Endoscopy – Hysteroscopy

What is endoscopy?

Endoscopy is a medical procedure that uses a long, thin tube called an endoscope to visualize the internal organs of the body. This device has a tiny camera attached at one end which allows doctors to view and examine areas inside the body like the digestive tract, lungs or bladder.

Endoscopy helps physicians detect abnormalities such as inflammation, ulcers or tumours otherwise not visible through imaging tests like X-rays or CT scans. It can also be used therapeutically by removing polyps from the colon during colonoscopies or inserting small tools into narrow passages within organs to remove blockages causing ailments like gallstones. Endoscopy is an essential tool in modern medicine that enables accurate diagnosis and treatment of many conditions affecting different parts of our bodies.

Applications of endoscopy

The keyword for this procedure is "endoscope" which comes in various types depending on the area being examined. For instance:

  • Bronchoscope for lung examinations,
  • Colonoscope for colon examinations
  • cystoscope for bladder examination
  • Hysteroscopy for womb examination
What is hysteroscopy

Hysteroscopy is a medical procedure for inspecting the uterus. During the procedure, a thin, flexible instrument called a hysteroscope is inserted through the vagina and cervix into the uterus. The hysteroscope has a light and camera on its end, allowing your doctor to see any abnormalities in real time.

Note: The hysteroscope is a type of endoscope

What are the types of hysteroscopy?

 There are two types of hysteroscopy: diagnostic and operative.

  • Diagnostic hysteroscopy: In this your doctor uses the hysteroscope to look at your uterus for any signs of abnormality or disease.
  • Operative hysteroscopy: This involves using specialized instruments inserted through the same device to treat various conditions such as polyps or fibroids.

  In general, this type of endoscopy is considered safe with minimal risks involved but only if performed by an experienced medical professional under appropriate clinical settings.

What is the use of hysteroscopy?

 Hysteroscopy can help diagnose several gynaecological conditions inside the womb among others. It also helps in monitoring treatment progress for certain conditions like endometrial hyperplasia.

Your healthcare provider may recommend hysteroscopy in case of following:

  • To investigate abnormal uterine bleeding: Hysteroscopy can help identify causes such as fibroids, polyps or other structural abnormalities that may contribute to heavy periods or bleeding between periods.
    • Hysteroscopy Polypectomy: hysteroscopy is used for surgical removal of polyps
    • Hysteroscopy Myomectomy: hysteroscopy is used for surgical removal of fibroids
    • Adhesions: These can also be removed through hysteroscopy
    • Septums: Hysteroscopy can be used for the diagnosis of septums
  • Diagnosing infertility issues: The procedure can provide information on problems such as scar tissue, adhesions or congenital abnormalities that may be preventing pregnancy from occurring.
  • To remove intrauterine devices (IUDs): For those that have become embedded in the uterine lining or perform endometrial biopsies when cancerous cells are suspected.

 Hysteroscopy plays an essential role in gynaecologic health by allowing doctors to detect and treat underlying medical conditions related to menstruation and fertility. If you are experiencing any of the symptoms of problems mentioned above, don't hesitate to consult your doctor for a diagnosis and possible treatment options.

Who is not eligible for hysteroscopy?

Despite being advantageous hysteroscopy is not recommended in the following cases:

  • Pregnancy
  • Pelvic infection

Risks and Benefits

What are the risks of hysteroscopy?

Hysteroscopy is considered a safe procedure, but like any medical intervention, there are potential risks involved.

  • Infection: This can occur when bacteria enter the uterus during the procedure. However, this risk can be minimized by taking antibiotics before and after the hysteroscopy.
  • Bleeding: This is possible particularly if tissue or polyps are removed during the procedure. Women who have blood clotting disorders may also be at an increased risk for excessive bleeding.
  • Uterine perforation: Uterine perforation happens when the instrument used in hysteroscopy punctures the wall of your uterus while fluid overload occurs when too much fluid (used to expand your uterus) is absorbed into your bloodstream.

