Hysteroscopy For Abnormal Vaginal Bleeding

Hysteroscopy For Abnormal Vaginal Bleeding

  • Hysteroscopy

Definition

A hysteroscope is a small metal tube connected to a light source and camera. It magnifies a woman's cervical opening, uterine cavity, and the openings of the fallopian tubes during a procedure called hysteroscopy. Hysteroscopy may be:
  • diagnostic, in which case it is only used to view the organs and observe any obvious abnormalities
  • therapeutic, in which case surgery is done through the scope

Who is a candidate for the procedure?

A hysteroscopy may be recommended:
  • if the source of bleeding is not found through other diagnostic tests
  • to aid in taking a biopsy, or tissue sample, from the lining of a woman's uterus after precancerous changes have been noted
  • to check the upper part of the cervix to see if a cancer stems from the cervix or the uterus
  • if a woman's medical history or a test suggests she has a uterine polyp or fibroid that might be removed by hysteroscopy
  • if other factors cannot be found to explain trouble getting pregnant or carrying a baby
It is now recommended that a dilation and curettage of the uterus (D and C) not be done for diagnostic purposes, without a hysteroscopy.

How is the procedure performed?

A hysteroscopy is usually done in the first 2 weeks of a woman's menstrual cycle. This ensures that she is not pregnant and that the lining is thin enough to allow the examiner to see inside the uterus well. It takes about 20 to 45 minutes. It can be done:
  • in the healthcare professional's office under local anesthesia. This approach is often taken when the procedure is diagnostic. On the other hand, if the procedure is likely to take longer, especially because another surgical procedure is being done at the same time, it may be done in the hospital under general anesthesia.
First, the cervix and vagina are cleansed. The cervix is opened so that the scope can be inserted into the uterus. The uterus is inflated with fluid or a harmless gas to make it easier to view. Any suspicious lesions (polyps, fibroids, ulcers, or growths) may be biopsied or removed using small tools placed in the scope. This tissue is sent for microscopic analysis. Pictures may be taken, too, before and after any surgery is done.

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