Hysteroscopy

If you’ve been scheduled for a hysteroscopy, it is likely you have been experiencing abnormal bleeding. Your physician at Gyn LA needs to discover why this condition is happening. A hysteroscopy is a procedure that will allow your physician to look inside your uterus and find the reason for the excess bleeding. It is also a test performed to discover the reason for unexplained spotting or bleeding in postmenopausal women.

A hysteroscopy is performed by using a medical tool called a hysteroscope. This tool is a lighted tube that is very thin and will be inserted through your vagina and into your uterus. It will be done as either an operative or diagnostic procedure.

Diagnostic Hysteroscopy

When you have diagnostic hysteroscopy, it is being done to diagnose a problem your doctor expects is occurring in your uterus. By doing a diagnostic hysteroscopy, your doctor can also confirm the results of other tests you may have had, such as the HSG (hysterosalpingography). The HSG is an x-ray test, and it is performed to check your fallopian tubes and uterus. Your diagnostic hysteroscopy can be scheduled at the Gyn LA clinic.

The diagnostic hysteroscopy can also be used with other tests, such as the laparoscopy, or before a D & C (dilation and curettage). A laparoscopy involves your doctor using a slender tube that has a fiber-optic camera attached, called an endoscope, into your abdomen to see outside of your uterus, fallopian tubes, and ovaries. An incision is made below or through your navel and used to insert the endoscope.

Operative Hysteroscopy

When you have an operative hysteroscopy, it is done to correct an abnormal condition which your doctor has discovered while performing the diagnostic hysteroscopy. Should an abnormal condition be discovered during the diagnostic hysteroscopy, your doctor can do the operative hysteroscopy right away and avoid you needing to undergo another procedure at a later date. When correcting the abnormalities detected, your physician will use small instruments that are inserted through the hysteroscope.

When Would You Need an Operative Hysteroscopy

These are some of the conditions which may be detected during a diagnostic hysteroscopy, which would mean your physician will perform the operative hysteroscopy:

  • Adhesions

Adhesions are also known as Asherman’s Syndrome and are a band of scar tissue that has formed in your uterus and are responsible for changes occurring during your period. These uterine adhesions can also be responsible for infertility. Through the hysteroscopy, your doctor at Gyn LA can locate these adhesions and remove them.

  • Abnormal bleeding

A hysteroscopy can help identify for your doctor, the reason behind your lengthy or heavy menstrual flow. This test can also detect the reason why you are bleeding between cycles or after menopause. Endometrial ablation is one test where the hysteroscopy, along with other medical tools, are used to destroy the uterine lining to treat the causes of heavy bleeding.

  • Fibroids and polyps

When polyps and fibroids are discovered, they can be removed through a hysteroscopy.

  • Polyps are growths that can occur in the endometrium, the inner lining of your uterus. These uterine polyps attach to your endometrium with a broad base or thin stalk and grow inward into your uterus. These growths are typically not cancerous, but they can cause you problems with your menstrual cycle or your ability to get pregnant.
  • Fibroids are typically not cancerous but are tumors made up of connective tissue from the wall of your uterus and muscle. Uterine fibroids can grow as a single nodule, or they can form in clusters ranging in size from one millimeter to as large as eight inches in diameter.

These growths develop within the wall of your uterus, or they can project into the interior cavity. There are some cases where the uterine fibroids project from the surface of the uterus. The symptoms associated with these growths vary between patients depending on their number, location, and size. Each uterine fibroid growth is unique and requires the individualization of therapeutic options.

  • Septums

Hysteroscopy can be performed to determine whether or not you have a uterine septum. A uterine septum is defective, or malformation of the uterus you would have been born with.

When is a Hysteroscopy Scheduled?

Your physician at Gyn LA will recommend you schedule a hysteroscopy the first week after your menstrual cycle ends. When scheduled after your period is complete, your doctor will have a better opportunity to view the inside of your uterus.

Are You a Good Candidate for Hysteroscopy?

There are numerous benefits connected to having a hysteroscopy, but it is not appropriate for all women. Your doctor at Gyn LA is a specialist in this field of gynecology and will determine if your medical history makes you a good candidate or not.

How is a Hysteroscopy Procedure Done?

Many times women having a hysteroscopy find a benefit in having a sedative to relax before the procedure begins. Talk to your physician at Gyn LA if you feel you are anxious about the test and may need an additional relaxant before anesthesia is administered.

Once you have been placed under anesthesia, the doctor will widen or dilate your cervix so the hysteroscope can be inserted. This tool is inserted through your vagina and cervix into your uterus. Either a liquid solution or carbon dioxide gas is then placed into your uterus with the use of the hysteroscope, which will expand it and clean away mucus or blood.

A light will then be shown through the hysteroscope so the doctor is able to see your uterus as well as the openings in your fallopian tubes, and into your uterine cavity. If there are any conditions detected, your physician will address their removal with the use of small instruments that are inserted into your uterus through the hysteroscopy.

The hysteroscopy procedure can last as much as an hour or as little as five minutes. How long it will take for your test depends on whether it is diagnostic or operative and whether or not you require an additional procedure. Typically the diagnostic hysteroscopy takes much less time than an operative hysteroscopy procedure.

What are the Risks of a Hysteroscopy, and is it Safe?

