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MoonDragon's Women's Health Procedures Information
HYSTEROSCOPY


For "Informational Use Only".
For more detailed information, contact your health care provider
about options that may be available for your specific situation.





  • Hysteroscopy Description
  • Reasons For Hysteroscopy
  • Hysteroscopy Risk Factors
  • Hysteroscopy Procedure Description
  • Hysteroscopy Expected Outcome
  • Hysteroscopy Complications
  • Hysteroscopy Post Procedure Care
  • Medication
  • Activity Recommendations & Restrictions
  • Diet & Nutrition
  • Notify Your Health Care Provider




  • HYSTEROSCOPY DESCRIPTION

    The hysteroscope is a small lighted telescope used for visual examination of the cervix and the uterus to help diagnose and treat infection or abnormalities within the genital tract.

    The hysteroscope is a thin telescope that is inserted through the cervix into the uterus. Modern hysteroscopes are so thin that they can fit through the cervix with minimal or no dilation. Although hysteroscopy dates back to 1869, gynecologists were slow to adopt hysteroscopy. Because the inside of the uterus is a potential cavity, like a collapsed air dome, it is necessary to fill (distend) it with either a liquid or a gas (carbon dioxide) in order to see inside it.

    The hysteroscope helps a health care provider to diagnose and treat a uterine problem. Hysteroscopy is minor surgery which is performed either in your health care provider's office or in a hospital setting. It can be performed with local, regional, or general anesthesia - sometimes no anesthesia is needed. There is little risk involved with this procedure for most women.

    hysteroscope


    DIAGNOSTIC HYSTEROSCOPY

    During diagnostic hysteroscopy the hysteroscope is used just to observe the endometrial cavity (inside of the uterus) and diagnose some uterine abnormalities. It may also be used to confirm the results of other tests such as hysterosalpinography (HSG). Other instruments or techniques, such as dilation and curettage (D&C) and laparoscopy, are sometimes used in conjunction with the hysteroscopy. Diagnostic hysteroscopy can be used to diagnose certain conditions such as abnormal uterine bleeding, infertility, repeated miscarriages, adhesions, fibroid tumors, polyps, or to locate displaced intrauterine devices (IUDs).

    Hysteroscopy may be either diagnostic or operative. Diagnostic hysteroscopy and simple operative hysteroscopy can usually be done in an office setting. More complex operative hysteroscopy procedures are done in an operating room setting.

    OPERATIVE HYSTEROSCOPY

    During operative hysteroscopy a type of hysteroscope is used that has channels in which it is possible to insert very thin instruments. These instruments can be used to remove polyps, to cut adhesions, and do other procedures. With the development of better and smaller instruments, health care providers find that they are able to remove some polyps in addition to doing other procedures that used to require a full operating room. In many situations, operative hysteroscopy may offer an alternative to hysterectomy.

    An operative hysteroscopy may be used, instead of open abdominal surgery, to both diagnose and treat certain conditions such as uterine adhesions, septums, or fibroids which can often be removed through the hysteroscope.

    The hysteroscope is sometimes used with other instruments such as the resectoscope to treat some cases of abnormal bleeding; however after this procedure, known as endometrial ablation, women can no longer have children so it is not an option for women who wish to have future pregnancies. Endometrial ablation is a procedure which destroys the lining of the uterus.

    MoonDragon's Procedures: Hysterectomy, Abdominal
    MoonDragon's Procedures: Hysterectomy, Vaginal

    THE RESECTOSCOPE

    The resectoscope is a telescope-like instrument with a wire loop, a rollerball, or a roller cylinder tip at the end. It uses high-frequency electrical current at the end of the tip is used to cut or coagulate tissue and destroy the uterine lining. The resectoscope is considered revolutionary surgery inside the uterus. This procedure is usually performed in an outpatient setting.

    The resectoscope has been used for male prostate surgery for over 50 years. It has been modified so it can be used inside the uterus.





    REASONS FOR HYSTEROSCOPY PROCEDURE

  • Staging of Uterine Cancer.
  • Fibroid tumors of the uterus and polyps or adhesions (e.g., Asherman's syndrome).
  • Evaluation and treatment of abnormal uterine bleeding.
  • To view the status or location of an IUD (intrauterine device).
  • Infertility.
  • Habitual Abortion (miscarriage).
  • Placement of silicone plugs for tubal sterilization.
  • Obstructed fallopian tubes.
  • Congenital malformations.





  • HYSTEROSCOPY RISK FACTORS

  • Active uterine bleeding.
  • Current infection.





  • DESCRIPTION OF HYSTEROSCOPY PROCEDURE

  • This procedure may be performed in a health care provider's office, an outpatient facility or a hospital.

  • The best time for hysteroscopy is during the first week or so after a menstrual period. During this time a health care provider is best able to view the inside of the uterus.

