A hysteroscopy is a test to examine the inside walls of the uterus.
This test is able to detect scar tissue, polyps, fibroids, and any uterine abnormality such as a septate uterus, that may prevent an embryo from implanting properly. Having an abnormality in the uterus can also reduce the chances for pregnancy.
The procedure :
The hysteroscopy is usually done in the office and takes about 30 minutes. A speculum is inserted into your vagina (like when having a Pap smear). A local anesthetic (paracervical block) is given, and then a tiny telescope with a camera is placed through the cervix into the uterine cavity. Sterile salt water is instilled into the uterus so that the walls can be seen. The TV monitor connected allows you to visualize the inside of the cavity. We have the latest in office hysteroscopy equipment, including a 3.9 mm hysteroscope which results in significantly less discomfort.
Although some women feel some cramping, especially when the sterile salt water is instilled. Women with blocked fallopian tubes may feel more uncomfortable. Even though we are using the smallest hysteroscope available. We do recommend that one hour before the procedure you take 2-3 pills of regular ibuprofen or Diclofenac suppositories to help prevent or reduce cramps during the procedure.
Apart from this discomfort, occasionally vaginal spotting or bleeding may occur. This can be managed accordingly.
Indications for office hysteroscopy
I. Evaluation of abnormal uterine bleeding
- Premenopausal ovulatory bleeding
- Premenopausal anovulatory bleeding that fails medical therapy
- Post-menopausal bleeding
II Infertility Evaluation
- Routine Infertility
- Pre-IVF evaluation
- Abnormal hysterosalpingogram
- Recurrent miscarriage
- History of Asherman’s syndrome
III Location of intrauterine devices and foreign bodies
IV Preoperative evaluation
- Grade 0, I, II submucous myomata
- Asherman’s syndrome
- Septate uterus
- Evaluation of endoentrial hyperplasia and carcinoma
V Minor surgical procedure
- Endometrial polypectomy
- Tubal recanalization
- Tubal occlusion