Name of the Procedure:

Hysteroscopy, diagnostic (separate procedure) Common name(s): Diagnostic Hysteroscopy Technical/medical term: Hysteroscopy

Summary

A diagnostic hysteroscopy is a minimally invasive procedure used to examine the inside of the uterus. A thin, lighted tube called a hysteroscope is inserted through the vagina and cervix into the uterine cavity, allowing the doctor to visualize the uterine lining.

Purpose

Conditions Addressed:

• Abnormal uterine bleeding
• Uterine fibroids or polyps
• Congenital uterine anomalies
• Recurrent miscarriages
• Infertility issues

Goals/Expected Outcomes: The primary goal is to diagnose any abnormalities within the uterine cavity, aiding in the development of an appropriate treatment plan.

Indications

Symptoms/Conditions Warranting the Procedure:

• Heavy or irregular menstrual bleeding
• Postmenopausal bleeding
• Unexplained infertility
• Suspected uterine growths or masses
• Evaluation of uterine anomalies

Patient Criteria:

• Women with unexplained uterine bleeding
• Patients with fertility issues
• Individuals experiencing repeated miscarriages

Preparation

Pre-procedure Instructions:

• Fasting may not be required, but it depends on the type of anesthesia.
• Patients may need to adjust medications, especially blood thinners.
• A pre-procedure ultrasound or pregnancy test may be performed.

Diagnostic Tests/Assessments:

• Pelvic ultrasound
• Blood tests

Procedure Description

Step-by-Step Explanation:

1. Patient is positioned on the examination table.
2. Sedation or local anesthesia is administered, if necessary.
3. A speculum is inserted into the vagina to visualize the cervix.
4. The hysteroscope is gently inserted through the cervix into the uterine cavity.
5. Saline solution may be introduced to expand the uterus for better visibility.
6. The doctor inspects the uterine lining for abnormalities.

Tools/Equipment:

• Hysteroscope
• Speculum
• Saline solution or carbon dioxide

Anesthesia/Sedation Details:

• Local anesthesia, sedation, or no anesthesia, depending on the case.

Duration

The procedure typically takes about 15-30 minutes.

Setting

This procedure is commonly performed in an outpatient clinic, surgical center, or hospital.

Personnel

Healthcare professionals involved may include:

• Gynecologist or specialist surgeon
• Nurses
• Anesthesiologist (if sedation or general anesthesia is used)

Risks and Complications

Common Risks:

• Cramping or mild pain
• Light bleeding
• Infection

Rare Complications:

• Uterine perforation
• Excessive bleeding
• Adverse reaction to anesthesia

Management:

• Antibiotics for infection
• Pain relief medications

Benefits

Expected Benefits:

• Accurate diagnosis of uterine conditions
• Tailored treatment plans based on findings Timeline:
• Immediate visual confirmation of diagnosis; further results depend on any biopsies taken.

Recovery

Post-Procedure Care:

• Rest for the remainder of the day.
• Avoiding heavy lifting or strenuous activities for a few days.

Recovery Time:

• Most patients can resume normal activities within a day or two.

Follow-Up:

• Follow-up appointment to discuss findings and next steps.

Alternatives

Other Treatment Options:

• Transvaginal ultrasound
• Sonohysterography
• Magnetic Resonance Imaging (MRI)
• Blind endometrial biopsy

Pros/Cons:

• Hysteroscopy provides direct visualization, making it more accurate than other imaging studies.
• Non-invasive alternatives might be less effective for certain conditions.

Patient Experience

During the procedure:

• Possible cramping or mild discomfort.
• Sedation or anesthesia can minimize discomfort.

After the procedure:

• Mild pain or cramping, similar to menstrual cramps.
• Light bleeding or spotting for a few days.
• Pain management with over-the-counter pain relievers and comfort measures like a warm compress.