Hysteroscopy
Hysteroscopy, also known as uterine endoscopy, is a medical procedure that allows healthcare professionals to visualize and examine the interior of the uterus using a specialized instrument called a hysteroscope. This technique is primarily utilized for diagnostic purposes, such as detecting abnormal growths, including cancers like uterine and endometrial cancer, as well as precancerous conditions and cervical abnormalities. During the procedure, tissue samples may also be taken for biopsy to assess the presence of cancer cells.
Typically performed as an outpatient procedure, hysteroscopy requires patient preparation, including routine laboratory tests and possibly anesthesia. The procedure involves inserting the hysteroscope through the cervix into the uterus, sometimes using fluid or gas to expand the uterine walls for a clearer view. While many patients experience only mild cramping or light bleeding post-procedure, some risks exist, including infection and bleeding.
Overall, hysteroscopy is an important tool in gynecological health, offering valuable insights and treatment options for women experiencing reproductive health issues.
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Subject Terms
Hysteroscopy
ALSO KNOWN AS: Uterine endoscopy
DEFINITION: Hysteroscopy uses a type of endoscope to allow a doctor to see, examine, and biopsy abnormal tissues or growths inside the uterus, the part of the female reproductive system where a fertilized egg develops. The procedure is used to check for cancer cells and remove suspicious tissue, precancerous tissue, or cancerous growths. It can also be used to detect abnormalities in the cervix, the opening to the uterus.
Cancers diagnosed or treated:Uterine cancer, uterine sarcoma, endometrial cancer, precancerous growths, cervical abnormalities
Why performed: Hysteroscopy is used as a diagnostic or a treatment procedure. It is used to view the inside of the cervix and uterus to detect possible cancerous growths, such as uterine and endometrial cancer. Suspicious tissues are biopsied. A biopsy entails removing tissue, mucus, or fluid samples with thin surgical instruments that are inserted through the hysteroscope. The tissues are examined for cancer cells in a laboratory. For small cancers, removing the cells helps to treat the cancer.
Patient preparation: The preferred time to receive a hysteroscopy is after the last day of menstruation and before ovulation, to prevent interrupting a pregnancy. Routine laboratory tests, including blood and urine tests, are conducted before the hysteroscopy. A pregnancy test, Pap smear, and sexually transmitted disease (STD) testing may be performed as well.
A hysteroscopy is an outpatient procedure performed in a doctor’s office, outpatient surgical center, or hospital. Hysteroscopy uses local anesthesia, general anesthesia, paracervical nerve block, or mild sedation. It can be performed with no anesthesia in select individuals. Patients receiving general anesthesia should not eat or drink after midnight prior to the day of surgery.
On the day of the hysteroscopy, patients are requested to empty their bladder before the procedure begins. Patients wear an examination gown with nothing on below the waist.
Steps of the procedure: Patients lie on their backs with their knees spread and feet placed and secured in stirrups. Patients receive anesthesia, and their vital signs are monitored during the procedure. A may be inserted through the urethra and into the bladder to collect urine.
A speculum is inserted into the vagina to separate the vaginal walls, allowing the doctor to see the cervix (opening to the uterus). The doctor may dilate the cervical opening with a device; some hysteroscopes are narrow enough to fit through the cervical opening without requiring dilation.
The hysteroscope is inserted in the vagina, moved through the cervix, and advanced to the uterus. Gas or sterile fluid may be used to expand the uterus and provide the doctor with a good view. The gas or fluid is delivered through a tube in the hysteroscope. Fluid is preferred in some cases because it washes mucus from the uterine walls, allowing the mucus to be collected for biopsy and creating a clearer image.
The doctor views the walls of the uterus, looking for any signs of abnormality, such as an irregular growth, fibroid, or polyp. A biopsy is taken of any abnormal or suspicious tissue or growths. At completion of the hysteroscopy, the gas, fluid, catheter, and hysteroscope are removed.
After the procedure: Patients are monitored in the recovery area. Patients are discharged when they are awake and alert. Patients should have another person drive them home.
Mild cramping or pain may occur for about eight hours after the procedure. Light bleeding may occur for a couple of days.
Risks: Rare complications of hysteroscopy include infection; prolonged bleeding; uterine, bowel, or bladder perforation; and fluid absorption into the bloodstream. Patients should contact their doctor if they develop a fever, severe pain, unusual discharge, or heavy bleeding.
Results: A healthy uterus has no abnormal growths or tissues. Suspicious growths are biopsied to determine whether cancer is present.
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