Hysteroscopy

Hystroscopy is a minimally invasive surgical procedures ,doctors use in the diagnosis and treatment of certain female factor infertility conditions.

Hysteroscopy is the visualization of the inside of the uterine cavity by inserting special visualization instruments through the vagina and cervical opening. Hystroscopy is a minimally invasive surgical procedures ,doctors use in the diagnosis and treatment of certain female factor infertility conditions.Several studies also suggest that hysteroscopy has helped enhance fertility rates in many infertile women.
Hysteroscopy can be performed for both diagnosis or also for treatment. Hysteroscopy can be used to help pinpoint the location of abnormalities in the uterine lining. Hysteroscopy can be carried out to aid in diagnosis or to perform minor surgical procedures.

HELPING WITH CONCEPTION-
• Uterine factors account for less than 10% of all infertility.
• The hysterosalpingogram has been the most useful method of evaluation as the initial screening test. The main indication for hysteroscopy in infertile patients is the abnormal or ambiguous hysterogram.
• In conjunction with hysterosalpingography, it adds accuracy and precision in the evaluation of uterine cavity and endocervical canal, ruling out factors that may affect fertility.
• This evaluation not only provides more accurate diagnosis, but also offers the opportunity for direct treatment under visual control.
• They can also correct congenital abnormalities such as uterine septum or adhesions which can cause miscarriage or premature labor.

WHEN A HYSTROSCOPY IN DONE??
Doctor may use hysteroscopy alone or in conjunction with laproscopy simultaneously, to diagnose the following conditions-
structural abnormalities that distort uterine cavity symmetry like
• Uterine Fibroids
• Endometrial Polyps
• Congenital anatomical uterine anomalies or of the female genital tract.
• Uterine Septum
• Scarring, or adhesions, from previous uterine surgery or instrumentation such as dilation and curettage (D&C)
Tubal Cornual Occlusions.
Abnormal Hysterogram
Abnormal Uterine Bleeding

Suspected Intrauterine Pathology
Postmenopausal Bleeding
Pelvic Pain
Repeated Miscarriages
Retained placenta or products of conception after a birth or miscarriage
Unexplained Infertility
Endometrial sampling
To locate an Intrauterine Device (IUD).

THERAPEUTIC HYSTEROSCOPY IN INFERTILITY

The hysteroscope offers not only the opportunity to visualize the intrauterine structures and provide diagnosis but treat them under direct vision Instruments can be guided visually and targeted to areas in the uterine cavity in need of treatment.

Hysteroscopy offers an excellent method of evaluation and therapy, particularly in patients with probable diagnosis of –
polyps submucous leiomyomas uterine septa intrauterine adhesions misplaced or embedded foreign bodies tubal cannulation (chromopertubation).

ADVANTAGES OF HYSTEROSCOPY

• Direct visualization of uterine cavity
• Diagnosis and specification of intrauterine lesions.
• Possibility of targeted biopsies and surgical therapy.
• Precise localization of abnormalities (polyps, myomas, malformations , adhesions, carcinoma and precursors)

• Direct access to tubal lumen for evaluation of fallopian tubes.
• Evaluation of tubal lumen, patency, epithelial folds and abnormalities
• Day Care Surgury

 

DISADVANTAGES OF HYSTROSCOPY

• Requires special instrumentation and experience.
• Expensive.
• Complications

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