What is hysteroscopy and why is it performed?

What Is Hysteroscopy?

Hysteroscopy is an advanced gynecological diagnostic and treatment method that allows direct and detailed visualization of the inside of the uterus (uterine cavity). During this procedure, a thin optical device with a high-resolution camera and light source at its tip is inserted through the vagina, passed through the cervix, and advanced into the uterus. The inner surface of the uterus is displayed on a screen and examined in detail. Hysteroscopy enables definitive diagnosis of intrauterine problems that cannot be clearly evaluated with methods such as ultrasound or hysterosalpingography.

Today, hysteroscopy is frequently preferred in the field of obstetrics and gynecology because it does not require an incision and is a minimally invasive procedure, prioritizing patient comfort. No surgical intervention is performed on the abdominal area during the procedure. This significantly reduces the risk of infection and shortens the recovery period. Thanks to hysteroscopy, intrauterine pathologies can be directly observed, allowing for accurate and clear evaluation.

Hysteroscopy can be performed for diagnostic purposes as well as for therapeutic (operative) purposes. In diagnostic hysteroscopy, the uterine cavity is only examined, whereas in operative hysteroscopy, identified problems can be treated during the same session. This makes it a highly effective method that both saves time and protects the patient from undergoing a second procedure.

Why Is Hysteroscopy Performed?

Hysteroscopy is performed to identify the causes of many intrauterine conditions and, when necessary, to treat these problems. It is an important diagnostic tool, especially in cases of menstrual irregularities, excessive bleeding, infertility, and recurrent pregnancy loss. Even the smallest structural abnormalities within the uterus can negatively affect menstrual regularity and the chance of pregnancy, making hysteroscopy crucial in clarifying these issues.

Intrauterine polyps, submucosal fibroids, intrauterine adhesions, and congenital uterine anomalies can be easily detected with hysteroscopy. These problems may often go unnoticed on ultrasound or may be difficult to diagnose definitively. Since hysteroscopy provides direct visualization, its diagnostic accuracy is very high.

Additionally, postmenopausal bleeding should always be evaluated carefully. Uterine bleeding during menopause is not considered normal, and the underlying cause must be identified. Hysteroscopy is a reliable method for determining the cause of bleeding observed during this period.

What Is Diagnostic Hysteroscopy?

Diagnostic hysteroscopy is a procedure in which the uterine cavity is examined solely for observation and evaluation purposes. During this procedure, the inside of the uterus is visualized in detail, but no surgical intervention is performed. It is usually completed in a short time and can often be performed under local anesthesia or without anesthesia.

Diagnostic hysteroscopy is particularly preferred in patients with unexplained infertility, recurrent miscarriages, and irregular menstrual bleeding. This method allows for a clear assessment of whether the uterine cavity is suitable for embryo implantation. It also helps to confirm the diagnosis in patients with suspected uterine septum, adhesions, or polyps.

This procedure causes minimal discomfort to the patient, and most patients can return to their daily activities on the same day. Diagnostic hysteroscopy contributes to creating the correct treatment plan by preventing unnecessary and more extensive surgical procedures.

Operative (Therapeutic) Hysteroscopy

Operative hysteroscopy is a method applied to treat intrauterine problems identified during diagnostic hysteroscopy or known beforehand. During this procedure, surgical instruments are used through the hysteroscope inserted into the uterus to remove or correct problematic tissues.

The removal of uterine polyps, excision of submucosal fibroids, release of intrauterine adhesions, and correction of congenital uterine septa can be performed with operative hysteroscopy. These procedures are carried out using minimally invasive techniques without the need for open surgery. This provides a safer and more comfortable process for patients.

Operative hysteroscopy is usually performed under general anesthesia, and the duration of the procedure may vary depending on the intervention performed. Patients can often be discharged on the same day after the procedure. The recovery period is rapid, and the return to daily life is relatively short.

In Which Situations Is Hysteroscopy Preferred?

Hysteroscopy is an effective method preferred in many different gynecological conditions. It is frequently used to evaluate the uterine cavity in women experiencing menstrual irregularities or prolonged and heavy bleeding. Correctly identifying the underlying causes of such bleeding is crucial for the success of treatment.

Hysteroscopy also plays an important role in patients diagnosed with infertility. Even a small polyp, adhesion, or structural abnormality in the uterus can prevent pregnancy from occurring or continuing. Therefore, a detailed evaluation of the uterine cavity is recommended before assisted reproductive treatments.

Hysteroscopy is also commonly preferred in women with a history of recurrent miscarriages. Correcting structural problems within the uterus can contribute to healthier progression of subsequent pregnancies.

Preparation Process Before Hysteroscopy

Before hysteroscopy, the patient’s general health status is evaluated, and some tests may be performed if deemed necessary. The procedure is usually preferred in the first days after the end of menstruation. This period allows clearer visualization of the uterine cavity and increases the success of the procedure.

Before the procedure, the patient is informed about the type of anesthesia to be used. While diagnostic hysteroscopies can often be performed without anesthesia or with local anesthesia, general anesthesia may be preferred for operative hysteroscopies. The patient may need to fast for a certain period before the procedure.

Following all instructions given by the physician is important to ensure the procedure is performed safely and smoothly. The patient should inform the doctor about any current medications and chronic illnesses.

Post-Hysteroscopy Process

After hysteroscopy, patients can usually return to their normal lives within a short time. Mild pelvic pain or spotting-type bleeding may occur after the procedure. This usually resolves on its own in a short period.

After operative hysteroscopy, the doctor may prescribe certain medications. It is important to follow the recommended treatments regularly to support healing of the uterine lining and reduce the risk of infection.

Not missing follow-up appointments after the procedure is necessary to evaluate the healing process of the uterine cavity. Sexual intercourse and intense physical activities may be postponed for a certain period in line with the doctor’s recommendations.

What Are the Advantages of Hysteroscopy?

The most important advantage of hysteroscopy is that it allows direct and clear visualization of the uterine cavity, resulting in high diagnostic accuracy. Not requiring an incision, being a minimally invasive method, and having a fast recovery period offer significant benefits for patients.

The ability to provide both diagnosis and treatment in the same session prevents the need for a second surgical procedure. This offers significant advantages in terms of both time and cost. In addition, the risk of complications is considerably lower compared to open surgery.

Hysteroscopy stands out as a reliable and effective method for evaluating intrauterine health, especially for women planning pregnancy. When performed by an experienced physician with appropriate patient selection, highly successful outcomes can be achieved.