Hysteroscopy is a minimally invasive diagnostic and surgical procedure used to evaluate and treat conditions of the uterus. It involves inserting a hysteroscope, a thin, lighted tube with a camera and instruments attached, through the vagina and cervix and into the uterus. Here are the fundamentals of hysteroscopy:

1. Indications: Hysteroscopy may be used for diagnostic purposes, such as to investigate abnormal uterine bleeding or infertility, or for therapeutic purposes, such as to remove uterine polyps or fibroids.

2. Preparation: Prior to the procedure, the patient may be given medication to help relax the cervix and reduce discomfort. The patient may also be advised to avoid food and drink for several hours before the procedure.

3. Anesthesia: Hysteroscopy may be performed with local anesthesia, conscious sedation, or general anesthesia, depending on the complexity of the procedure and the patient's preference.

4. Insertion of the hysteroscope: The hysteroscope is inserted through the vagina and cervix and into the uterus. Carbon dioxide gas may be used to expand the uterus and provide a better view of the uterine cavity.

5. Evaluation of the uterine cavity: The camera attached to the hysteroscope allows the surgeon to visualize the uterine cavity and identify any abnormalities such as polyps, fibroids, or adhesions.

6. Treatment: If a problem is identified, the surgeon may use the instruments attached to the hysteroscope to remove or biopsy the abnormal tissue. In some cases, a separate procedure may be scheduled to remove the abnormal tissue.

7. Recovery: After the procedure, the patient may experience some cramping and vaginal bleeding for several days. Patients are usually able to return to normal activities within a few days.

Hysteroscopy is generally considered a safe and effective procedure, but like all surgical procedures, it carries some risks such as infection, bleeding, or injury to surrounding organs. It is important for patients to discuss the risks and benefits of the procedure with their healthcare provider before undergoing hysteroscopy.

 

There are certain medical conditions and situations that may make hysteroscopy unsuitable or more risky. Contraindications for hysteroscopy include:

1. Active pelvic infection: Hysteroscopy may spread an infection or increase the risk of pelvic inflammatory disease.

2. Pregnancy: Hysteroscopy is generally avoided during pregnancy due to the potential risk to the developing fetus.

3. Recent childbirth or abortion: The uterus needs time to heal after childbirth or abortion, and hysteroscopy may increase the risk of complications.

4. Cervical cancer: Hysteroscopy may spread cervical cancer cells and increase the risk of cancer recurrence.

5. Uterine cancer: Hysteroscopy may spread uterine cancer cells and increase the risk of cancer recurrence.

6. Severe cervical stenosis: Hysteroscopy may not be possible if the cervix is severely narrowed or blocked.

7. Bleeding disorders: Hysteroscopy may increase the risk of bleeding in patients with bleeding disorders such as hemophilia.

8. Allergies to medications or anesthesia: Patients with known allergies to medications or anesthesia used during hysteroscopy may not be suitable candidates for the procedure.

9. Severe heart or lung disease: Hysteroscopy may not be suitable for patients with severe heart or lung disease due to the increased risk of complications.

It is important for patients to discuss their medical history and any potential contraindications with their healthcare provider before undergoing hysteroscopy. In some cases, hysteroscopy may still be appropriate with special considerations or modifications.