Hysteroscopy treatment is modern surgical treatment method for many gynecological problems. Hysteroscopy is a surgery where the patients are usually discharged on the same day. The surgery is easily tolerated.

Best time for hysteroscopy is after menstruation. Hysteroscopy is performed after day five of cycle. Hysteroscopy during period (Hysteroscopy during menstruation) is not possible. The bleeding can obscure the view of the camera. Hysteroscopy is contraindicated while pregnant. Laparoscopy is sometimes performed with hysteroscopy at the same time.

Hysteroscopy treatment

In gynecology, hysteroscopy is used for both diagnosis and treatment. Saline is used to expand the uterine cavity during hysteroscopy. Purpose of hysteroscopy depends on the case.

There are different indications of hysteroscopy

• Hysteroscopy ablation
• Hysteroscopy iud removal
• Hysteroscopy after d and c
• Hysteroscopy for fibroids
• Hysteroscopy and endometrial biopsy
• Hysteroscopy and infertility
• Hysteroscopy and polypectomy
• Hysteroscopy after miscarriage
• Hysteroscopy bleeding (AUB)
• Hysteroscopy and curettage
• Hysteroscopy and biopsy

Types of hysteroscopy

Types of hysteroscopy can be listed as office (diagnostic) and operative hysteroscopy. Diagnostic and operative hysteroscopy are two different procedures.

• Diagnostic hysteroscopy is usually performed without anesthesia in office setting. Hysteroscopy operation is not painful for the patient. Outpatient hysteroscopy is also called office (diagnostic) hysteroscopy. Vaginal route is used for diagnostic hysteroscopy. It is also called vaginoscopic approach. The hysteroscopy instrument is inserted through the vagina into the uterus without anesthesia. It is not painful. Hysteroscopy camera is very small in office hysteroscopy (<3 mm). Cervical dilation for hysteroscopy is not required in office or diagnostic hysteroscopy. Hysteroscopy without anesthesia can be performed in the office setting and the patient can be discharged on the same day (Ambulatory hysteroscopy).
• On the other hand operative hysteroscopy requires cervical dilatation, which is painful. The cervical dilatation in operative hysteroscopy necessitates general anesthesia or sedation/analgesia. Surgical hysteroscopy, operative hysteroscopy or therapeutic hysteroscopy are different terminologies used for operative hysteroscopy. Operative hysteroscopy procedure is performed to remove myomas (fibroids), polyps, and to restore uterin septum or T shape uterus.

Hysteroscopy surgery time is very short (half an hour or less) in office hysteroscopy performed for diagnostic purposes. Operative hysteroscopy time depends on the procedure. Hysteroscopy time also depends on surgical equipment and surgeon.

Hysteroscopy for different purposes;

• Hysteroscopy after d&c :Hysteroscopy can be performed after curettage to remove the remnant tissues.
• Hysteroscopy iud removal : Embedded iud removal by hysteroscopy is feasible.
• Hysteroscopy for endometrium biopsy procedure is very easy and can be performed in the office setting.Diagnostic hysteroscopy with d&c is usually performed to diagnose endometrial pathologies. The surgeon performs the hysteroscopy and then d&c for endometrial biopsy. That is also called hysteroscopy and curettage procedure.
• Hysteroscopy and myomectomy :Hysterectomy myomectomy is feasible up to fibroids 5 cm in diameter growing inside the uterine cavity (figo type 0, 1 and 2 fibroids). Hysteroscopy for fibroids can be performed in a single session. But sometimes, large fibroids (type 2) can require more than one session of hysteroscopy. Hysteroscopy for fibroids is a common procedure. Expert hysteroscopic surgeons can perform hysterectomy myomectomy. Adhesions might occur after hysterectomy myomectomy but not common.
• Myosure hysteroscope : this is a special hysteroscope which makes tissue removal easy for the surgeon in hysteroscopy. Hysteroscopy fibroid removal is also possible by other methods.
• Hysteroscopy infertility : Hysteroscopy test is used to explain the cause of infertility. After hysteroscopy getting pregnant is much easier with higher probabilities. Embryo transfer after hysteroscopy increases the chances of pregnancy in some cases. Hysteroscopy is also required in recurrent miscarriages if there are congenital uterine abnormalities.
• Hysteroscopic tubal ligation is performed with a special device. The instrument is inserted in the fallopian tubes with hysteroscopy. 3 months later the tubal occlusion is confirmed with hysterosalpingography (hsg).
• Hysteroscopy and polyp removal : The most common procedure by hysteroscopy is polyp removal. Hysteroscopy and polypectomy can be done with office or operative hysteroscopy, that depends on the size of the ovary.
• Hysteroscopy ablation is an ambulatory hysteroscopy for abnormal uterine bleeding(aub).
• Hysteroscopy adhesions (Hysteroscopy Asherman’s syndrome) : Uterine surgical procedure known as dilation and curettage for pregnancy termination is a major risk factor for uterine adhesions. Hysteroscopy is the treatment modality of uterine synechiae. The adhesions in the uterine cavity can be removed by office or operative hysteroscopy. Hysteroscopy in severe adhesions ultrasound can be used intraoperatively.
• Tubal catheterization hysteroscopy : In infertile cases with proximal tubal occlusion an easy way of checking the tubal patency is by tubal catheterization hysteroscopy.

