It is a procedure done to visualise the uterine cavity (uterus from inside). A thin telescope is put inside the uterus from the vagina. The inside of the uterus can then be visualised (image displayed on a monitor) and if a pathology / disease like septum, fibroid, polyp is detected, it can be simultaneously removed. An endometrial tissue sample (lining of the uterus) can be obtained and send for histopathology (for microscopic examination).
This procedure is done under general anaesthesia. There are very thin hystetoscopes/telescopes available which can be used for out patient hysteroscopy in the opd (mainly to diagnose).
Hysteroscopy is also done many a times before an ivf cycle, to do endometrial scratching or to asses any intrauterine pathology noted on sonography.
Prior to doing hysteroscopy, we usually insert a medication into the vagina, a few hours before the procedure so as to soften and dilate the cervix. This eases the procedure and reduces the chances of complications. A urinary Cather maybe put in if an operative hysteroscopy has to be done or a simultaneous operative laparoscopy is planned.
After hysteroscopy the recovery is quick and one is allowed to go home the same day in case of a simple diagnostic hysteroscopy, once the effect of the anaesthesia weans off and the patient is comfortable. When operative procedures are carried out hysteroscopically, overnight stay is recommended in the hospital.
Some of the common indications for which hysteroscopy is done are :
1) In cases of abnormal uterine bleeding : To look for any intrauterine pathology and take an endometrial sample.
2) Fibroids in the uterine cavity : Sub mucous fibroids, or along with laparoscopy for intramural fibroids distorting the uterine cavity.
3) Uterine Septum removal
4) Adhesiolysis : To remove intrauterine adhesions.
5) To look for any pathology in patients with history of recurrent miscarriages.
6) Locate a misplaced intrauterine device.