abnormalities that can be found on diagnostic hysteroscopy:
- Myomas, uterine polyps, or other abnormal growths, including endometrial cancer
- Scarring of the uterus, as in Asherman's syndrome
- The size or shape of the uterus is not normal
- blockage in the fallopian tube
The doctor will discuss the results of the hysteroscopy with the patient, especially if further treatment is needed to overcome the problems found. However, if no abnormalities are found on hysteroscopic examination, further examination may be needed to determine the cause of the patient's complaints.
Hysteroscopy is a safe procedure. However, in rare cases, this procedure causes complications such as:
- Infection in the uterus
- Damage to the uterus due to puncture or tear
- Damage to organs around the uterus, such as the bladder
- Allergic reaction to the liquid used during the procedure