Hysteroscopy
There are two main types of hysteroscopy that a patient may encounter: diagnostic hysteroscopy and operative hysteroscopy. Both use a hysteroscope (a fibre optic mini telescope) used for observing the interior of the uterus.
Diagnostic hysteroscopy
Diagnostic hysteroscopy is a simple procedure used to inspect the inside of the uterus and detect abnormalities such as: polyp, adhesions, fibroids and uterine septum (a piece of tissue dividing the cavity of the uterus). The diagnostic hysteroscopy procedure can be performed as an outpatient procedure. No anesthetic is usually required but some times a local anesthetic is injected into the neck of the womb.
A speculum is inserted into the vagina to visualize the cervix, which is then cleaned from any discharge. A fine fibre-optic telescope about the same thickness as a pencil is then inserted through the cervix into the uterus. Either carbon dioxide gas or fluid is used to distend the cavity of the womb in order to get a clear view of the cavity.
Hysteroscopy showing normal uterine cavity
Hysteroscopy showing normal ostia (opening) of the Fallopian tube
Operative hysteroscopy
If an abnormality is confirmed at the time of diagnostic hysteroscopy e.g. septum or adhesions, and it has been discussed and agreed before with the patient; it can be surgically treated by operative hysteroscopy at the same time. This is usually performed under a general anesthetic. If surgery is carried out the patient may stay overnight.
The operative hysteroscopy procedure is very similar to diagnostic hysteroscopy except that operating instruments such as a pair of fine scissors or biopsy forceps can be placed into the uterine cavity through a special channel in the operative hysteroscope.
Many women can have laparoscopy and/or hysteroscopy with no complications. However, possible complications include: infection, making a hole through the uterus, injury to internal organs and bleeding. After hysteroscopy the patient may experience some discomfort, with period like cramps and vaginal staining for few days.