How is Uterine Endoscopy (Hysteroscopy) Performed?

Uterine endoscopy is a procedure performed to examine and treat the inside of the uterus, also known as hysteroscopy. This minimally invasive method is used to identify abnormalities within the uterus and to address various gynecological problems.

Hysteroscopy is suitable for the evaluation and treatment of intrauterine adhesions, polyps, fibroids, and abnormalities of the uterine lining.

How is uterine endoscopy (hysteroscopy) performed?

1. Preparation: Pain relievers are usually given to the patient before hysteroscopy, which is typically performed on an outpatient basis. In some cases, the procedure may also be performed under general anesthesia.
2. Speculum placement: A device called a speculum is inserted into the vagina to widen it and allow visualization of the cervix.
3. Cervical dilation: The cervix is usually wide enough to allow the passage of the hysteroscope. However, in some cases, further dilation may be necessary. For this purpose, a thin instrument called a dilator is inserted into the cervix to widen it.
4. Insertion of the hysteroscope: A thin, lighted tube called a hysteroscope is inserted through the vagina and cervix into the uterus. The hysteroscope contains a camera and a light source to examine the inside of the uterus.
5. Uterine cavity expansion: To clarify the view inside the uterus and allow easier movement of the hysteroscope, the uterine cavity is expanded using carbon dioxide gas or a liquid.
6. Examination and treatment: The hysteroscope magnifies and displays the structures and tissues inside the uterus on a screen. This allows for the detection of abnormalities or problems and the application of appropriate treatment. When necessary, special instruments can be inserted through the hysteroscope to perform procedures such as the removal of polyps or fibroids.
7. Post-procedure: Once the hysteroscopy is complete, the hysteroscope and speculum are removed. The procedure typically takes between 30 minutes and 1 hour.

Who Is Hysteroscopy Surgery Performed On?

Hysteroscopy is performed to diagnose and treat various gynecological problems and disorders. The situations in which hysteroscopy surgery is performed include the following:

Abnormal uterine bleeding: Hysteroscopy can be used in cases of abnormal bleeding such as irregular, heavy, or prolonged menstruation. This type of bleeding may be caused by hormonal imbalances, polyps, fibroids, or abnormalities in the uterine lining.

Intrauterine adhesions (Asherman's syndrome): Tissue growths or adhesions inside the uterus can cause irregular menstrual bleeding, recurrent miscarriages, and infertility. Hysteroscopy may be preferred to diagnose and treat these adhesions.

Endometrial polyps: Polyps, which are abnormal tissue growths inside the uterus, can lead to abnormal bleeding and infertility. Hysteroscopy is used to diagnose and remove these polyps.

Intrauterine fibroids (submucosal fibroids): Fibroids growing on the inner wall of the uterus can cause pain, abnormal bleeding, and infertility problems. Hysteroscopy can be used to diagnose and remove such fibroids.

Diagnostic hysteroscopy: When radiological imaging methods are insufficient, hysteroscopy can be performed to evaluate structural abnormalities in the uterus, congenital anomalies (e.g., septum), or the thickness of the endometrial lining.

Infertility evaluation: Hysteroscopy can be performed to investigate the causes of infertility and diagnose abnormalities inside the uterus.

When Can IVF Be Done After Hysteroscopy?

The timing to start IVF treatment after hysteroscopy depends on the purpose of the procedure and the patient’s overall condition. If hysteroscopy is performed solely for diagnostic purposes (i.e., no treatment is applied), there may be no need to wait long to begin IVF treatment. Generally, IVF treatment can be started in the patient’s next menstrual cycle.

However, if any treatment was performed during hysteroscopy (such as removal of polyps or fibroids, or correction of intrauterine adhesions), a waiting period may be necessary before starting IVF treatment. This period varies depending on the treatment applied and the patient’s recovery process. Generally, it is possible to start IVF treatment after a recovery period of 1 to 3 months.

Who Is Hysteroscopy Performed On?

Hysteroscopy is generally recommended to evaluate conditions such as abnormal uterine bleeding, recurrent miscarriages, presence of polyps or fibroids. It can also be used in women experiencing fertility problems or to check for tubal blockages. This procedure is used as a tool to diagnose or treat abnormalities inside the uterus.

Is Hysteroscopy Surgery Difficult?

Hysteroscopy surgery is generally not a difficult procedure when performed by an experienced surgeon. However, like any surgical procedure, it carries certain risks and potential complications.