Hysteroscopy is the observation of the uterine cavity with a special optical device called a hysteroscope by entering through the vagina and cervix. Hysteroscopy is performed under a light general anaesthesia. Generally, the operation time does not exceed 30 minutes.
In this procedure, firstly a speculum is placed in the vagina and vaginal disinfection is provided. Then a 3 to 5mm thick hysteroscope is inserted through the cervix into the uterus. CO2 gas or special fluids given through the channel of the hysteroscope are used to inflate the uterus. The image taken with the hysteroscope is transferred to the monitor via the optical-camera system.
What is diagnostic hysteroscopy?
Diagnostic hysteroscopy is the observation of the uterine cavity for diagnostic purposes. It is usually performed under local anaesthesia. It is done for definitive diagnosis in cases where other measures are not enough for definitive diagnosis or when it is not sure. Whether there is a disorder in the uterus, or not, and if there is a disorder, its true size and location can be determined and the treatment method can be easily programmed. If necessary, operative hysteroscopy can be performed in the same session.
Hysteroscopy helps in the diagnosis of the following conditions:
- Polyps and myomas causing excessive bleeding
- Congenital anomalies of the uterus (septum, bicornuate, arcuate, hypoplasia)
- Intrauterine adhesions
- Early stage cancer of intrauterine tissue (endometrium) can be diagnosed. A biopsy from a suspicious area can be taken with direct view.
- Removal of the intrauterine device whose string is invisible or escaped into the uterus
- Investigation of recurrent abortions
- Investigation of recurrent IVF failure
- Confirmation of abnormal hysterosalpingography or ultrasonography findings
What is operative hysteroscopy?
Intrauterine disorders are treated with the operative hysteroscopy method, which is usually performed under general anesthesia. It is a more advanced form of diagnostic hysteroscopy. After all kinds of structures in the uterus are viewed in detail, any pathology can be corrected or removed with an electrosurgical system called a resectoscope.
The following conditions are treated:
- Excision of polyp
- Myomectomy (Submucosal)
- Congenital anomalies of the uterus (septum): may lead to recurrent abortions.
- Intrauterine synechiae
- Excessive menstrual bleeding: Endometrium is excised to stop excessive menstrual bleeding that continues despite medical treatment (there should be no desire for children in the future)
What are the advantages of operative hysteroscopy?
The above-mentioned problems are treated without open surgery or removal of the uterus. Especially in women who are under infertility treatment or who desire to have a child in the future, curettage and open surgery on the abdomen may make it difficult to get pregnant in the future or lead to new causes of infertility (such as adhesions in the abdomen). Especially in this group of women, hysteroscopic surgery is the most successful treatment method. Hysteroscopic surgery is the most successful treatment modality especially in this group of women.
