Hysteroscopic Surgery

Hysteroscopy is used to check the shape, size, and lining of the uterus and to diagnose and treat abnormalities affecting fertility or causing miscarriages. A thin tool called a hysteroscope is inserted vaginally, through the cervix and into the uterus. A light and camera hooked to the end of the hysteroscope allows the doctor to view the inside of the uterus on a screen in order to diagnose any problems within the uterus.

Depending on what is found, a small tool can be inserted through the hysteroscope into the uterus to fix certain problems. For instance, hysteroscopy may be used to open blocked fallopian tubes, or remove uterine fibroids or polyps. If the woman is experiencing abnormal bleeding and she does not desire to conceive in the future, heated tools can be passed through the hysteroscope to destroy the endometrium and thereby reduce or eliminate bleeding.

A laparoscopic procedure may be performed in conjunction with a hysteroscopy when infertility is an issue.

Risks of hysteroscopy

Only two in 100 women undergoing a hysteroscopy experience complications. The most common problem that occurs is perforation of the uterus, where a small hole is inadvertently created. This normally closes on its own, but can cause bleeding or damage to nearby organs, which would require additional surgery to repair. Uterine adhesions or infections may also develop following a hysteroscopy.

Serious complications that can occur are fluid in the lungs, blood clotting issues, electrolyte imbalance, fluid overload, and severe allergic reactions. These are far more likely if a kind of distension media called hypotonic media is used. If some of these complications occur, it may prevent the surgery from being completed. Severe or life-threatening complications are very uncommon.

Patients should discuss any concerns about the procedure and its risks with their doctor before undergoing a hysteroscopy procedure.