Southwest Florida's Health and Wellness Magazine Health and Wellness Articles
By Joseph Gauta, MD, FACOG
What is a hysteroscopy?
Hysteroscopy is a procedure that can be used to both diagnose and treat causes of abnormal bleeding. The procedure allows your doctor to look inside your uterus with a tool called a hysteroscope. This is a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus. Hysteroscopy can be a part of the diagnosis process or an operative procedure.
What is diagnostic hysteroscopy?
Dr. Gauta normally performs a diagnostic hysteroscopy in the office. The patient receives analgesia so they will be comfortable during the test. It is used to diagnose conditions such as abnormal uterine bleeding, adhesions, fibroids, polyps or to locate displaced intrauterine devices IUDs.
One of the newest technologies he uses in the office and in conjunction with the hysteroscope is RESECTRTM. RESECTR allows Dr. Gauta to gently remove and eliminate intrauterine fibroids without the need to remove or even cut the uterus and without harming your uterine lining. This is especially important if you want to have children in the future. The procedure is performed under local analgesia and most patients experience only mild to moderate cramping. Patients go home the same day and on average, a 3 cm fibroid (about the size of a grape) can be removed in approximately 10 minutes.
What is operative hysteroscopy?
Operative hysteroscopy is used to correct an abnormal condition that has been detected during a diagnostic hysteroscopy. If an abnormal condition was detected during the diagnostic hysteroscopy, an operative hysteroscopy can often be performed. Many conditions can be treated in the office using advanced technologies such as RESECTR which eliminates the need for a second visit and is a cost savings to the patient.
The time it takes to perform a hysteroscopy can range from less than five minutes to more than an hour depending on your specific condition. If an operative hysteroscopy is required Dr. Gauta will determine if it should be done in the office or surgery center. The choice is yours however where you would like your procedure done.
When is operative hysteroscopy used?
Your doctor may perform a hysteroscopy to correct the following uterine conditions:
• Polyps and fibroids: Hysteroscopy is used to remove these non-cancerous growths found in the uterus.
• Adhesions: Also known as Asherman’s Syndrome, uterine adhesions are bands of scar tissue that can form in the uterus and may lead to changes in menstrual flow as well as infertility. Hysteroscopy can help your doctor locate and remove the adhesions.
• Septums: Hysteroscopy can help determine whether you have a uterine septum, a malformation (defect) of the uterus that is present from birth.
• Abnormal bleeding: Hysteroscopy can help identify the cause of heavy or lengthy menstrual flow, as well as bleeding between periods or after
menopause. Endometrial ablation is one procedure in which the hysteroscope, along with other instruments, is used to destroy the uterine lining in order to treat some causes of heavy bleeding.
When should hysteroscopy be performed?
Your doctor may recommend scheduling the hysteroscopy for the first week after your menstrual period. This timing will provide the doctor with the best view of the inside of your uterus. Hysteroscopy is also performed to determine the cause of unexplained bleeding or spotting in postmenopausal women.
How is hysteroscopy performed?
Prior to the procedure, your doctor may prescribe a sedative to help you relax. You will then be given analgesia appropriate for where you are having the procedure done. The procedure itself takes place in the following order:
• The doctor will dilate (widen) your cervix to allow the hysteroscope to be inserted.
• The hysteroscope is inserted through your vagina and cervix into the uterus.
• Carbon dioxide gas or a liquid solution is then inserted into the uterus, through the hysteroscope, to expand it and to clear away any blood or
mucus.
• Next, a light shone through the hysteroscope allows your doctor to see your uterus and the openings of the fallopian tubes into the uterine
cavity.
• Finally, if surgery needs to be performed, small instruments are inserted into the uterus through the hysteroscope.
What can I expect after a hysteroscopy?
Most patients require nothing more than tylenol or ibuprofin to help with mild cramping.
Florida Bladder Institute
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