Diagnostic hysteroscopy is a diagnostic test performed by the operative department of Gynaecology. Hysteroscopy is a minimally invasive endoscopic technique that, through the use of a lens with a thin camera and appropriate tools, you can diagnose (diagnostic hysteroscopy) and treat (operative hysteroscopy) various pathological conditions.
Diagnostic hysteroscopy becomes useful for abnormal uterine bleeding during childbearing age and especially after menopause. The test can highlight uterine malformations such as baffles, diseases of the cavity of the uterus such as polyps, fibroids, and hyperplasia or in some cases malignant tumors.
In Humanitas it is possible to perform diagnostic hysteroscopy after a routine gynaecological visit or with an appropriate recommendation from a doctor. The procedure can be performed in one day (no admission) under sedation or regional anaesthesia. The instrumental procedure can last from 5 to 20 minutes.
What is hysteroscopy?
Hysteroscopy is a technique that allows one to "see" inside the uterine cavity through a thin instrument (hysteroscope) that is connected to a camera. The hysteroscope is inserted into the uterus through the vagina without having to apply the speculum (vaginal retractor) and without using traumatic tools (pliers, dilators etc.). The method eliminated any device that can cause anxiety, fear and above all pain. The method allows one to diagnose and occasionally solve the problem (remove adhesions or remove small polyps).
Is hysteroscopy painful?
The examination includes the infusion of water into the sterile vagina, which then gently expands the cervical canal and relaxes the uterine cavity. The extension of the cervical canal with water allows the hysteroscope to pass and enables vision of the uterine cavity. The uterus responds by contracting such as during menstruation and sometimes evoking a menstrual-like cramping pain above the pubis or at the shoulder, which disappears within minutes without any treatment. In 5% of patients, the examination causes more severe pain. In these cases, if the patient requests it, the doctor immediately stops the procedure and places the patient under complete anaesthesia (total sedation) and continues the procedure in the operating room.
Why is hysteroscopy performed in the clinic and not in the operating room?
The outpatient procedure allows doctors to identify with certainty the cause of symptoms or confirm (or deny) an ultrasound, avoiding anaesthesia. It must be considered that, after a diagnosis, it is necessary to discuss the best course of treatment, which may not always be surgical. The outpatient procedure avoids patients to be subjected to two anaesthetics.
The examination is performed in the clinic; therefore, it does not require the patients to fast or involve any kind of anaesthesia preparation or pharmacological preparation. Antibiotics are only used as prophylaxis in patients with valvular heart disease. It is recommended to continue taking the medication regularly, however, it is important to notify medical staff of any medications if the examination involves anticoagulants or aspirin.