Having a hysteroscopy is a relatively safe procedure. You must remember, however, with any form of surgery, complications can occur. The difficulties that could possibly happen with a hysteroscopy are less than one percent, but can include:

  • Infection
  • An injury to your bladder, bowel, uterus, or cervix
  • A reaction to the substance used to widen your uterus
  • Risks typically associated with the use of anesthesia
    • Typical symptoms or risk of having been placed under general anesthesia are:
      • Dizziness
      • Soreness or bruising from the IV drip
      • A sore throat from the breathing tube used
      • Difficulty urinating
      • Vomiting and nausea
      • A feeling of being cold and shivering
    • Typical symptoms or risks of having local anesthesia include:
      • Muscle twitching
      • Blurry vision, vomiting, or dizziness
      • Headache
      • Tingling, weakness, or continued numbness
    • Typical symptoms or risks associated with regional anesthesia include:
      • Bleeding around the spinal column
      • Drop in blood pressure
      • Nerve damage
      • Severe headache
      • Allergic reaction to the anesthesia used
      • Difficulty breathing
      • Infection in your spine
      • Seizures (this is the rarest side effect)
  • Heavy bleeding
  • Intrauterine scarring
    • Intrauterine scarring is also called scar tissue or synechiae and is a band of fibrous scar tissue that grows within your uterus. This scarring affects the functional lining inside your uterus. This scarring can affect your ability to become pregnant. The cause of intrauterine scarring can be a result of trauma to the lining of your uterus resulting from a medical procedure or an inflammation.

What to Expect After Your Hysteroscopy

If you have been given a general or regional anesthesia for your hysteroscopy, you might have to be monitored for several hours before being allowed to go home. Once the procedure is complete, you may feel some cramping or even slight vaginal bleeding for possibly one to two days. You may also have some shoulder pain if gas was used during your procedure, and it is not unusual to feel a bit sick or faint. If you should experience any of these symptoms, contact your physician at Gyn LA:

  • Severe abdominal pain
  • Fever
  • Heavy discharge or vaginal bleeding

A hysteroscopy is considered minor surgery and typically does not require you to stay overnight in the hospital. In some rare circumstances, such as a severe reaction to the anesthesia, your physician may ask that you spend the night for observation.

Types of Anesthesia Used for Hysteroscopy

Anesthesia for a hysteroscopy procedure can be one of three:

  • Regional anesthesia

-Regional anesthesia has several names. You may recognize it as spinal anesthesia, a spinal block, intradural block, or perhaps the intrathecal block. Whichever name you know this form of anesthesia by, it involves the injection of a local anesthetic or opioid into the subarachnoid space (the interval between the arachnoid membrane and the pia mater, or the continuous around your spinal cord).

A fine needle approximately three-and-half-inches long is used to inject the substance by an anesthesiologist. This form of anesthesia is an alternative to general anesthesia as it involves the lower extremities and surgeries below the umbilicus. The anesthetic, which is injected into the cerebrospinal fluid, will block your motor and sensories, so you do not feel any sensation or pain below your abdomen.

  • Local anesthesia

Local anesthesia is used to induce the absence of sensation in a specific part of your body. Typically it is used to create an insensitivity to pain, although other local senses may be affected as well. This form of anesthesia will allow you to undergo a surgical or dental procedure with reduced distress and pain.

In a lot of situations, such as cesarean sections, it is a lot safer and more superior to general anesthesia. This form of anesthesia is also often used for the relief of non-surgical pain and allows for a diagnosis for the cause of certain chronic pain conditions. This form of anesthesia is often combined with general anesthesia techniques.

  • General anesthesia

With general anesthesia, you are put into a medically induced coma. With this form of anesthesia, there is a loss of protective reflexes that results from the administration of one or more agents of anesthetics. This form is used to allow medical procedures that would otherwise be intolerable due to pain levels to patients or where the type of procedure being done precludes the patient being awake for it.

The type of anesthesia that will be used for your procedure will be determined by where your hysteroscopy will be done, in the Gyn LA clinic, or the hospital. If you have other procedures being done at the same time, that will also play a factor in what type of anesthesia is given. If it is determined you need general anesthesia, you will not be able to drink or eat for a specific amount of time before your hysteroscopy.

Procedures a Gynecologist Can Perform with a Hysteroscope

A gynecologist typically uses a hysteroscope to exam your uterus lining and determine the cause of heavy bleeding, check for polyps, fibroids, or determine the reason for postmenopausal women. There are also other assessments that can be performed with the hysteroscope such as:

  • Biopsy of the endometrial lining
  • Removing intrauterine adhesions
  • Removal of a lost intrauterine contraceptive device
  • Endometrial ablation

What are the Benefits of Having a Hysteroscopy?

When you compare the hysteroscopy with other invasive procedures, it provides you these benefits:

  • It involves a shorter hospital stay
  • You are given less pain medication that many need after a surgical procedure
  • It possibly avoids you having to undergo an ‘open’ abdominal surgery
  • You have a shorter recovery time
  • You will possibly have avoided needing a hysterectomy

Your outlook after having a hysteroscopy will depend upon your individual health. Most minor surgical procedures are successfully performed using hysteroscopy, and your doctor at Gyn LA will be able to answer any questions you may have before your appointment. Complications with this procedure are rare, and most women recover with no or little minor post-procedure bleeding or cramping.

Where Can I Have a Hysteroscopy Near Me?

At Gyn LA, we offer you comprehensive, full-service, quality health care for all women’s needs. With our team, you will find we can help you through low, high, or advanced gynecological surgeries or treatments. If you need a hysteroscopy, call today at 310-375-8446 and talk to one of our skillful and compassionate doctors to discuss your health and options. It is our mission to provide you with the best care possible in a friendly, personalized environment. At Gyn LA, we specialize in women’s needs with state-of-the-art equipment using the latest technology. Call today and schedule your appointment to improve your health.