Post Hysteroscopy Care

Post hysteroscopy you will have no pain. Bleeding after hysteroscopy is very few. Bright red bleeding after hysteroscopy can occur few days after the procedure. Bleeding after hysteroscopy and polypectomy can last for 7 – 10 days but it is like spotting. Heavy bleeding after hysteroscopy is possible in cases undergoing hysteroscopy for fibroids. These cases need to be observed for few hours postoperatively.

Hysteroscopy is a procedure that you can heal in short time and return back to your daily activities the day after the procedure. Hysteroscopy after care rules can be listed as no sexuel intercourse for one week, painkillers where needed.

Menstural Cycle After Hysteroscopy

Painful period after hysteroscopy is unexpected. Menstruation after hysteroscopy will be regular. First period after hysteroscopy polypectomy will be on expected date. Your period after hysteroscopy or your period after hysteroscopic myomectomy will be 30-40 days after the procedure.

If you have no period after hysteroscopy, wait up to 40 – 45 days.  Then you might undergo a transvajinal ultrasound and consult your gynecologist.

Average Cost of Hysteroscopy

Hysteroscopy surgery cost is not too high. Operative hysteroscopy costs are much higher than office hysteroscopy. Hysteroscopy procedure cost mainly changes regarding the procedure. Hysteroscopy treatment prices in Turkey range from 1200 to 1400 dollars on average.

Frequently Asked Questions

How painful is hysteroscopy?

The level of pain experienced during a hysteroscopy varies from woman to woman. While some may not feel any discomfort, others may experience severe pain. It’s important to communicate any discomfort to the doctor or nurse, who can stop the procedure if needed. Overall, pain during a hysteroscopy is generally manageable with the use of pain relievers and sedatives. To stay comfortable, you should wear comfortable clothing and relax as much as possible during the procedure.

Are you put to sleep for a hysteroscopy?

Yes, for longer or complicated hysteroscopy procedures, such as fibroid removal, general anaesthesia is used where the patient will be asleep during the surgery. However, for less complex procedures, the doctor may use a local anaesthetic to numb the cervix and make the procedure less painful. It is important to discuss the anaesthesia option with your doctor before the surgery. This will ensure that you are comfortable with the procedure and that there are no complications.

How long does it take to recover from a hysteroscopy?

Recovery time after a hysteroscopy is usually quick. Most women can return to work and normal activities, including exercise, the day after the procedure. However, if you underwent treatment like fibroid removal or general anesthesia, then it is recommended to take a few days off to rest.

Is hysteroscopy a major surgery?

Hysteroscopy is typically classified as a minor surgery, and it does not usually require an overnight hospital stay. Depending on the patient’s reaction to anesthesia, a healthcare provider may recommend an overnight stay.