Dr Karuna Raja

Hysteroscopy

 

What if I am bleeding or having my period?

Although it is ideal to preform a hysteroscopy just after a period, it can be performed at other times in the cycle-  particularly when a hysteroscopy is being preformed for investigation of abnormal bleeding.

 

Operative Hysteroscopy

Many operations can be preformed using the hysteroscope. These include:

  • Endometrial ablation (burning the lining of the uterus (i.e. in cases of heavy bleeding))
  • Removal of endometrial polyps (growth of the lining of the uterus)
  • Removal of fibroids
  • Removal of division of scar tissue inside the uterine cavity
  • Excision of uterine septa

The procedure is similar to a diagnostic hysteroscopy but takes longer and has more potential risks.  During these procedures general anaesthesia is used.  A large hysteroscope is needed so that special instruments can be passed through it (i.e. scissors, diathermy, laser, etc.).

A special fluid called glycine is used to expand the uterine cavity and wash away any bleeding.  Hysteroscopic surgery may take from a few minutes to over an hour depending on the particular procedure being done.  As for a diagnostic hysteroscopy, hysteroscopic surgery should not be preformed in the presence of a normal pregnancy or an infection.  In addition, there may be special risks for women with certain medical problems such as heart disease.

 

Additional risks and complications of hysteroscopic surgery

  • Anaesthetic complications
  • Fluid imbalance or overload from the fluid used to distend the uterus
  • Damage to the uterus or organs such as bladder, bowgel or blood vessels
  • Bleeding

More serious complications such as brain swelling or death are VERY rare.

 

Post-Operative Instructions

You will usually be able to go home 2-3 hours after the procedure is preformed, but should not drive or operate machinery for at least 24 hours. You would be asked to arrange transportation for after your surgery. It is wise to have someone stay with you for at least 24 hours, incase of emergency. It is usual to need simple pain relief due to abdominal cramping. In these cases you can take over the counter pain relief medication. It is also usual to have some vaginal bleeding for up to a week and some bloody discharge for longer periods. It is advisable to avoid bathing and/or swimming, as well as tampons for at least 2-3 days following surgery. Showering is okay.

 

Alternatives

You should discuss with me if you have any questions before booking the surgery.  You should consider all the alternatives and should be convinced that the benefits outweigh the risks before undergoing surgery.

 

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