Hysteroscopy is a safe and effective procedure that can help diagnose and treat issues within the uterus. However, it has its risk like any medical procedure.  It's important to discuss these risks with your doctor before undergoing the procedure.

What is the success rate of hysteroscopy?

It's important to note that most women experience no discomfort beyond mild cramping after their procedures and the risk of complications is as low as 1%. Nonetheless, it's always best to discuss any concerns you have with your healthcare provider beforehand so they can tailor their approach accordingly and manage possible post-hysteroscopy symptoms effectively.

What are the advantages of hysteroscopy?

  • Makes it possible to do the diagnosis and treatment in one surgery
  • Precise
  • Minimally invasive
  • Ensures surrounding tissues are not damaged during treatment

Procedure Details

What happens during a hysteroscopy?
  1. After a pelvic exam, the cervix is dilated
  2. A thin tube with a camera attached (hysteroscope) is inserted into the vagina and through the cervix into the uterus. The camera allows your doctor to examine the lining of your uterus for abnormalities or growth.
  1. To clear the blood and mucus in the uterus and for expanding it a liquid solution is also sent through the hysteroscope. This along with the light of the hysteroscope improves visibility.
  1. Depending on what is found during the examination, further treatment may be necessary such as removing polyps or fibroids or performing endometrial ablation to treat heavy periods.

If you're experiencing symptoms related to your menstrual cycle or fertility concerns, it's worth discussing whether hysteroscopy could be helpful in diagnosing or treating those issues. By understanding what happens during this procedure and being aware of potential risks and recovery processes involved, you'll be better prepared for making informed decisions about your health.

Recovery

What should you expect during recovery from hysteroscopy?

After a hysteroscopy procedure, the recovery process is generally quick and straightforward. Most women will experience:

  • Some mild discomfort or cramping for a few hours after the procedure.
  • Some light bleeding or spotting for up to several days following the procedure.

What happens after a hysteroscopy?

Understanding the recovery process can help you prepare for what to expect post-procedure.

  • To manage any discomfort, doctors may recommend taking over-the-counter pain medications such as ibuprofen. It's important to avoid using tampons or having sexual intercourse for at least a week after the procedure to reduce the risk of infection.
  • In addition, it's recommended that you rest and avoids strenuous exercise for a day or two following your hysteroscopy. This will allow your body time to heal and recover from the procedure.
  • It's also essential to keep an eye out for any signs of complications during your recovery period. If you experience heavy bleeding, fever, severe cramps or other concerning symptoms, be sure to contact your doctor right away.

 With proper care and monitoring during your recovery period, most women are able to resume their normal activities within just a few days after their hysteroscopy procedure.

Key Takeaway:

  • Endoscopy is a medical procedure that uses an endoscope to view and examine organs inside the body like the digestive tract, lungs or bladder.
  • There are various types of endoscopes, like a bronchoscope for lung examinations, a colonoscope for colon examinations, or a cystoscope to examine urinary tract infections.
  • The procedure helps physicians detect abnormalities such as inflammation, ulcers or tumours that are otherwise not visible through imaging tests.
  • Endoscopy is also used therapeutically to remove polyps from the colon or insert small tools into narrow passages within organs to remove blockages causing ailments like gallstones.
Frequently asked questions:
  1. Is Endoscopy painful?
    The process itself may be uncomfortable but not painful
  2. Is Hysteroscopy a major surgery?
    No it is a minor surgery
  3. Can I get pregnant after hysteroscopy?
Reference
  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9491051/
  2. https://www.ncbi.nlm.nih.gov/books/NBK564345/#:~:text=Hysteroscopy%20involves%20inserting%20a%20rigid,of%20endocervical%20and%20intrauterine%20pathology.
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4925130/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4165957/
  5. https://pubmed.ncbi.nlm.nih.gov/12101319/
Dr Purva Singh
MBBS MS OBGYN
IVF Specialist