What is Hysteroscopic surgery?

Hysteroscopic surgery is a minimally invasive surgical procedure which uses a hysteroscope that aids to examine the interior of the uterus along with the cervical canal. The hysteroscope is inserted via the vagina and then into the cervical opening which allows visualizing interiors of the uterus, in addition to direct examination of the cervical canal, and vagina. Hysteroscopic surgery can either be operative or diagnostic.

Why is Hysteroscopic surgery performed?

Hysteroscopic surgery is used for diagnosis and treatment and is performed by a gynecologist under short general anesthesia. This procedure can be done to:

• Explore the cause of abnormal bleeding or severe cramping
• Discover the reason for repeated miscarriages
• Look at the uterine openings to the fallopian tubes, for which a dye test can be performed to see for tubal blockage under a laparoscopic vision.
• Find and remove small polyps or fibroids
• Aids to pinpoint the location of abnormalities in the uterine lining for sampling and biopsy

How to prepare for Hysteroscopic surgery?

Not much preparation is required for Hysteroscopic surgery. The doctor might give certain guidelines to be followed before the test is performed.

• The doctor will explain the technique and give an opportunity to ask any questions regarding the technique.
• Consent will be taken to ensure the patient’s approval to perform the technique.
• Further to an absolute medical history, the doctor might perform a complete physical examination to make sure that the patient is in good health before undergoing the procedure. One might also need to undergo other diagnostic tests or blood tests.
• The doctor must be informed about any allergies to any medication like aesthetic drugs. Notify the doctor about pregnancy if any.
• Notify the doctor about any bleeding problems or if taking any blood-thinners like warfarin or aspirin
• Notify the doctor about any treatment for a cervical, vaginal, or pelvic infection in the past 6 weeks
• Notify the doctor about any lung or heart problems if any.
• Do not douche, use vaginal medicines, or use tampons for 24 hours before the hysteroscopy.
• Always come assisted by someone for the procedure.

How is the procedure performed?

• General anesthesia will be administered to make the procedure comfortable and relatively painless
• The procedure is scheduled on the day when the patient is not menstruating.
• To dilate the cervix, medication may be given prior to the surgery.
• The procedure begins with the insertion of a speculum into the vagina.
• Followed by this, the hysteroscope is inserted and moved carefully through the cervix into the uterus.
• To expand the uterine space, carbon dioxide gas or saline (salt water) is pumped.
• The inner lining of the uterus and openings of the fallopian tubes can be clearly observed through the hysteroscope.

What are the precautions that need to be taken after the procedure?

• The patient will be discharged from the hospital on the day of the procedure itself.
• If general anesthesia is not administered, one can drive back home and resume normal activities
• One may experience cramping for a few days post-procedure which can be ameliorated by using over-the-counter painkillers
• Spotting of bleeding may occur in the first week of the procedure, which is a normal occurrence. It is preferable to avoid the use of tampons as it can lead to infection of the cervix
• There are no restrictions on the diet. Avoid any sexual activity for a week or till the bleeding stops.
• Seek immediate medical attention if:
  • Severe pain is persistent and regular painkillers have failed to reduce the pain
  • Heavy bleeding occurs
  • Blood clots with bleeding
  • High fever
  • Foul smelling discharge from the vagina