  • A general or regional anesthetic will be administered. If you are having general anesthesia in the hospital, you will be told not to eat or drink anything for a certain period of time (usually after midnight the night before) before the procedure. Routine lab tests may be ordered as well for women having a hysteroscopy in the hospital. Sometimes a drug to help you relax is ordered. Next you will be prepared for anesthesia:
    • Local anesthesia: You will receive an injection of anesthetic around the cervix to numb it, with this type of anesthesia you remain awake and may feel some cramping.

    • Regional anesthesia: A drug is injected, through a needle or tube in your lower back, that blocks the nerves that receive sensation from the pelvic region. You are awake with this type of anesthetic, but feel no discomfort. Regional anesthesia is also called a spinal or epidural.

    • General anesthesia: You will not be conscious during your hysteroscopy when general anesthesia is used. A mask over your mouth and nose allows you to breathe a mixture of gases. Once you are under anesthesia, a tube may be inserted down your throat to help you breathe.

    • Your health care provider will determine which type of anesthesia is best for you based on the reason for your hysteroscopy. Remember to ask questions if anything is about your procedure or anesthesia is unclear.

  • The bladder will be emptied and the vaginal area will be cleansed with an antiseptic. The cervix is gradually dilated or made wider with special rod-like cervical dilation instruments.

  • The hysteroscope is inserted through the vagina and cervix, and into the uterus.

  • Fluid or carbon dioxide gas (CO2) is usually released through the hysteroscope and may be used to distend (enlarge) the uterine cavity to improve visualization and allow any operative manipulations to be achieved.

  • The a light source shone through the hysteroscope allows the health care provider to see inside of the uterus and the openings of the fallopian tubes into the uterine cavity. A camera is passed through the hysteroscope and Video monitoring is often used at the same time. If the patient is awake and aware, she may be able to visualize the monitor.

  • A variety of instruments are available for use in hysteroscope procedures including micro scissors, special clamps with electrocautery attachment, wire loops for excision and lasers when needed.

  • The examination and any surgical measures will be performed.

  • Sometimes a laparoscope is used at the same time to view the outside of the uterus. When this happens a gas such as carbon dioxide or nitrous oxide is allowed to flow into the abdomen. The gas expands the abdomen so that the health care provider can see the organs easier. Most of the gas is removed at the end of the procedure. A laparoscopic procedure will be done in a hospital setting.

  • The hysteroscope is withdrawn.





  • HYSTEROSCOPY EXPECTED OUTCOME

    There may be some discomfort following the procedure. Some patients may experience shoulder pain following laparoscopy or when gas is used to expand the uterus. Once the gas is absorbed the discomfort should subside quickly. You may feel faint or sick, or you may have slight vaginal bleeding and cramps for 1 to 2 days following the procedure.

  • Hysteroscope diagnostic studies may rule out a medical problem or indicate the need for further evaluation and treatment.
  • Hysteroscopic treatment or surgical procedures have a high success rate.





  • HYSTEROSCOPY POTENTIAL COMPLICATIONS

    Hysteroscopy is a fairly safe procedure. Problems that can occur happen in less than 1 percent cases, but include:

  • Excessive, heavy bleeding.
  • Pelvic infection.
  • Injury to cervix or uterus. Uterine perforation.
  • Anesthetic complications and side effects (depending upon method used).
  • Allergic reaction to the fluid used to distend the uterus.


  • Although general anesthesia is sometimes used, in the majority of cases it is not necessary. Hysteroscopy allows the health care provider to see inside the uterus and aids in the accurate diagnosis of some medical problems. The procedure and recovery time are usually short.





    HYSTEROSCOPY POST PROCEDURE CARE

  • Following the procedure, the medical staff will monitor your vital signs for a period of time. Have someone drive you home.
  • There may be some slight bleeding and cramping. Use sanitary napkins for the bleeding.





  • MEDICATION

  • Medicine is usually not necessary following the procedure. In some surgical procedures, estrogen may be prescribed to promote regrowth of the uterine lining.

  • You may take non-prescription drugs, such as acetaminophen for minor pain.





  • ACTIVITY RECOMMENDATIONS & RESTRICTIONS

  • Rest at home the rest of the day. Additional restrictions may be required depending on the extent of the surgical procedure.
  • Avoid sexual relations for 2 weeks or as instructed.





  • DIET & NUTRITION

  • No special diet. However, you should continue following a nutritious dietary plan for a strong immune system and fast recovery from surgery.

  • MoonDragon's Nutrition Information: Adult Regular Diet
    MoonDragon's Nutrition Information, Guidelines, Dietary Recommendations





    NOTIFY YOUR HEALTH CARE PROVIDER

    If any of the following occurs:

  • Excessive bleeding.
  • Abdominal pain.
  • Signs of infection develop: headache, muscle aches, dizziness, or a general ill feeling or fever.
  • New, unexplained symptoms develop. such as nausea, vomiting, constipation, or abdominal swelling.






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