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What is Hysteroscopy and How is it Performed?


What is hysteroscopy?

In the hysteroscopy method, the uterus is generally entered using a thin tube-shaped lens system. This method is used for diagnostic purposes or visually for surgical procedures. The image of the patient's uterus can be easily viewed on a small monitor. This tube-shaped tool, which is mostly composed of a lens system or camera system that is entered into the uterus, is called hysteroscopy. In particular, the hysteroscopy method can be applied under local anesthesia in the examination environment or under general anesthesia in the operating room environment and with spinal anesthesia. The hysteroscopy method is usually performed within a week after the patient's menstrual period ends; because this period is the most suitable for viewing the inside of the uterus.


Diagnostic hysteroscopy: It is also used to monitor and diagnose pathologies such as myomas , adhesions, and septums that occur inside the patient's uterus. In addition, this method is sometimes performed alone or together with laparoscopy.


In which cases is hysteroscopy performed for diagnostic purposes?

  • If there is excessive and irregular menstrual bleeding,

  • In cases of infertility ,

  • In cases of repeated miscarriages ,

  • If the patient is suspected of having an adhesion in the uterus,

  • If the presence of polyps or myomas is observed in the patient's uterus with ultrasound,

  • It is performed if the patient has an IUD that has not been removed or has become displaced inside the uterus.


For surgical purposes (operative) hysteroscopy: It is generally used to cut and remove polyps, myomas or other lesions that occur inside the patient's uterus or to open adhesions that have formed. The hystroscopy method can also be used with hysteroscopy to perform "endometrial ablation".


What are the risks of hysteroscopy?

Hysteroscopy is usually a very safe procedure. However, in rare cases, complications such as perforation of the uterus (uterine bleeding), injuries to the cervix, infections in the uterus, and sometimes anesthesia-related complications may occur.


How is hysteroscopy performed?

In general, before the hysteroscopy method is performed on the patient, sometimes the cervix needs to be opened. In this case, the patient is given medication to be placed orally or into the vagina. The hysteroscopy method can mostly be performed in the gynecological examination position and with spinal or general anesthesia. In order for the cervix to be opened sufficiently for the hysteroscopy to pass, it may be necessary to dilate it with the help of a long and thin rod called a bougie. In the next procedure, the hysteroscope passes through the patient's cervix and moves into the uterus. During this time, it can be easily watched in the image reflected on the monitor. In addition, fluid is injected into the patient's uterus so that the inside of the uterus can be better dilated and observed. In fact, surgery can be performed with the burning or cutting tool on the tip of the hystroscope in necessary cases. The patient can be discharged home a few hours or a day after the hysteroscopy application. In addition, a small amount of bleeding and classic pain in the form of cramps occur for a day or two.

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