Diagnostic hysteroscopy is the gold standard test for patients suffering from:
Irregular menstrual bleeding
Heavy bleeding during periods
Bleeding in older age and after menopause
Scanty/ Minimal bleeding during periods
Operative hysteroscopy helps to manage problems like:
Fibroids inside uterine cavity
Polyps inside uterine cavity
Uterine adhesions/ synechiae
Opening of blocked tubes in infertile patients
Widening of cavity in small uterus/ T shaped uterus
Removal of foreign bodies
Removal of lost Copper T/ intra uterine contraceptive device
Hysteroscopic Surgery is performed using a telescope to look within the uterus, through the vagina. The inner lining of the uterus, called the endometrium is checked.
This is precisely the area from where menstrual bleeding takes place. This is also the area where the pregnancy takes roots and grows. Hence, plenty of defects can be identified in patients of abnormal menstrual bleeding, infertility and abortions, which can be completely missed even by sonography or CT scan/ MRI.
This is a zero scar procedure, and patients are sent home within 4 to 6 hours of surgery.
Who requires Hysteroscopy?
You may need hysteroscopy if
a) You are having difficulty in getting pregnant (infertility)
b) You have a successful start of pregnancy but had an abortion
c) You have either excessive or decreased menstrual bleeding
d) You have failures with infertility treatments like IUI/ IVF/ ICSI
e)You have a specific abnormality seen on sonography
Which abnormalities can be detected or treated by hysteroscopy?
The normal uterine cavity is a spacious hollow structure with two openings on its two sides. It has a soft, fluffy inner lining called the endometrium.
Some of the abnormalities that can be commonly found are:
1. Endometrial Polyp: This is an overgrowth of the endometrium itself. It may be as small as 0.5 cm to as large as 5cm. It causes heavy bleeding, infertility and abortions. Surgical removal of the polyp gives immediate relief
2. Submucous Fibroid: is a non cancerous tumor growing within the uterus that causes similar effects as a polyp, i.e. Infertility, heavy menstrual bleeding, cramping pain during periods and sometimes abortions. Surgical removal of fibroids hysteroscopically is a much more complex surgery than polyp removal
3. Septate Uterus: is a muscular partition within the uterus that divides the uterus into 2 halves, completely or incompletely. This is a birth defect, also called a congenital anomaly. It is one of the commonest anatomical causes of abortions. Cutting this septum causes the 2 halves of the uterus to become one, and a successful pregnancy can be achieved.
4. Synechiae: These are abnormal connections between the walls of the uterus. They form after a prior abortion, or after an infection like tuberculosis. As these are due to an extended healing process of the body, they may sometimes be minor in nature. At times, these adhesions may destroy the lining of the endometrium completely. Patients with adhesions are usually not able to get pregnant without a surgical correction. In a large percentage of cases, these are also associated with decreased menstrual flow.
5. Foreign Body: Intra uterine contraceptive devices, like Copper T may sometimes get displaced inside the uterine cavity. These can be removed easily by hysteroscopy.
Gynecological Endoscopy (Hysteroscopy & Laparoscopy)- Keyhole Surgery/ Minimally Invasive Surgery
Mumbai (Bombay), India