What is diagnostic hysteroscopy and why is it used for?
A hysteroscopy is performed with a hysteroscope, a small fiber-optic tube connected to a video camera. The close-up recordings from the inside of the uterus are projected to a computer screen and observed by the doctor performing the procedure.
We use hysteroscopy to diagnose the following cases:
- Endometrial polyps (small non-cancerous masses in the lining of the womb that can cause heavy and irregular periods; they can also be diagnosed by ultrasound transvaginal scan).
- Submucosal fibroids (non-cancerous growths in the muscular wall of the uterus; they can cause pain and heavy periods)
- Uterine anomalies (for instance, a different-shape uterus that tilts towards the spine, or a uterus divided by a muscular wall, called septum)
- Cervical stenosis (a narrower-passage cervix)
- Intra-uterine adhesionsor Asherman’s syndrome (scar remnants that make the uterus’ interior walls to stick to one another; they are due to trauma from a recent pregnancy or miscarriage)
- Endometrial hyperplasia (overgrowth and thickening of the lining of the womb; it is a risk of uterine cancer)
We also perform diagnostic hysteroscopy as part of investigations for implantation failure and repeated miscarriage. During hysteroscopy, we may retain an endometrial biopsy for analysis (ERA® test, for instance).
Who may need a diagnostic hysteroscopy?
Hysteroscopy is very a useful diagnostic tool for women undergoing infertility investigations and have symptoms relating to the above conditions.In most cases, problems such as these are the cause of infertility and recurrent pregnancy loss.
Some of these uterine conditions can be treated with surgical hysteroscopy.
How is a diagnostic hysteroscopy done?
The procedure is performed by a gynecologist doctor in our day AAFC clinic. It can be done without the use of an anesthetic, but for a longer session in the theatre, we use conscious sedation. The length of the hysteroscopy depends on the finding or the reason for the procedure and individual circumstances. For diagnostic purposes, it generally takes 10-20 minutes.
The hysteroscopeis inserted through the vagina and cervix into the uterus; then the doctor inflates the womb with a fluid to improve the resolution of the recorded images.
After the procedure, you may experience cramping similar to your period pains, but thisusually passes quickly (up to an hour later). You may return to your daily activities as normally.