Hysteroscopy; is a procedure in which the inside of the uterus is visualized through the vaginal route without making any incision, with the help of a thin tube (hysteroscope) that has an illuminated camera at its tip. If hysteroscopy is to be used only for diagnostic purposes, it is performed using narrower cameras and is called Diagnostic Hysteroscopy.
✓How is Hysteroscopy Performed and Who Is It Applied To?
The hysteroscopy procedure is performed through the vaginal route, so it leaves no marks on the abdomen. During the procedure, the uterus is inflated with special fluids and a clear view is provided with a camera. This method is ideal for those experiencing unexplained infertility, those with recurrent IVF failures, those with abnormal bleeding, or those with suspicious masses seen on ultrasound.
✓Some diseases in which hysteroscopy is used as a basic treatment tool
Removal of abnormal tissue inside the uterus such as polyps and submucosal fibroids,
✓Opening of intrauterine adhesions, also called Asherman syndrome,
✓Cutting and opening of intrauterine septum,
✓Investigation of abnormal intrauterine bleeding and treatment by burning it with a method called tissue ablation.
✓What is hysteroscopy used for?
Before hysteroscopy, it was not possible to visualize problematic tissue inside the uterus. With curettage, an attempt was made to blindly remove tissue within cannulas. Curettage is considered a technique with lower success chances compared to hysteroscopy.
✓Bleeding caused by millimetric fibroids under the endometrium tissue in the uterus could not be prevented with curettage. Hysteroscopy provides very easy access to fibroids and polyps embedded in the uterine wall and offers treatment options.
✓With additional instruments attached to the hysteroscope, fibroids and polyps can be safely removed from the uterine wall area where they are located.
✓Before hysteroscopy, intervention was not possible for congenital anomalies such as uterine septum that negatively affect reproduction and pregnancy continuation. Today, these problems can be corrected with a 20-25 minute hysteroscopic procedure.
✓IUDs embedded in the uterus or with broken strings are visualized hysteroscopically and safely removed.
✓Untreated or treatment-resistant vaginal bleeding used to necessitate removal of the uterus. Today, many women have been prevented from losing their uterus through hysteroscopy.
✓How is hysteroscopy performed?
The correct timing for hysteroscopy is the first week after the end of your period. During this period, the uterine tissue called endometrium has not yet thickened, so the inside of the uterus can be visualized more easily.
✓If the hysteroscopy procedure will be performed while awake, sedative medications are recommended to provide relaxation before the procedure. If the procedure will be performed under general anesthesia, sedatives are not necessary.
✓During the hysteroscopy procedure, in order:
The patient is placed on a gynecological examination table, and the cervix is visualized in the vagina using an examination instrument called a speculum.
✓The cervix is dilated and the hysteroscope is inserted into the uterus.
✓Volume-expanding solutions are introduced into the uterus to obtain a clear image from inside the uterus.
✓The light source illuminating the inside of the uterus allows visualization of the fallopian tube openings and possible pathologies.
✓If surgical intervention is needed, some additional cutting and bleeding control devices are attached to the hysteroscope.
✓Hysteroscopy duration is 5-10 minutes for diagnostic purposes and about 20-25 minutes for operative or surgical procedures. If laparoscopy is additionally planned, the total procedure time may be extended.
✓Diagnostic (Office) Hysteroscopy
Performed for the purpose of observing and evaluating only the inside of the uterus. Most of the time it does not require anesthesia; mild menstrual cramps may be felt.
✓Operative Hysteroscopy
If during the hysteroscopy procedure we perform the procedure for treatment purposes using additional cutting and bleeding prevention devices attached to the telescope entering the uterus, this procedure is called operative hysteroscopy. In this procedure, a wider diameter optic is used compared to diagnostic procedures.
✓Hysteroscopy Followed by IVF
After hysteroscopy, IVF applications have become a common routine with the use of hysteroscopy following failed embryo transfers. Many IVF specialists prefer to evaluate the uterus with a camera before placing the embryo in the uterus.
✓Menstruation After Hysteroscopy
After hysteroscopy, since fluid is used in the procedure, some bleeding and spotting continues. Irregular menstruation can be expected in the month hysteroscopy is performed. Subsequently, with the completion of treatment, normalization of the menstrual cycle is expected.
How Long Does Hysteroscopy Surgery Take?
If hysteroscopy is performed as a diagnostic procedure, it takes 5-10 minutes, and if it is performed as operative hysteroscopy for surgical treatment purposes, it takes 20-25 minutes.
Is Hysteroscopy Dangerous?
With increasing clinical experience, hysteroscopy has ceased to be a dangerous procedure in the hands of surgeons trained in this field. However, it is recommended that the procedure be performed in centers that have the capability for rapid conversion to laparoscopy and have intensive care facilities.
Will I Feel Pain During the Procedure?
Office hysteroscopy is generally felt like mild period cramps and often does not require anesthesia. In operative procedures, since anesthesia is applied, you will not feel any pain.
When Can I Get Pregnant After Hysteroscopy?
Generally, pregnancy attempts can begin in the first menstrual cycle following simple procedures. In cases such as adhesion lysis or septum surgery, your doctor may recommend that you wait 1-2 months.
What Are Hysteroscopy Prices?
Prices vary depending on whether the procedure will be office-based or operative, the experience of the selected doctor and the clinic's pricing policy, the type of anesthesia to be used, and the size of the pathology to be removed (fibroid, polyp). A consultation is required for definitive information.
