Hysteroscopy

Definitions

This operation is performed by introducing a hysteroscope through the cervix (a very fine and rigid tube looking like a straw from 5 to 10 mm of diameter) connected to a source of light with optical fiber and a camera. This allows the practitioner to visualize directly the uterine cavity. The other possible instruments can be passed through the sheath of the camera. This kind of operation is short time one (15-30 minutes) and requires a general anaesthesia. It is realised in order to specify the diagnosis or to carry out treatments.

The diagnostic hysteroscopy allows:

- The direct visualisation of the uterine cavity and thus the diagnosis of some defects (“fibroma”, polyp, malformation, cancer...).
- The realisation of a puncture (biopsy or curetting) of the mucous membrane of the uterus (“endometrium”) in order to analyse it.

The operational hysteroscopy allows:

- Treatment of anomalies of the uterine cavity (ablation of polyp, “fibroma”, destruction of the endometrium or of a “septum”…) by using specific instruments.
- The endometrium ablation – in case of abundant menses – is restricted by national guidelines that recommend techniques like thermo-ablation by balloon (cf dedicated details).

These kind of operation is done as an outpatient procedure: you will be able to leave the Hospital within the day and you may rarely need a work leave.

Risks & Complications

In spite of a meticulous procedure, it is not possible to guarantee neither the therapeutic success nor the absence of complications.

During the intervention

- Uterus perforation: it can cancel the hysteroscopy initially planned. Usually, a simple antibiotic therapy is relevant, associated with a 24 hours monitoring at the hospital. The intervention will then be postponed to the next month.
- Significant blood loss: may rarely lead to a blood transfusion.
- Exceptional risks related to the reabsorption of the liquid injected into the uterus have been noticed (oedema of the lung, allergic reaction, cardiac disorders). These risks are eliminated when using a physiological salt solution to distend the uterine walls, which we try to do as often as possible (with specific equipment).

Post-operation

An urinary tracts or uterine infection (endometritis) and/or of the Fallopian tubes (salpingitis) can occur and will require an antibiotic treatment.

Last update: 10/2/2013